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Riverview Lodge Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 30 April 2019

Our inspection of Riverview Lodge took place on 28 November 2018. This was an unannounced inspection.

Riverview Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home is situated in Kingsbury and is registered to provide care to up to 36 older people living in three units. At the time of our inspection there were 35 people living at the home, many of whom were living with dementia.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our previous inspection of Riverview Lodge in March 2016 we gave the home a rating of Good.

People who lived at the home told us that they felt safe, and this was confirmed by family members whom we spoke with.

People had care plans and risk assessments which were person centred. However, these had not always been updated to ensure that they fully reflected changes to people’s health needs and the support they required with these. Behavioural charts had not always been completed by staff to show they had followed guidance contained within a person's care plan. This meant that we could not be sure that people always received the support they required.

Daily records of people’s care were otherwise well maintained. Systems were in place to share information between outgoing and incoming staff at shift changes.

There were systems in place to review and monitor the quality of the service, and we saw that action plans had been put in place and addressed where there were concerns. However, the home's quality assurance systems and regular care plan reviews had failed to identify where there had been changes to people's health needs which had not been included in their care plans. There was no regular monitoring of behavioural records which did not always show if staff had followed the guidance contained within a person's care plan. This meant that we could not be sure that people's needs were being safely met. The registered manager told us that there would be an immediate review of people's care records.

People’s nutritional needs were met and their food and fluid intake was recorded and monitored. Choices were available at mealtimes and alternatives were provided to people with religious or cultural needs and preferences. However, we found that the home's menus were designed by the provider and people had not been consulted or involved in making decisions about what they included.The registered manager told us that they would ensure that regular food satisfaction surveys would be conducted in future and these would be used to make changes to menus where required.

People were protected from the risk of harm or abuse. Staff members had received training in safeguarding and were able to demonstrate their understanding of what this meant for the people they were supporting. They were also knowledgeable about their role in ensuring that people were safe and that concerns were reported appropriately.

Medicines at the home were well managed. People’s medicines were stored, managed and given to them appropriately. Records of medicines were well maintained.

Staff at the home supported people in a caring and respectful way and responded promptly to meet their needs and requests. There were enough staff members on duty to meet the physical and other needs of people living at the home. People who remained in their rooms for part of the day were regularly checked on.

Staff who worked at the home received regular relevant training and were knowledgeable about their roles and respo

Inspection areas

Safe

Good

Updated 30 April 2019

The service was safe. Risk assessments were clearly linked to guidance in people’s care plans how to manage identified risks.

Staff we spoke with understood the principles of safeguarding adults, how to recognise the signs of abuse, and what to do if they had any concerns.

Medicines were well managed and recorded.

Effective

Requires improvement

Updated 30 April 2019

The service was not always effective. Although people were offered choice at mealtimes they had not been consulted or involved in developing the menus they were offered.

The requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards 2007 had been met.

Staff members received the training and support they required to carry out their duties effectively.

People were supported to maintain good health and to access health services when they needed.

Caring

Good

Updated 30 April 2019

The service was caring. People and family members told us that they were satisfied with the care provided by staff. We observed that staff members respected people’s privacy and dignity.

Staff members spoke positively about the people whom they supported, and we observed that interactions between staff members and people who lived at the home were caring and respectful.

People’s religious needs were respected and supported.

Responsive

Requires improvement

Updated 30 April 2019

The service was not always responsive. Care plans did not always include up to date information about people's health care needs. One person's behavioural charts did not always show if staff members had followed the guidance contained in their care plan.

People were supported to participate in a range of individual and group activities.

The service had a complaints procedure and people and family members knew how to make a complaint.

Well-led

Requires improvement

Updated 30 April 2019

The service not always well led. However, although systems were in place to monitor the quality of the service we noted that these had not always identified failures to ensure that information in relation to people's health needs were recorded in their care plans or that staff members always followed guidance in relation to behavioural support.

The registered manager demonstrated leadership and accountability. She was approachable and available to people who used the service, staff members and visitors.

Staff members told us that they felt well supported by the manager. People and family members of people who used the service felt that the home was well managed.

The registered manager had a good working relationship with health and social care professionals and organisations