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Inspection Summary


Overall summary & rating

Good

Updated 26 May 2017

We inspected Riverside House on 24 April 2017. The inspection was unannounced and carried out by one inspector. Our last inspection took place on the 30 September 2015 during which we found that people’s care plans did not always clearly state how people would be supported to achieve their goals.

Riverside House is a forensic mental health service that provides accommodation, supervision and support for nine males with complex mental health needs. At the time of the inspection there were nine people living in the home. The home was laid out over three floors, with shared communal bathrooms, lounge and kitchen. The manager’s office is housed in the communal garden and the staff office is located in the premises. The home does not have a lift and there is CCTV on site in communal areas.

The service had a registered manager who was present during the day of the inspection. 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.

Clear guidance was in place to make certain the likelihood of potential risks was reduced and there was a planned multi - agency approach to monitoring and responding to risk. Risk assessments were reviewed when there had been a change in people’s circumstances. Safeguarding practices was followed to protect people from abuse and staff understood how to protect people from harm. Care was delivered by staff who had received specific training and skills that were reflective of the needs of people who lived in the home.

Staff were deployed to support people when this was needed and background checks were carried out to assess the suitability of employees before they began work. Medicines were managed safely and staff had obtained the necessary training to administer these. Referrals were made to health professionals when there were concerns about people’s healthcare needs. People’s nutritional requirements were met and they were encouraged by staff to eat a well - balanced and healthy diet.

Environmental checks were carried out on the premises and people were updated on matters affecting the home. Care plans were personalised and showed how people attained their achievements and participated in the interests that suited them. Positive interventions were sought when people needed support and advice. People were aware of who to raise their concerns with and complaints were investigated and responded to within a reasonable timescale.

Staff used the least restrictive measures when people’s capacity required assessments under the Mental Capacity Act (MCA) 2005. Deprivation of Liberty Safeguards (DoLS) authorisations were in place for two people and the conditions of these were adhered to. Easy read information was accessible for people and their confidential records were safely stored. People had access to their own personal records when they chose.

People’s independence was encouraged to enable them to take steps to make their own decisions and choices. Staff sought to engage people and when this was refused, their decisions were respected. They listened to people’s views and sought their opinions and ideas through the use of surveys; however these had not been evaluated. Staff ensured people’s privacy was respected and advocates were used so people’s views could be heard.

Staff were committed to delivering quality care and people felt confident about the ability of staff to support them when this was needed. The registered manager established good links with partner agencies, and people and staff spoke positively about the registered manager’s ability to provide good care. Quality assurance systems were in place to effectively improve the quality of care delivered.

Inspection areas

Safe

Good

Updated 26 May 2017

The service was safe.

Staff understood how to protect people from abuse and people told us they felt safe. Systems included a multi-agency response to manage potential risks.

The provider deployed enough staff to support people when this was needed.

Protocols were followed to ensure the safe management of medicines.

Checks were undertaken by staff to make certain the environment was safe.

Effective

Good

Updated 26 May 2017

The service was effective.

People’s capacity had been assessed and best interests meetings held to consider the circumstances relevant to them about their care.

Staff were knowledgeable about the care they provided and had attended training to update their skills.

People were supported to cook healthy meals and took part in preparing meals that met their preferences.

People accessed professional healthcare appointments with guidance from staff support.

Caring

Good

Updated 26 May 2017

The service was caring.

People told us when they required help staff were available to assist them with their needs. Staff were committed to providing care to enhance people’s wellbeing.

Staff respected people’s decisions about how they wished to spend their private time.

People were given information to inform them about their rights and responsibilities.

Advocacy was sought to make certain people’s views were heard. Information was provided in accessible formats and there was no restrictions placed on people viewing their own personal records.

Responsive

Good

Updated 26 May 2017

The service was responsive.

People monitored their own progression with guidance from staff to show how they attained their goals and achievements.

Care plans were personalised and focused on maintaining people’s wellbeing. Staff implemented preventative measures and were responsive to people’s needs

Positive interventions were sought to empower them to make their own decisions and choices.

People were given the opportunity to raise any concerns, and were concerns were raised, these were resolved.

Well-led

Good

Updated 26 May 2017

The service was well led.

The registered manager was held in high regard by staff and the people in the home.

Surveys had been sent to people to obtain their views and opinions about the quality of the provider’s service.

Quality assurance systems identified improvements that were needed and these were acted on.

The provider had worked in partnership with external organisations to ensure the quality of care was maintained.