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Inspection carried out on 5 November 2019

During a routine inspection

About the service

Riverside House is a residential care home providing personal care to nine people with mental health conditions. The care home accommodates people over three floors in one adapted building. There were nine people living at the home at the time of the inspection.

People’s experience of using this service and what we found

People were supported by kind and caring staff who treated people as individuals and with dignity and respect. The provider had robust recruitment systems to ensure staff were safely recruited. Staff spoke knowledgably about the systems in place to safeguard people from abuse. People were supported by staff who were appropriately inducted, trained and supervised.

People told us they felt safe and systems were in place to safeguard people. Risks to them were identified and managed. Where required people were safely supported with their medicines. Infection control measures were in place to prevent cross infection. The support required by people with health and nutritional needs was identified and provided.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People’s privacy and independence were promoted. Systems were in place to deal with concerns and complaints. This enabled people to raise concerns about their care if they needed to.

People had person centred support plans in place. They were actively involved in their care and contributed to the development of care plans and reviews. People had staff support to access activities in the home and the community. People’s communication needs were identified. However, people’s end of life wishes were not explored and recorded. We have made a recommendation in relation to people’s end of life wishes being explored.

The provider had effective quality assurance systems to monitor the quality and safety of the care provided. People were asked for their views and their feedback used to improve the service and make any necessary changes.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (Published 26 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 24 April 2017

During a routine inspection

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 carried out on 30 September 2015

During a routine inspection

This inspection took place on 30 September 2015 and was unannounced. The last inspection to this service took place on 25 June 2013. At our last inspection we found that the provider was meeting all of the regulations we checked.

Riverside House is a specialist service offering care and support to nine people who have mental health needs and have a forensic mental health history. The provider offers accommodation, supervision and support for people preparing to live within the community.

There was a registered manager in place. 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.

People who used the service said they felt safe and knew who to approach if not. There had been no allegations of abuse in the past year. Staff understood how to safeguard the people they supported and knew what procedures were in place if they had concerns.

Medicines were safely managed and people received their medicines as they needed.

Risks to people were carefully assessed, recorded and included in individual care plans. Staff were knowledgeable about the risks to individuals and skilful at working with people to minimise those risks.

There were sufficient numbers of staff to meet people’s needs. All staff were vetted prior to commencing work and essential recruitment documents and records were in place.

Staff were knowledgeable about the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and procedures were in place in relation to the Act.

Staff used their knowledge about the needs of individuals to support people effectively and received support, training and supervision as they needed to help with this.

People were supported with their dietary needs effectively.

The provider worked in partnership with health and social care professionals to promote and optimise the health and wellbeing of people .

People were supported by kind and caring staff. They said that staff were always there and were approachable whenever they needed to talk.

People were involved in decisions about their care and treatment. They were treated with dignity and respect and their views were taken into account when developing what support they received.

People’s needs were assessed prior to their admission to ensure they received the right care and support.

Whilst care plans identified actions to meet needs, care plans developed did not always clearly state how rehabilitation and recovery goals would be achieved. However, people were supported to develop their skills and abilities, and to pursue their personal interests.

A complaints procedure was in place. People who used the service knew how to complain and said they had no complaints. Where issues or shortfalls were raised these were promptly addressed.

People using the service and staff told us there were good management arrangements in place. Staff said they felt well supported and there was good leadership.

There was a system of regular audits to check that policies and procedures were being implemented correctly.

The structure within the service for decision making and accountability made sure that people's care and support needs were met consistently.

Inspection carried out on 25 June 2013

During a routine inspection

We spoke with two people who lived in the home who said they liked living in the home and that staff supported them with their needs. People were asked for their consent before they received care and support. People told us that they received support according to their wishes. People were helped to re-acquire skills to become more independent. People living in the home had significantly improved their independent skills. The service encouraged people to eat healthily.The provider worked in co-operation with other professionals to protect the health, safety and welfare of people who used the service. There was an effective complaints system and staff addressed any issues raised by people in the service.

Inspection carried out on 21 November 2012

During a routine inspection

People who used the service told us they were happy living in the home. They said staff were friendly, supportive and helpful to them. The service encouraged people to be independent and supported people to lead varied and active lives of their choice. People were respected and involved in decisions affecting them. The service worked effectively with other professionals to meet the needs of people who had mental health issues. We found there were sufficient numbers of staff who were appropriately vetted and suitably skilled and experienced to work with people. Staff said they received good training and supervision which supported them when working with people.