Archived: Riverside Close

Riverside Close is a is a residential care home. This service supports people with autism; The service is registered to care for three people; there was one person living at the service at the time of the inspection.

People’s experience of using this service:

The service applied the principles of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using this service reflected the principles and values of Registering the Right Support in the promotion of choice and control, independence and inclusion.

People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

We saw many examples where staff had supported people to become more independent, make choices and increase their physical and emotional wellbeing. With staff support and by increasing their understanding, personalised daily routines were established, reflecting people's preferences and healthy eating was promoted.

Riverside Close is located in an area that enabled people using the service to participate in their own local community. Good local transport links enabled people to travel independently to many community facilities and places of interest.

The service was highly effective at promoting people's independence. People had made significant achievements, made possible by the dedication and persistence of staff. This included personal care and daily activities such as laundry, cleaning their home, shopping, preparing snacks and drinks.

Staff demonstrated great skill and tireless patience when working with a person to increase their skills and knowledge in daily activities. People were encouraged and supported to follow a healthy lifestyle; they chose and planned their meals and prepared their own drinks and snack. People were offered choice and control and consented to their care and support.

Staff had worked exceptionally hard in relation to developing effective communication with a person. This meant that they were able to make their own decisions about their support; staff ensured they were supported to make choices on a day to day basis. Pictures depicting activities, places, people and meals were used, together with picture boards to demonstrate the day of the activity.

Risks that people faced had been assessed and those identified were safely managed. Staff showed an excellent understanding of their roles and responsibilities of keeping people safe from avoidable harm. Medicines were managed safely by appropriately trained staff. The person who used the service self-medicated. The person had a locked facility in their room to store the medicines. The environment was safe and in a good state of repair and decoration.

The leadership of the service promoted a positive culture that was person-centred and inclusive. We received positive feedback about the quality of care and support people received and the overall management of the service from people's relatives. The registered manager and the staff team showed a desire to improve on the service provided and in turn the quality of life experiences for the people at Riverside Close.

Effective systems were in place to check the quality and safety of the service.

The service met the characteristics of Good in most areas, rated Outstanding in Caring; more information is in the full report.

Rating at last inspection:

At the last inspection the service was rated Good (Report published 3 November 2016).

Why we inspected:

This was a planned inspection to confirm that this service remained Good.

Follow up:

We will continue to monitor the service through the information we receive. If any concerning information is received, we may inspect sooner.

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

Riverside Close is registered to provide accommodation for three people who require personal care. The service is provided by Autism Initiatives and the registered Landlord for the property is Riverside Housing Association. At the time of our inspection one person was using the service.

There was no 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. The manager at the service was in the process of applying to become the registered manager and had issued their application form into the Care Quality Commission.

At the time of inspection the person who used the service self-medicated their own medicines. The person had a locked facility in their room to store the medicines. One medicine was stored in the managers office due to it not being able to be removed from its original packaging and placed in a compliance aid. We made a recommendation about this medicine.

Staff understood safeguarding issues, and felt confident to raise any concerns they had in order to keep people safe.

Risks to people arising from their health and support needs or the premises were assessed, and plans were in place to minimise them. Risk assessments were regularly reviewed to ensure they met people’s current needs. A number of checks were carried out around the service to ensure that the premises and equipment were safe to use.

Accidents and incidents were monitored each month to see if any trends were identified. The last incident had taken place in January 2016. The manager used reflective practice to learn from incidents that this had reduced them dramatically.

The registered provider followed safe recruitment practices. A number of recruitment checks were carried out before staff were employed to ensure they were suitable. The service had employed a new staff member who was due to start, once the person who used the service was settled with the new member of staff another member of staff was to be recruited.

Staff received training to ensure that they could appropriately support people, and the service used the Care Certificate as the framework for its training.

Staff received support through regular supervisions and appraisals. Staff felt confident to raise any issues or support needs they had at these.

Staff had completed a range of training that enabled them to meet people’s assessed needs effectively. Staff had received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) training and clearly understood the requirements of the Act which meant they were working within the law to support people who may lack capacity to make their own decisions. The manager and staff understood their responsibilities in relation to DoLS.

People were supported to maintain a healthy diet, and people’s dietary needs and preferences were catered for. People told us they had a choice of food at the service, and that they enjoyed it.

The service worked with external professionals to support and maintain people’s health. Staff knew how to make referrals to external professionals where additional support was needed. Care plans contained evidence of the involvement of GPs and other professionals.

From observations we saw staff knew the person really well and showed extreme patience.

Procedures were in place to support people to access advocacy services should the need arise.

Care was planned and delivered in way that responded to people’s assessed needs. Plans contained detailed information on people’s personal preferences. Care plans were regularly reviewed to ensure they met people’s current needs. Care plans contained an ‘All About Me’ document, this provided key information about the person and what they like or dislike. The person who used the service also completed a daily report to say how their day had gone and what they had done.

People had access to a wide range of activities, which they enjoyed.

The service had a clear complaints policy that was applied when issues arose. People and their relatives knew how to raise any issues they had.

Staff were able to describe the visions and values of the service, and felt supported by manager in delivering them.

The manager was a visible presence at the service, and was actively involved in monitoring standards and promoting good practice.

People's individual needs were recorded and understood by staff. People were encouraged to live independent and safe lifestyles.

People were given a choice of nutritious food and drink. People who used the service had a nutritional support plan which included goals they had set and agreed to.

We found there were the right numbers of suitably qualified and experienced staff to support people who used the service.

People had access to a complaints procedure in a format they could understand. People's complaints had been listened to and acted upon.

We looked at the care file of the person living at the home. We looked at staff files, training and supervision records.

We spoke with the registered manager and one of the support workers employed at the home.

We were unable to have any conversation with the person living in the home. We contacted the service user's relative by phone the following evening to obtain information and gain their opinion.

The feedback received from the members of staff and the relative of the service user were all positive.

Some of the comments from the person's relative were, 'Gets on really well with the staff," "(Person named) is very content and happy," "The people who work with (Name) have the right temperament and there is something rather special about the attitude of the people who work with (Name) and relates to them really well" and "They (staff) have motivated and encouraged (Name) and brought the best out in (Name)."