Archived: Rivendell

Rivendell 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.

Rivendell is detached property in Christchurch. The home provides accommodation for up to three people with learning disabilities or autistic spectrum disorder and mental health needs. At the time of our inspection two people were living at the home.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were protected from avoidable harm as staff understood how to recognise signs of abuse and the actions needed if abuse was suspected. There were enough staff to provide safe care and recruitment checks had ensured they were suitable to work with vulnerable adults. When people were at risk of falling or seizures staff understood the actions needed to minimise avoidable harm. The service was responsive when things went wrong and reviewed practices in a timely manner. Medicines were administered and managed safely by trained staff.

Fire safety was reviewed. Although people had Personal Emergency Evacuation Plans (PEEPs) in place we had concerns that the home did not have necessary fire safety measures in place to ensure that people could be supported safely in the event of a fire. This included a lack of fire doors, firefighting equipment, emergency lighting and accessible fire exits. We shared these findings with Dorset Fire and Rescue.

People had been involved assessments of their care needs and had their choices and wishes respected including access to healthcare when required. Their care was provided by staff who had received an induction and on-going training that enabled them to carry out their role effectively. People had their eating and drinking needs understood and met. Opportunities to work in partnership with other organisations took place to ensure positive outcomes for people using the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and professionals described the staff as caring, kind and friendly and the atmosphere of the home as homely. People were able to express their views about their care and felt in control of their day to day lives. People had their dignity, privacy and independence respected.

People had their care needs met by staff who were knowledgeable about how they were able to communicate their needs, their life histories and the people important to them. A complaints process was in place and people felt they would be listened to and actions taken if they raised concerns. The home was in the process of updating and creating new booklets which gave staff the information required to get to know them. These included; communication, preferences, likes, dislikes, interests and people important to them.

The service had an open and positive culture that encouraged involvement of people, their families, staff and other professional organisations. Leadership was visible and promoted teamwork. Staff spoke positively about the management and had a clear understanding of their roles and responsibilities. The home was in the process of creating audits and quality assurance processes which would be effective in driving service improvements. The service understood their legal responsibilities for reporting and sharing information with other services.

Further information is in the detailed findings below

Rivendell provides care and accommodation for up to three people. On the day of the inspection two people lived in the home. Rivendell provides care for people who have a learning disability.

The service had 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.

People and staff were relaxed, kind and caring interactions took place. The environment was clean and people were well cared for. A relative said, “It is a lovey bright place the staff are so caring and understanding.”

Care records contained information that described what staff needed to do to provide personalised care and support. Staff responded quickly to people’s change in needs. Where appropriate friends, relatives and health and social care professionals were involved in identifying people’s needs. People preferences, life histories, disabilities and abilities were taken into account, communicated and recorded.

People’s risks were managed well and monitored. Policies and procedures were in place and understood by staff to help protect people and keep them safe.

People were promoted to live full and active lives and were supported to go out and use local services and facilities. Activities were meaningful and reflected people’s interests and individual hobbies.

People were supported to maintain a healthy balanced diet. Dietary and nutritional specialists’ advice was sought so that people with complex needs in their eating and drinking were supported effectively.

People had their medicines managed safely and received their medicines as prescribed. People were supported to maintain good health through regular access to health and social care professionals, such as GPs and psychiatrists.

Staff were encouraged to be involved and help drive continuous improvements. This helped ensure positive progress was made in the delivery of care and support provided by the service.

The service supported people to share their concerns and complaints. The registered manager confirmed that, whilst they had never received any form of complaint, if they did, they would investigate the matter thoroughly and use the outcome as an opportunity for learning to take place.

People were kept safe and protected from discrimination. All staff had undertaken training on safeguarding adults from abuse and equality and diversity. Staff displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm.

There were sufficient staff to meet people’s needs. Staff were appropriately trained and had the correct skills to carry out their roles effectively. A relative commented, “There are always plenty of staff looking after her every need.” Safe recruitment practices were followed to help ensure staff were suitable to work with vulnerable adults. Staff described the management as very open, supportive and approachable. Staff talked positively about their jobs.

There were quality assurance systems in place. Incidents were appropriately recorded and analysed. Learning from incidents were used to help drive improvements and ensure positive progress was made in the delivery of care and support provided by the service.

Before people received any care or treatment they were asked for their consent and the provider respected their wishes. Where people did not have the capacity to consent, the provider took measures to ensure they acted in accordance with legal requirements.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. One individual who was able to speak with us told us they felt happy and safe at Rivendell.

People were protected from unsafe or unsuitable equipment. One person said their bed was comfortable.

People were cared for by suitably qualified, skilled and experienced staff.

The provider assessed and managed the quality of the service and risks to people's safety and welfare. They were not registered as a food business with the environmental health department, but assured us they would contact the environmental health department.

We saw that relationships between the manager and people living in the home were relaxed, friendly and informal. We saw the manager knew the needs of people who lived in the home well and could often anticipate the help they required.

People's diversity, values and human rights were respected.

A relative we spoke with told us the care their daughter received at Rivendell was 'excellent'.

We found that care plans were detailed, person centred, accurately reflected people's needs and had been drawn up with their involvement where possible.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were supported by sufficient numbers of suitably qualified staff that were supported to deliver care and treatment safely and to an appropriate standard.

People's personal records were accurate and fit for purpose. Records were kept securely and could be located promptly when needed.