Archived: Riverside Grange - Care Home

Updated 24 April 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 23 and 24 February 2015 and was unannounced.

The inspection was completed by two adult social care inspectors who were accompanied by an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience had expertise in dementia care.

Prior to the inspection we spoke with the local safeguarding team and the local authority contracts and commissioning team about their views of the service.

Because of the complexity of people’s needs, we were unable to speak with them about how care was provided to them. Instead we spoke with four relatives who were visiting during the inspection and we observed how staff interacted with people who used the service. We received information from a health professional visiting the service during the inspection.

We spoke with the registered manager, the deputy manager and eight members of staff from a range of roles. We also spoke with an area manager, a quality assurance manager and a director of operations to feedback the concerns we found during the inspection.

We looked at five care files which belonged to people who used the service. We also looked at other important documentation relating to people who used the service such as medication administration records (MARs). We looked at how the service used the Mental Capacity Act 2005 and Deprivation of Liberty code of practice to ensure that when people were deprived of their liberty or assessed as lacking capacity to make their own decisions, actions were taken in line with the legislation.

We looked at a selection of documentation relating to the management and running of the service. These included two staff recruitment files, the training record, the staff rotas, minutes of meetings with staff and people who used the service, quality assurance audits and maintenance of equipment records.

Updated 24 April 2015

We undertook this unannounced inspection on the 23 and 24 February 2015. The last full inspection took place on 6 and 7 May 2014 and the registered provider was non complaint in three of the areas we assessed. These included how people’s nutritional needs were met, staffing numbers and how the service was managed overall. Some improvements had been made but there remained concerns regarding the management of the service.

Riverside Grange is a two storey building situated on the outskirts of Hull. It is registered to provide accommodation and personal care to 33 older people, specifically those people living with complex dementia care needs. On the day of the inspection there were 25 people living in the home. Fifteen people lived on the ground floor and 10 lived on the first floor. Bedrooms, communal areas and bathrooms are located on both floors.

The service has a registered manager. 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.

During the inspection we had concerns about the overall management of the service. This had impacted on areas of care and support provided to people who used the service. This is being followed up and we will report on any action when it is complete. The quality of the service had not been monitored effectively and shortfalls had not been dealt with or had not been identified.

Policies and procedures were in place to guide staff in how to protect vulnerable from abuse and harm and how to make sure senior managers and relevant agencies were alerted to concerns. The procedures had not been consistently followed, although we found some staff had raised concerns when required.

We found some people did not have risk assessments in place for specific concerns and incidents and accidents had not been analysed to help find ways to reduce them.

We found there was a lot of important and personalised information in care plans although some of them had not been updated when people’s needs had changed. Some care had not been delivered effectively to ensure people’s care and welfare.

We found some parts of the environment required attention to make sure they were hygienic.

The above areas breached regulations in safeguarding people from abuse, care and welfare, cleanliness and infection control and monitoring the quality of the service. You can see what action we told the registered provider to take at the back of the full version of the report.

We found there had been improvements in people’s nutritional intake and their dining experience. New equipment such as tables, to use when eating meals whilst sitting in easy chairs, had been purchased. The dining area had been rearranged and people encouraged to use the dining tables for meals.

We found most people had their medicines given to them as prescribed although one person’s preferences and times of rising had affected their administration. The area manager told us this would be discussed with the person’s GP.

Staff understood the need to gain consent from people prior to carrying out care and support tasks. When people were unable to give consent, the staff acted within best interest principles of the Mental Capacity Act 2005.

There were activities available to help people maintain skills and previous interests.

New staff were recruited safely and employment checks were carried out before they started work in the service. We found staffing numbers had been increased following the last inspection but a recent reduction in staffing numbers had an impact on the care received by some people who used the service. This was addressed by the operations director on the second day of the inspection.

Staff had access to a range of training to help them develop knowledge and the skills required to support people. They had supervision meetings with their line manager but some staff felt they required more support but this had not always been available at the time it was needed.

There were systems in place to manage complaints and relatives told us they felt able to raise concerns and complaints.