Rivermead

Updated 21 February 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

One inspector and one expert by experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Rivermead is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with six people who used the service and three relatives about their experience of the care provided. We spoke with seven members of staff including the registered manager, senior care workers, care workers and the chef. We also spoke to two professionals who visit the service regularly. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at activity logs and policy and procedures.

Updated 21 February 2020

About the service

Rivermead is a residential care home providing personal care to 33 people aged 65 and over who are living with dementia at the time of the inspection.

Rivermead accommodates 33 people in one adapted building. The service can support up to 33 people. The home has 33 bedrooms with shared communal bathrooms and three communal living areas and a family room

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

Although people’s daily care needs were met by a staff team who knew people well, we found there was a lack of personalisation in people’s care and missed opportunities for staff to engage and interact with people in a meaningful way. This meant there were often periods where people were left in communal areas with minimal staff interaction and engagement.

There was a lack of meaningful activities within the home. The provider had put into place an additional staff member on shift to facilitate activities for people. However, we found these activities were sometimes limited and not always suited for people. This meant that people did not always have opportunity to take part in stimulating and meaningful activities which could lead to people becoming bored and anxious. We discussed this with the provider who told us they would review the activities on offer to people.

Areas of the home were not always well maintained. During inspection we found lifted flooring on the entrance to a person’s bedroom who had a risk of falls. This had not been identified in the maintenance records and there was no system in place for regular checks of the environment. We told the provider about our concerns and when we returned for the second day of inspection this had been rectified.

Some of the premises had been adapted to support the needs of people. Signage and decoration supported people living with dementia to orientate themselves and understand the facilities at the service. This included a new bus stop area in the home which people appeared to enjoy. However, some areas of the home were tired and needed re-decoration. The provider had acknowledged that areas of the home needed decoration. However, there were no clear timescales to when this work would be completed to improve standards of the environment people.

People were positive about the food at the service. However, during the inspection we found some people were seated at the dining tables waiting long periods of times for meals to be brought out. During this time, we observed people became bored and started to move around cutlery on the tables. People were supported to visit or be visited by health professionals when this support was needed.

People were supported with kindness, respect and compassion. Staff had taken the time to get to know people and knew how to communicate with people in their preferred communication methods and encouraged people's independence. People were supported to make choices about their care and how they would be supported by staff members.

People were protected from harm and abuse by systems and checks in place at the service including areas such as food safety and medication. There were enough staff to support people safely.

People were supported by a knowledgeable staff team who received training and supervision which supported them to be effective in their job roles.

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 had access to a complaints policy and complaints had been responded to and actioned in a timely manner. People had been supported to discuss plans for the end of their life if they chose to do so.

The registered manager was very visible at the service and promoted a positive culture for people and the staff team.

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 27 July 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.