Rivermead

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.

At the last inspection on 20 July 2015 the service was rated Good. At this inspection we found that it continues to be Good.

The service had 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.

People's care was not always person-centred. We found that activities and entertainment did take place but were not regular enough to ensure that people were as active and stimulated as possible. The service was however taking steps to attempt to address this. Care plans were in place and reviewed on a regular basis and feedback, including complaints, was welcomed and acted upon.

People were supported to stay safe. Staff members were knowledgeable about abuse and the requirement to report any incidents and accidents which took place. Systems were in place to assess risks to people and staffing levels were sufficient to meet people's basic care needs. Medicines were stored, administered and recorded appropriately.

Staff members received training and support to enable them to perform their roles. People's consent to their care and support was sought and procedures were in place to ensure the principles of the Mental Capacity Act 2005 were being followed. The health and nutritional needs of people were being met.

There were positive relationships and interactions between people and members of staff. Staff knew people well and worked hard to ensure their needs were met. People were involved in their care and provided with the information they needed about the service. People's privacy and dignity were promoted and staff treated them with respect.

There was an open and positive culture at the service and staff were motivated to perform their roles. The registered manager was well known to people and staff and provided them with the support they needed. There were systems to ensure they were meeting their regulatory requirements and quality assurance and audit processes were in place to help monitor and improve the service.