Riverlee Residential and Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm

People using the service were protected from abuse and avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was a positive learning culture within the service, and managers and staff communicated effectively to help drive improvements. The provider had effective systems for reporting and learning from incidents. When incidents occurred, investigations were conducted, and appropriate actions were taken to prevent recurrence. Records showed that management held regular staff meetings to help ensure any learning from events was shared and implemented. We also saw that ‘behaviour sessions’ were held with staff to develop and improve practice.

There were policies and procedures in place for responding to incidents, accidents and complaints and staff we spoke with were knowledgeable about these. A staff member commented, “I am aware of all the policies and feel confident on how to respond. Management support is very good.”

There were systems in place to ensure safe transitions and pathways for people. Assessments of people’s needs, risks and wishes were completed and reviewed to ensure they were reflective of people’s needs.

Care plans were developed and shared with health and social care professionals when required to ensure people’s well-being. Staff worked effectively with health and social care professionals to ensure people received appropriate support when meeting their physical and mental health needs. These included GP’s, hospital staff, community mental health teams and dietitians amongst others.

The provider had procedures in place to protect people from harm and abuse. Information was displayed within the service to remind staff how to speak up and report any concerns and to also inform people and visitors to the service.

People and their relatives told us they felt safe and well care for. Comments included, “I feel that my [loved one] is safe, when I go home at night, I have no worries”, “These carers are lovely here”, and “[loved one] likes her carers, she smiles when they come in.”

There were safeguarding policies and procedures in place and staff were trained to recognise and respond to concerns, potential abuse and harm. Staff told us they had received training on safeguarding adults and felt confident any concerns they raised would be managed appropriately. A staff member said, “I would report any concerns I had to the team leader or home manager. I am sure they would make referrals to the local authority safeguarding team and CQC. We have a whistle blowing policy here and I would follow that policy if I needed to report poor care practice.”

Staff promoted people's rights and worked within the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. People and their relatives were consulted and supported to make choices and decisions for themselves. Mental capacity assessments were completed and reviewed regularly to ensure they were reflective of people’s needs and wishes. The provider had requested legal authorisations where restrictions were in place. Decisions around these were made in people’s best interests and for their safety.

At our last inspection of the service, we found risks to people's health and safety were not always assessed or guidance available to reduce possible risks and maintain people's safety. This was a breach of regulation 12 of the Health and Social Care Act 2008. At this assessment of the service, we found improvements had been made and the service was no longer in breach of this regulation.

Staff worked with people and their relatives to understand and support with managing identified risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff told us how they supported people who were assessed as being at risk due to their medical or health conditions. A staff member told us how they supported a person at risk of falls through supervision and following the person’s falls risk assessment. Another staff member told us how they supported a person at risk of choking by following the person’s eating and drinking care plan which had advice from a speech and language therapist, they also told us about the action they would take in an emergency.

Risk assessments were completed with people, and care plans were developed following assessments to mitigate identified risks. For example, risk of falls, skin integrity and nutrition and hydration. Reviews of risk assessments and care plans were completed to ensure they remained reflective of people’s needs and effective in helping people to keep safe.

The design of the premises was meeting people's needs. The service had adapted bathrooms, dining rooms, and quiet areas with suitable furniture to support people with limited mobility. We saw dementia friendly signage located around the service including memory boxes and photographs to aid people’s orientation and pictures for people to reminisce. There was a garden area at the rear of the service with suitable furniture for people to use in warmer weather.

The services maintenance person told us they assessed and maintained the environment and equipment used. We saw servicing records for the fire alarm system, portable appliances, gas safety and legionella testing. Checks and audits were also carried out on slings and hoisting equipment, baths, the call bell system and regular fire drills were conducted. The fire alarm system was tested on a weekly basis.

The kitchen was clean and well maintained. We saw food was stored safely and hygienically and food that had been opened had been labelled with the date of opening. The kitchen had received a food hygiene rating of 5 from the Food Standards Agency.

People and their relatives told us they felt there was enough staff to meet their needs in a timely manner. A person using the service told us, “The staff here get on really well, you can tell they enjoy working here.” Comments from relatives included, “There always seem to be enough staff,” and “There are plenty of staff, there is always someone to talk to.”

We observed there were enough staff deployed throughout the service to meet people’s needs when required. Staff told us staffing levels are very good. A staff member said, “We are fully staffed and have no issues.” Another staff member commented, “We have enough staff. If someone calls in sick, we always get other staff in to cover.”

We saw a training matrix which indicated that staff had completed training in areas such as diabetes awareness, Parkinson’s disease, dementia awareness, falls prevention, health and safety, basic life support, infection control, medication administration, moving and handling, equality and diversity, and the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Nursing staff had completed training for example, in areas such as venipuncture, catheterisation, and pressure area care.

Staff told us they had received training and supervision in relation to people’s care and support needs. A staff member told us, “All the training I have had has been very helpful in my job. Dementia training helped me understand people living with dementia better. I also have 1-1 supervision with a manager, and I feel well supported.” Another staff member said, “I have learned so much each time I go to training, I always learn something new. I can give people 100% due to the good training. I have a team leader, and they give me supervision and check I am well and that my training is up to date.”

The service followed safe recruitment practices, ensuring all necessary pre-employment checks were completed before staff began work. Nursing staff’s National Midwifery Pin numbers were also sought and recorded.

There were systems in place to help prevent and control infections. The service appeared clean and was free from offensive odours. The provider employed domestic staff to oversee cleaning and laundry. We saw an infection control audit and action plan for February 2025. This identified areas for improvement, for example, making sure the sluice room was clean and free from non-appropriate items and conducting a handwashing quiz with staff.

Comments from relatives about the home included, “As you come through the door it is welcoming and very clean”, “The home is immaculate and feels welcoming when you come in”, and “The home is clean and very well maintained.”

Staff were provided with personal protective equipment (PPE) when needed. We saw they wore this appropriately. Training records confirmed that all staff had received training on infection prevention and control.

At our last inspection of the service, we found medicines were not always safely managed. This was a breach of regulation 12 of the Health and Social Care Act 2008. At this assessment we found improvements had been made and the service was no longer in breach of this regulation.

People received their medicines safely and as prescribed. A relative commented, “Staff administer my loved one’s medicines and all seems well.” Medicines were administered by trained staff who had completed up-to-date medication competency assessments. Staff followed the providers medicines policy and received annual refresher training. Medicines rounds were unhurried, and staff were observed checking MAR (Medication Administration Record) charts carefully before administering medicines.

MARs were completed with clear signatures and codes for non-administration where appropriate. PRN (as required) medication protocols were in place. Medicines were stored securely in locked cabinets and medication trolleys within the service. Controlled drugs were stored in a locked cabinet with restricted access, in line with legal requirements. Room and fridge temperatures for medicine storage were monitored and recorded daily, with records available for review.

Regular audits of medicines practices were carried out by the management team. Where issues were identified, action plans were put in place and followed up to completion. All staff responsible for administering medicines had received appropriate training, with competency checks completed annually.