Archived: The Riverside Nursing Home

Is the service safe?

We saw that people were treated with dignity and respect. One visitor told us they felt their relative with a dementia was safe at the home and said, 'I'm pleased with the way they treat her, staff are always very nice and caring. They're also chatty and cheerful.' Safeguarding procedures are robust and members of staff understood their role in safeguarding the people they supported. Relevant staff had received training about the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards to understand when an application should be made, and how to submit one.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Recruitment procedures were thorough and made sure that all the required information was obtained before any new employees started working at the home. These procedures helped to protect people from the recruitment of unsuitable staff.

We saw that the skirting boards in almost all areas of the home were dusty and dirty. The provider had not taken any action to improve the environment in any areas of the home since the last inspection. The decorations looked tired and wallpaper was peeling off the walls in one of the lounges.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to cleanliness and the premises.

Is the service effective?

People's health and social care needs were assessed with them or their relatives and they were involved in writing their care plans. Specialist dietary, mobility and equipment needs had been identified in care plans where required. Care plans were reviewed regularly and amended to reflect people's changing needs.

Discussion with care workers and examination of records confirmed that induction training for new employees and a rolling programme of training was in place so that all members of staff were kept up to date with current practice.

Is the service caring?

We saw that members of staff were attentive to people's needs and spoke to people in a courteous and friendly manner. People who used the service told us they liked living at the home and received the care and support they needed. One person said, 'It's a great place to live.' The relative of one person said, 'The care is second to none, they're looked after very well.'

People's personal preferences, interests and diverse needs had been recorded in their individual care plans.

People who used the service and their representatives were given the opportunity to complete satisfaction questionnaires annually in September. We saw that comments written on the questionnaires from September 2013 were mainly positive.

Is the service responsive?

Leisure activities were organised at the home. One care worker explained that people played games such as draughts or cards, watched television, listened to music and were taken out for a walk. A local vicar visited the home regularly and offered Holy Communion to people who wished to practice their faith in that way.

People knew how to make a complaint if they were unhappy. One person told us they would tell a member of staff and said, 'I've no complaints at all.'

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

There were systems in place for assessing and monitoring the quality of the service provided. We saw that audits completed regularly by the manager covered most aspects of the service provided. However, these audits had not identified the shortfalls we found during this inspection.

Discussion with members of staff confirmed that they had received appropriate training and understood their roles and responsibilities. This helped to ensure that people who used the service received the care and support they needed.

Prior to this inspection we had been informed of other concerns about this service. The concerns related to how peoples' nutritional needs were being met, the cleanliness and infection control measures at the home, the condition of the equipment used in peoples' care, staffing levels and the support and training available to staff.

On inspection we saw that improvements had been made to the systems in place to monitor the quality and safety of the service and record keeping. Provision of food was good, with well-balanced menus, offering choice. There were adequate numbers of qualified and skilled staff to meet people's needs and the care we observed was provided in a calm, patient and unhurried manner. We saw that the equipment in place was appropriately maintained.

The systems in place to monitor and maintain the cleanliness of mattresses and bedding was inadequate. We also found that several areas of the home required redecoration and that evidence could not be provided that essential work had been carried out to the home's electrical system following an 'unsatisfactory' inspection in 2008.

We found improvements had been made in all the areas of concern previously identified. This included the management of medication, staff training and development and the home environment.

People living at the home had complex health care needs such as dementia or mental ill health. This meant that they were unable to tell us about their experiences of receiving a service. However, we spoke with two visitors. One told us they were 'generally happy' with the care provided. They said the staff were 'good' but the environment that people lived in could be more 'homely'. The second visitor said they had 'no complaints' and 'The care is good'.

We saw that people received respectful and supportive care from staff. Care staff had a good understanding of providing individual support to people with complex health care needs including managing challenging behaviour. Appropriate health care professionals were involved as needed.

Not all care records were up to date and these records were not stored securely. Quality assurance systems needed improving.

Therefore we spent sometime observing people and how staff interacted and supported them. It was evident that staff understood people's needs and were helpful and polite when assisting people.

We spoke to the relatives of two people visiting the home during our visit. Both spoke positively about the care staff and the support provided for their relative. One of the relatives said; 'The staff are very helpful', 'Excellent care', 'Nothing is too much trouble' and 'They keep in contact with me if there's anything I need to know'. The second person told us their relative had 'Settled very well since moving in'. They also told us that they felt reassured that their relative was being looked after.

We found that improvements could be made in some areas, including, the management and administration of medication, staff training and development and standards within the environment.