Rivers

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. There was a positive culture within the service. We observed interactions between staff and people were positive, and staff spoke positively about the people living at the home. A staff member told us the visions and values of the service were, “Improving the quality of life for the residents”. A professional told us the registered manager was, “Passionate, engaging and dynamic in ensuring the people she supports are able to lead the lives they choose and makes opportunities for growth and development.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. The management team were open, honest and responsive throughout the inspection, acting on any queries raised. Staff felt supported by the management and relatives spoken to felt the home was well-managed. Comments included, “Strong leadership we know where we need to go and raise issues and they are dealt with satisfactorily”, “[Manager] does verbal conversations, emails, and she’s quick to reply and reassure us.” And, “Always open with us, when we contact them never put off or ignored, always addressed things. We get reassurance they heard what we said.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff spoken to felt able to raise concerns and were confident action would be taken. A member of staff said if they had any worries or concerns they would, “Go to the manager.” Staff told us there was regular engagement with people and their relatives. Relatives knew the process to raise any concerns they may have. Relatives told us, “I raised an issue, they listened, and we acted together, resolved for better outcome.” And, “I have raised a complaint, it was looked into resolved and I felt happy, it was sorted, and they listened and took it on board.”

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Staff told us they were treated fairly and equally, with support and reasonable adjustments made for staff as and when needed. A staff member told us, “If we have any emergency, they [management] will support us. They swap days to support us, for sick leave or other leave.”

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. Since the last inspection improvements had been made to how quality was monitored. However, the system was not fully effective as it did not identify the concerns we found during the inspection in relation to the person’s DoL’s condition not being met, and areas of risk and medicine’s management. We found no evidence that people had been harmed, and the provider immediately actioned the concerns. The provider had a quality team with various audits carried out at the service and by the quality team. When shortfalls were identified, these were added to a service improvement plan which was monitored to make sure improvements were made. For example, take up of staff training had been lower than the expected standard. This had been added to the improvement plan, and we saw how improvements had been made. During the inspection, we shared concerns raised by relatives with the registered manager who was already aware of a number of these concerns as they had been raised during the service’s recent family survey. The registered manager provided assurances they were addressing the concerns.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. Professionals told us, “Staff have been proactive in making referrals to speech and language therapists, psychology, the learning disability team.” And, “They engage well, take our recommendations on board, make appropriate and timely referrals, know their clients well and are able to participate well, follow up on funding changes and implement changes.”

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research. The provider had been involved in numerous initiatives. This included a local initiative called Proud to Care Somerset, raising awareness of working in care. They have also worked alongside the Community Team for Adults with Learning Disabilities on a quality improvement project around clinical skills. Involvement in this project was fed back to the select committee at the House of lords to support with future policy and recommendations.