Five Rivers Living Residential 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. At our last assessment we rated this key question required improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of the legal regulations in relation tosafe care and treatment and, premises and equipment. Improvements were found at this assessment and the provider was no longer in breach of these regulations.

This service scored 69 (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 proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider was open and transparent about accidents and incidents, ensuring records were kept and people, relatives, and staff made aware. A relative said when their family member fell, staff informed them and put measures in place to prevent a reoccurrence.

The registered manager ensured learning from safety events was communicated and acted on. Staff gave us examples of how accidents and incidents were used as opportunities for learning and discussed at team meetings and on the service’s online messaging platform. This meant risks were identified and managed to reduce risk to people.

The provider worked with people and health and social care partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The registered manager and staff involved people, relatives, and health and social care professionals when people were referred to the service. Pre-assessment documentation was completed to ensure the service could meet people’s needs and manage any risks present. People were encouraged to visit the service prior to admission to check it was suitable for them.

The provider worked with people and healthcare partners to understand what being safe meant to people and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

At our last inspection poor accident and incident recording meant we could not be sure people were protected from the risk of improper treatment and/or abuse. At this inspection safeguarding systems, processes and practices had improved, and people were safe.

People and relatives said the service was a safe place. A relative told us, “[Person] is kept safe, staff are straight onto any problems.” Another relative said, “There are no signs of any form of abuse or safeguarding, and I am very aware of signs.”

Staff were trained in safeguarding and knew what to do if they had concerns about the wellbeing of any of the people using the service. A senior member of staff, either the nominated individual, registered manager, or deputy manager, was always available or on call to support and advise staff should a safeguarding event occur.

The provider worked with people to understand and manage risks holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

At our last inspection people were not always protected from the risk of harm. At this inspection improvements had been made and risk reduced.

People had clear and detailed risk assessments in place and the equipment and support they needed to reduce the risk of accidents or incidents occurring. The call bell system was working effectively and records showed it was regularly checked and monitored.

People had personal emergency evacuation plans (PEEPs) which were fit for purpose, well-organised, and easy to locate. The use of repositioning charts in the management of pressure areas had improved. Records showed repositioning was carried out in a timely manner with staff following instructions in people’s care plans and risk assessments.

The provider ensured risks were assessed and managed appropriately, with the involvement of the person where possible, so they understood any decisions made about their safety. Risk assessments were person-centred, proportionate, and regularly reviewed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The premises were well-maintained. The head of maintenance followed an audit schedule to check the premises were safe for people, staff, and visitors. Equipment, including slings, hoists, and wheelchairs, was regularly inspected and maintained. Weekly fire alarm tests and routine fire drills were conducted, and fire wardens and first aiders were always onsite.

There were several garden areas for people to use. At the rear of the premises access was down a step which could present a risk to people, as could the commercial scale waste bins which were not fenced off. The garden area at the front of the service was at the edge of a large car park and not secure. We discussed this with the nominated individual and registered manager who agreed to risk assess the garden areas and make improvements where necessary to ensure they were safe to use.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

At our last inspection there were insufficient numbers of suitably trained staff. At this inspection staffing numbers had increased to a safe level. Records showed people’s dependency levels (the degree to which they relied on others for support to meet their basic needs) were assessed and reviewed monthly, or more frequently if people’s needs changed. Staffing levels were adjusted accordingly to ensure appropriate care and support was provided.

People, relatives, and staff told us the service was well-staffed. A relative said, “I visit frequently and see continuity of staff, and enough staff, and no issues with their training. [Person] is well attended to.” Staff told us the service was never short-staffed, and they were able to use agency staff if they ever needed to. We observed there were enough staff on duty to meet people’s needs. Staff were attentive to people and proactive in meeting their needs.

Some improvements were needed to recruitment and induction records to ensure they were clear and accurate. Although people had identity and criminal record checks as required, some staff members’ employment histories and other documentation lacked detail, and some induction records were incomplete, undated or unsigned. The nominated individual and manager said this would be addressed.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

At our last inspection infection prevention and control (IPC) was not always sufficient, service cleanliness was poor, equipment was not kept clean, and there were malodours on the premises.

At this inspection improvements had been made. The provider had implemented a robust IPC framework to minimise the risk of infection and safeguard the health of people, staff, and visitors. All areas of the premises and the equipment we inspected were cleaned to a good standard.

Relatives made many positive comments about the cleanliness of the premises. A relative said, “The home is immaculate, spotless, as is [person’s] room and bathroom.” Another relative told us, “The home is extremely clean, staff are forever cleaning, and there is a very good laundry service.”

Staff completed mandatory infection control training during induction and received annual refresher courses to stay updated on best practices. Training covered hand hygiene, proper use of personal protective equipment (PPE), safe cleaning practices, and the management of infection outbreaks. Staff also receive specific training on managing airborne, droplet, and contact-transmitted infections, including COVID-19.

The registered manager worked closely with infection control specialists, including local healthcare teams and public health authorities, to ensure best practices were followed. Regular audits of IPC systems were carried out and monthly infection control meetings reviewed audit outcomes, discussed challenges, and planned improvements.

During our site visits we observed staff using handwashing facilities and PPE correctly. The housekeeping team followed cleaning schedules to ensure the cleanliness of the premises was continually maintained. The provider’s head housekeeper told us they were well-supported by management and had the resources and equipment they needed to keep the premises clean and infection-free.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Relatives were satisfied with how staff managed their family members’ medicines. A relative said, “Staff keep me informed about [person’s] medication, I have no concerns.” Another relative told us their family member’s medicines were reviewed and updated, and they were informed of any changes.

People had personalised medicines care plans which staff followed to ensure people had their medicines safely and in the way they wanted. We observed a medicines round. Staff were attentive and patient, administering medicines with a drink if people preferred this, and staying with them until they had taken their medicines.

Staff had medicines administration training and regular competency checks to ensure their skills remained relevant and up to date. Medicines were stored securely in temperature-controlled areas. Medicines administration was recorded on MARs (medicines administration records) and audited daily, weekly, and monthly.