Archived: Riverside House

Our inspection team was made up of one inspector. We gathered evidence against the outcomes we inspected to help answer the five key questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

We looked at a range of records, spoke with the manager, the office administrator and three staff. We visited and spoke with three people in their homes and spoke with four relatives of people who used the service. We also spoke with a district nurse who had regular contact with the service.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, the manager and staff.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw that there were systems in place to keep people safe. People were provided with appropriate levels of staffing and sufficient time for their care to be delivered and to keep them safe.

Care plans and risk assessments were in place and were updated as people's needs changed. Care records detailed the support people required and encouraged people to be independent where possible. People we spoke with during the inspection told us that they were confident with the staff who provided them with care and support.

There were effective systems in place for the on-going maintenance and servicing of the office environment and office equipment. There were also good systems in place in respect of fire safety and fire training. Environmental risk assessments had been completed for people's homes and for the equipment in use.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care home. The service had proper policies and procedures in relation to safeguarding vulnerable adults. The manager had a good understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards and staff had received training in respect of safeguarding vulnerable adults.

Is it effective?

People all had their needs assessed and had a comprehensive individual care in place, which set out their care needs. It was clear from speaking with staff that they had a good understanding of the people's care and support needs and that they knew the person well.

Is it caring?

People we spoke with told us that they were provided with very good care and support. They told us that they were treated with dignity and respect and that the staff were very professional.

People's needs had been assessed and care plans put in place which detailed people's needs and preferences. These records provided comprehensive information to staff on what care and support people who used the service needed.

Care and support had been provided in accordance with people's needs.

Is it responsive?

There was clear evidence contained within people's care plans to show how they worked with other health and social care professionals. We saw lots of evidence of multi-agency working.

It is well led?

The service had a registered manager. There were systems in place to assure the quality of the service they provided. The way the service was run was regularly reviewed. Actions were put in place when needed and we were able to see that these actions had been addressed.

Staff had a good understanding of the ethos of the service and were knowledgeable about people's needs. This helped to ensure that people received a good quality service at all times.

What people told us.

During this inspection we visited three people in their own homes and spoke with them about the care they received. We also spoke with four relatives of people who used the service.

People were very positive about the service, care and support provided to them. Their comments included, "Very happy with the service. Can't fault their attitude and manner." "They are very good and they always check if I need or want anything." "They are punctual and stay for the time they are meant to and they are all familiar faces."

People confirmed that they received a week staff rota so that they knew who was coming to provide care and at what times. People confirmed that they found this very useful.

We found that people had their needs assessed and staff had the information they needed to provide people with individual care and support. People we spoke with said, 'I have been very satisfied with the care, they are so kind.'

Relative's comments included, 'Brilliant care provided by them.' 'They really value her; they are so kind and caring.'

We found that there were effective systems for working with other professionals. We saw that the service provided flexible support to enable people to attend hospital or GP appointments.

Effective systems were in place for the handling and administration of medication.

We found that there were no effective systems in place to ensure that health and safety arrangements were in place in respect of the premise.

People received care from the same group of carers ensuring continuity of care. People said, 'Yes, continuity of staff and I receive a weekly rota.' Relatives said, 'Definitely continuity of care, we have some of the same staff from the very beginning.'

We spoke with the families of three people who received support from the agency. People told us that they were happy and satisfied with the care and support being provided. Comments made to us included "We've always found them a smashing lot', 'very impressed, the staff are always kind and thoughtful' and 'very satisfied with the service.'

People told us that they held copies of their care plans and confirmed that they were always involved in any care planning with the agency. We looked at three people's care records and saw evidence that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. The agency had in place policies and procedures covering safeguarding and the protection of vulnerable adults.

We looked at the administration and recording arrangements made by the service to ensure that people's medication was recorded properly. We found that medication administration records (MAR) had not been filled in correctly, so that it was not possible to verify whether doses had been missed, or whether the person had taken the medicine themselves. We have asked the provider to take action to address this.