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Inspection Summary

Overall summary & rating


Updated 9 November 2016

We carried out an announced inspection on the 8 September 2016. This was first inspection of this service.

River Garden Care is a domiciliary care service that provides personal care to people in their own homes. They may have a range of conditions including physical disabilities and people living with dementia. There were 35 people using the service at the time of the inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

The management team at River Garden Care provided excellent leadership and, in particular, the registered manager was a very good role model for staff at the service. She provided clear direction and always sought the views and feedback of people, their relatives and professional involved with the service.

There was a strong emphasis on continually striving to improve and this was reflected in the feedback from a ‘client survey’ undertaken in April 2016. The overall satisfaction rate was 96%. As a result of the survey and to seek ways to further improve communication, a client newsletter was introduced. This was to ensure people were kept updated of the outcome of surveys and any actions planned as a result, as well as other important issues in relation to the organisation. People and their relatives were also encouraged to contribute to the newsletter.

There were regular audits undertaken, including, care records, the recruitment process, staffing levels, training and whether people had been involved in decision making. These were checked in line with the CQC five domains, Safe, Effective, Caring, Responsive and Well-led to ensure a high quality service was being delivered.

The complaints process was included in the information book given to people when they started receiving care. People and their relatives were satisfied with outcomes of the complaints recorded and we saw that concerns and complaints were viewed very much as part of driving further improvements.

The safety of people using the service as well as staff was taken very seriously and procedures were in place to safeguard people from abuse as well as ensuring that risks to people’s safety and wellbeing were identified and addressed.

Care plans were detailed and people and their relatives were involved in their development. Staff had a full understanding of people’s care needs and received training and supervision to ensure they had the skills and knowledge to fulfil their roles. People received consistent support from care workers who knew them well.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and how to support people who lacked the mental capacity in line with the principles of the act and particularly around decision making. People were asked what they liked to eat, how they wanted to dress and their preferences for care delivery. People’s consent was obtained about decisions regarding how they lived their lives and the care and support provided.

Positive, caring relationships had been developed with people, based on compassion and kindness. The registered manager was motivated and committed to providing person centred care that made a positive difference to the wellbeing of people and their relatives that supported them. This commitment was shared by the staff team and we saw this in their enthusiasm for the way they cared for people and their desire to go the extra mile.

Staff had a good understanding of equality and diversity and understood the need to treat people as individuals. There were equality and diversity policies and procedures in place that included clear explanations of the Equalities Act 2010 to ensure staff understood their responsibilities when supporting people.

Inspection areas



Updated 9 November 2016

The service was safe. Staff knew how to report concerns or allegations of abuse. People felt safe with the care and support provided and staff were clear about individual’s needs in relation to safety.

Individual risk assessments had been prepared for people and measures put in place to minimise the risks of harm.

Health and social care professionals associated with people’s care were consulted and referred to appropriately with regard to how risks were identified and managed in a way that promoted people’s development and independence.

There were sufficient staff available to meet people’s needs People tended to have the same care workers visit them to ensure continuity.

There were suitable arrangements to ensure medicines were managed safely, in line with the provider’s medicines policies and procedures.



Updated 9 November 2016

The service was effective. People were supported by staff that had the knowledge and skills to meet people’s needs.

Staff were supported via an induction programme, training and on-going supervision.

Most people were supported by their relatives to access their GP or other health services but staff were available to assist if it was required.

People were supported with their dietary needs and this was detailed in their care plans.

Staff had a good understanding of the Mental Capacity Act 2005 and how to support people using the principles of the Act.



Updated 9 November 2016

The service was caring. Positive, caring relationships had been developed with people, based on compassion and kindness.

Staff understood the importance of promoting independence and this was reinforced in peoples care plans. They outlined clearly what level of support was required by a person and how it should be delivered.

People were supported by staff as much as possible, who understood their individual needs in relation to equality and diversity.



Updated 9 November 2016

The service was responsive. People told us their care and support was flexible and staff went above and beyond to ensure their needs were met.

Assessments were undertaken to identify people’s support needs and care plans were developed outlining how these needs were to be met.

Care and support was planned proactively with people using the service and their relatives.

People and their relatives were actively encouraged to give their views and raise concerns about the service they were receiving.



Updated 9 November 2016

The service was well led. The management team provided outstanding leadership and in particular the registered manager was an excellent role model for staff at the service.

There was a positive, transparent and flexible culture at the service and the management team strived to recruit staff with the same shared values towards care in order to uphold the high quality support provided by the service.

There was a clear vision that underpinned practice. This included building relationship with people and families and ensuring care and support was always driven by what people wanted from the service and how they wished for it to be delivered.

There was a strong emphasis on continually striving to improve and this was reflected the introduction of a ‘client newsletter’ to ensure people were updated on organisational developments as well as encouraged to contribute.