Riverside

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. At our last assessment, under the previous provider registration we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 62 (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 supported effective care and treatment by assessing and reviewing people’s health, care, wellbeing, and communication needs with them. However, this was not always done consistently.

Assessments of need, including risk assessments, were in place but improvements were needed to ensure these were effectively reviewed and involved people and their families consistently in the review process.

The provider did not always plan and deliver care and treatment in partnership with people, including considering what was important and mattered to them.

It was not always evident that evidence-based care was being delivered. For example, in supporting people at risk of weight loss, records did not demonstrate that dietitian advice was being followed. There were no clear records showing that snacks were offered throughout the day, although we observed that meals and snacks were regularly provided. Similarly, there was no documented evidence that food was being fortified with extra calories where this had been recommended.

Despite these gaps in documentation, most people were happy with the support they received to eat and drink, and people’s weights were generally stable.

The provider worked well across teams and services to support people, ensuring that individuals only needed to tell their story once by sharing assessments of need when people moved between services.

We observed that staff generally worked well together. However, further work was needed to ensure a more consistent approach to aspects of care and record keeping across the different units. Visiting professionals were supported by staff who knew people well, and medical attention was sought when people showed signs of being unwell.

The provider did not always support people to manage their health and wellbeing, which meant individuals could not always maximise their independence, choice, and control. Staff did not consistently support people to live healthier lives or, where possible, reduce their future care and support needs.

Although healthcare advice was sought, there was limited evidence to show that this advice was consistently followed. Care plans and daily notes lacked sufficient detail and were not always completed contemporaneously. For example, repositioning records were not completed at the time care was delivered, making it unclear whether people consistently received the correct level of care. However, wounds generally appeared to be well managed.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations, and the expectations of people themselves.

Staff knew people well and were able to identify when people were becoming unwell. We observed medical advice was sought where needed. However, as records were not being maintained contemporary, we could not be certain that accurate records were being completed and any decline in health would be noted on review of these records.

It was not always evident that appropriate action had been taken to review care delivery in response to change, such as following a fall. However, from discussion with staff and observation, it appeared staff were supporting people appropriately and equipment was implemented where it was needed.

The provider informed people about their rights around consent and respected these when delivering person-centred care and treatment.

Consent was generally sought by staff before providing care. Where people lacked capacity, appropriate mental capacity assessments and best interest decisions were made, involving relevant individuals in decisions, including those related to consent to care and the use of equipment. However, we found some shortfalls in how the requirements of the Mental Capacity Act were applied in relation to covert medicines. This is discussed further in the 'Safe' section of this report.