Rivermere Retirement and Care Home

Rivermere Retirement and Care Home is a residential care home providing personal care and support for up to 102 older people. At the time of the inspection there were 47 people living in the service. A number of double rooms are available for partners or people who chose to share, some with kitchenettes and living rooms.

The home has two separate units, one of which is for people living with dementia. There were communal areas in each unit for people including activity lounges, café and cinema room.

Rivermere Retirement and Care Home is managed by Willowbrook Healthcare Limited (which is part of the Brand Avery) under licence from WT UK Opco 2 Limited.

People’s experience of using this service

People and their relatives told us that the service was well run and that they would recommend it to other people. One person told us, “They put their residents first. She has developed a nice relationship with the staff”; and “The care my mother receives at the home gives her a good quality of life”.

Improvements had been made to medicines management and staff consistency. Previous recommendations in relation to creams and lotions had been implemented. There were enough staff available to meet people’s needs. Regular agency staff had developed in staff teams, so everyone knew people well. Staff continued to receive training that ensured they were skilled and competent to meet people's needs. There were opportunities for staff to develop their skills through qualifications. Staff were supported through supervision meetings and team meetings

Risks to people's safety had been assessed and minimised to eliminate avoidable harm. The premises and equipment had been well maintained and there were effective systems in place to respond to emergencies.

The service was kept clean and staff followed national guidance to reduce the risk of infection.

People had enough to eat and drink to meet their needs and they were enabled to make choices about their

meals. Health professionals were contacted for advice when there were changes in people’s weights.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 28 January 2018).

Why we inspected

We undertook this targeted inspection to check specific concerns we had received about staffing levels, risk management, infection control, nutrition and the overall management of the service. The overall rating for the service has not changed following this targeted inspection and remains Good.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service is required to have a registered manager as part of the conditions of their registration. A registered manager is a person who has registered with the CQC 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. Willowbrook healthcare had a registered manager in post who was registered with the Care Quality Commission (CQC). WT UK Opco 2 ltd did not have a registered manager in post who was registered with the Care Quality Commission (CQC). However, in terms of day to day management of the service there was a registered manager in post. WT UK OPCO ltd took steps, following the inspection, to resolve this issue.

This inspection was carried out on 18 October 2017. The service was registered to provide accommodation with care to older people and those living with dementia. At the time of our inspection there were 49 people using the service. The service was structured into two units. The assisted living unit was located across two floors for older people and the memory care unit was located on the top floor for those who were living with dementia. There were 13 people living on the memory care floor.

This was the first inspection of this registered provider since they were registered for this location.

People told us they felt safe using the service and had their needs met. Staff knew what action they needed to take to keep people safe. Risks to people’s safety had been assessed and minimised to eliminate avoidable harm. One potential safeguarding matter had been reported through the complaints procedure rather than using the safeguarding policy. This was resolved during the inspection. We made a recommendation about this for future practice. The premises and equipment had been well maintained and there were effective systems in place to respond to emergencies. The service was kept clean and hygienic to reduce the risk of infection. People were supported to manage their medicines safely. We made a recommendation about the system for disposing of topical medicines (creams and lotions).

There were enough staff working in the service to meet people’s needs. There were staff vacancies in the service that were being covered by agency staff. The registered manager had an ongoing recruitment plan to fill the vacancies. We made a recommendation about this. Staff recruitment procedures were robust and ensured that staff were safe and suitable to work in the service. Staff received training that ensured they were skilled and competent to meet people’s needs. There were opportunities for staff to develop their skills through qualifications. Staff were supported through supervision meetings and team meetings.

People had enough to eat and drink to meet their needs and they were enabled to make choices about their meals. They had care plans that ensured their health needs were met. People were supported to access relevant healthcare professionals and advice given was followed by staff.

People were asked for their consent to care before it was provided. Where people lacked capacity to make their own decisions the principles of the Mental Capacity Act 2005 were followed. People’s right to liberty was upheld and staff understood their responsibilities to ensure people’s human rights were upheld. The service had an effective policy for ensuring care provided did not discriminate in any way.

People received flexible and personalised care. They had been involved in developing and reviewing their care plans. People told us that their care was based around their preferred routines. Consideration had been given to the specific needs of people living with dementia when developing care plans and when planning the environment.

People told us they knew how to raise concerns about their care and they felt confident they would be listened to. There were a number of ways that people were supported to have their say about the service. The registered manager had responded appropriately to concerns, complaints and comments.

The registered manager and the registered provider had effective systems for monitoring the quality and safety of the service. They understood the risks and challenges the service faced and had a clear strategy to ensure continuous improvement of the service.