A single inspector carried out this inspection on 19 August 2014. As part of this inspection we spoke with the regional manager, a senior care worker, five members of staff and we reviewed information given to us by the provider. We spent time with people who lived at the home; they were relaxed and comfortable, and we saw that the staff had a good rapport with them. We also spoke with family members who were visiting a person who lived at the home. Below is a summary of what we found. The summary is based on our observations during the inspection, observations of people using the service, the staff supporting them and from looking at records. We used the evidence we collected during our inspection to answer the five questions.
Is the service safe?
From our observations and the information we saw in care plans, policies, procedures and audits, the provider's safety monitoring systems were adequate. Staff training records showed that the staff received training on safeguarding. The staff demonstrated that they knew the people well and had a clear understanding of their role in providing care and in safeguarding the people they supported.
We saw evidence that when people lacked the capacity to make decisions on important areas of their lives, best interests, safeguarding and deprivation of liberty discussions had taken place.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. The regional manager told us that there were no current safeguard orders in place for people who lived at Riverside. They said that the provider was in discussion with the local safeguarding service in the light of recent changes in legislation.
Staff showed people respect and maintained people's dignity at all times.
We last inspected this service on 12 November 2013. At that time the inspector found some areas of the home required urgent repair and refurbishment. At the time of our visit we saw that the provider had addressed the areas of concern and refurbishment work was being undertaken at the home to modernise some of the bedrooms, en-suite facilities and to replace area of floor covering. All the risk assessments and safety checks were in place and up to date. This meant that the building was safe and met the needs of the people who used the service.
The staff rotas showed that people's care needs were taken into account when making decisions about the number of staff required, the skills mix and experience. This showed that the staffing provision was safe and met people's support needs.
There were systems in place for management and staff to learn from events such as accidents and incidents, complaints, concerns and investigations. This meant that people were benefiting from a service that was taking on board lessons learnt.
Is the service effective?
People's care needs had been assessed and detailed care plans were in place. There was evidence that the people and/or their representatives were involved in the assessments of their needs and care plan reviews.
We saw that people's health care needs were continually assessed and included in care plans. Specialist health and social care professionals regularly provided care support to people at the service.
All care, activity and risk assessment plans were reviewed regularly. We saw that the people who lived at the home were supported to maintain their mobility and independence. We saw evidence in care plans and from talking with people who used the service that the care provided was being constantly adapted to meet people's needs.
Is the service caring?
The people we spoke with who lived at the home told us, they were very happy there. One person said, "The place is nice, I like it here." Another person said, "They all look after me and I have no complaints, I am happy." A family representative we spoke with said, 'The care is really good and the staff are excellent, they really look after 'x', we have nothing to worry about'.
The staff we spoke with told us they were committed to provide high standards of care for the people who used the service. They demonstrated they were aware of potential risks, people's rights and their responsibilities.
Is the service responsive?
We found that care plans were person centred and contained detailed information about people's choice and preferences. We saw that people's health and support plans were regularly updated to reflect people's changing needs.
There was regular support from external social care and health professionals when needed. This meant that people's health and welfare was regularly reviewed and monitored.
The people we spoke with who lived at Riverside said that staff were good and helped them. The family representative we spoke with said the staff were very good with their relative and the standard of care was very good.
The staff said they had training and help from colleagues which equipped them with the knowledge to meet the support needs of the people who used the service.
Is the service well-led?
When we visited Riverside the registered manager's post was vacant and a new manager was being recruited. We saw during our inspection that senior care workers provided leadership at the home. They demonstrated to us that they were continuing to provide a good level of service and support to the people who lived at Riverside during this period of change.
The staff we spoke with said that they had been supported by the regional manager, a temporary manager, and the deputy manager since the registered manager left their post. They said that they could contact a manager for advice and support. There were systems in place to provide feedback to staff about changes and developments.
All the staff we spoke with said they understood their responsibilities around safeguarding people's welfare. They were knowledgeable about all the people who lived at the home. They said that if they witnessed poor practice they would report their concerns.
The staff we spoke with said they had worked with the people who lived at the home for some time and really enjoyed their work. They told us that there was a good team spirit.