Archived: Riverside House

Updated 7 January 2017

We undertook an unannounced focused inspection of Riverside House on 29 September 2016. This inspection was done to check that improvements to meet legal requirements planned by the provider after our 24 February 2016 and 27 May 2016 inspection had been made. We inspected the service against four of the five questions we ask about services: is the service safe, effective, responsive, and well led. This is because the service was not meeting some legal requirements.”

Prior to the inspection, we reviewed all of the information we held about Riverside House including any statutory notifications that the provider had sent us and any safeguarding information we had received. Notifications are made by providers in line with their registration obligations under the Care Quality Commission (Registration) Regulations 2009. They are records of incidents that have occurred within the service or other matters that the provider is legally obliged to inform us of.

We spoke with the local authority safeguarding adults team and the contracts monitoring team who informed us of the outcome of their own monitoring visits and we used this information to inform our planning of the inspection.

We spoke with the manager, regional manager, seven people who used the service, six care staff, four relatives, a cook, a district nurse and a member of the challenging behaviour team.

Updated 7 January 2017

Riverside House is a residential care home which provides accommodation and personal care for up to 46 people, some of whom are living with dementia. It is situated close to the centre of Morpeth, Northumberland.

The inspection took place on 29 September 2016 and was unannounced. We last inspected this service on 24 February and 27 May 2016 where two breaches of legal requirements were found. After the comprehensive inspection, the provider told us what they would do to meet legal requirements in relation to safe care and treatment and good governance. We undertook this focused inspection to check that they had followed their plan and to establish if they were now meeting legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Riverside House on our website at www.cqc.org.uk

There was no registered manager in post at this inspection, but a new manager had been appointed and was in the process of registering with the Care Quality Commission (CQC). 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 and associated Regulations about how the service is run.

At the last inspection, there were a number of safeguarding issues which were being investigated by the local authority. We received feedback from the local authority safeguarding and contracts teams prior to this inspection, and both departments reported that significant improvements had been made in respect of the service delivered.

We checked the management of medicines and found that these were being managed safely. We looked at medicine records and found that these were complete and legible. A pharmacist who provided support to the service following our last inspection, told us that the provider had made the necessary changes to systems and auditing processes to ensure medicines were administered safely.

During the last inspection we found high levels of agency staff were used and we recommended that this was kept under review. At this inspection we found that a number of new staff had been recruited and the use of agency staff had significantly reduced.

We checked the premises and found that new flooring had been provided and the odour issue evident at the previous inspection was significantly improved. There remained some mild malodour in one room but this was being addressed by the manager. A number of improvements to the environment were noted during this inspection. A room in the centre of the first floor had been refurbished to make a welcoming seating area with a television and comfortable chairs.

At the last inspection we found that suitable checks on the safety of the premises were carried out and that emergency contingency plans were in place. We did not look at all of these checks again during this inspection. All of the showers and the bath which had been out of order, had now been fixed, although the bath was temporarily out of use again as it was awaiting a new part and it was fixed the following day.

During this inspection we found that individual risks to people had been identified and plans were in place to address these. Risk assessments had been evaluated regularly. The sensor mats we saw which were in place to help to prevent falls, were plugged in and placed appropriately. Moving and handling assessments had been carried out and appropriate care plans were in place. Staff had received training in the safe moving and handling of people, as this had been a concern which was raised following our findings at our last inspection.

We found shortfalls in the recording of food and fluid intake at the last inspection, which meant it was difficult for staff to identify, and take steps to reduce the risk of malnutrition and dehydration. At this inspection we found assessments of the risks of inadequate dietary and fluid intake had been carried out, and care plans were in place. Food and fluid charts were completed, and there was a clear protocol to follow in the event that a person did not reach their target intake. Weights were recorded and monitored.

We checked people’s care records and found that people had been seen by a variety of health professionals. Bespoke training took place on the day of the inspection which was designed to assist staff in how to identify the causes of behavioural disturbance and distress, and support people at these times.

We saw an improvement in the standard of care planning documentation during this inspection, although this was work in progress. Detailed audits of care plans had taken place and managers were aware of areas that required further development and plans were in place to address these. There was also in improvement in care plan evaluation dates which we found were up to date.

A complaints procedure was in place, and there had been no formal complaints since the last inspection. A new manager was in post who was in the process of registering with CQC. They had previously worked in the service as a deputy manager and visitors and staff told us that they felt the appointment of the new manager, and input from regional managers, had resulted in improvements to the service. Staff also told us they thought that morale in the service was improving amongst staff due to consistent staffing and a period of stability in the management team.

We checked systems in place to monitor the quality and safety of the service. We found that governance arrangements had improved. The manager told us, and we observed, they had carried out regular checks, and daily management reports were submitted to the senior management team.

We have not changed the rating of the home at this inspection. This was because we wanted to be reassured that improvements made would be sustained over a longer period of time.