River View is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home provides accommodation for up to three people with a learning disability. On the day of our inspection there were three people using the service.The home is a semi-detached house that has been adapted to meet the needs of the people living there. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The service had a registered manager in place, who were responsible for two locations owned and run by the provider. A registered manager is a person who has registered with the Care Quality Commission (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. Both locations are adjoining each other and the larger property River Cottage is used to store some records relating to the staff team at River View.
River View was last inspected by CQC in March when the service was rated as Good. At this inspection we found the service remained Good and met all the fundamental standards we inspected against.
At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service Good.
Family members told us they felt their relatives were safe and there were sufficient staff to meet people's needs. There was now a more stable staff team following recruitment and we saw that people were supported by a consistent staff team.
Medicines were safely stored and the registered manager immediately addressed two minor issues we found in relation to medicine records.
People had risk assessments that described the measures and interventions to be taken to ensure people were protected from the risk of harm. The records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary, for example: their GP and care manager.
Staff told us they felt well supported in their role; they received induction and training. Staff had not always received supervision in 2017 due to management changes at the service but we saw from the start of 2018 with a new registered manager and team leader recruitment that supervision occurred regularly and was planned for the rest of the year.
People had choice and control of their lives and staff supported them in the least restrictive way; the policies and systems in the service supported this practice.
Staff were aware of the importance of supporting people with good nutrition and hydration. Staff told us they supported them to eat healthily and reduce weight where this was a concern. We saw that people were encouraged to shop for and prepare their own meals with staff support.
People had access to healthcare services, in order to promote their physical and mental health. We saw that people were supported to have annual health checks and to attend health screening appointments.
The premises were homely and suitable for people's needs. People were involved in decisions about the decoration and the provider had taken steps to make the environment more accessible in response to changes in people's needs. The environment and equipment was regularly checked and serviced.
There were detailed, person-centred care plans in place, so that staff had information on how to support people. ‘Person-centred’ is about ensuring the person is at the centre of everything and their individual wishes, needs, and choices are taken into account.
People were able to take part in a range of activities of their choosing and which were meaningful to them. People were supported to look for volunteering roles and training to support them to develop the skills for employment. People were supported to play an active role in their local community, which supported and empowered their independence.
There was a complaints procedure in place, should anyone wish to raise a complaint. There were opportunities for people to raise concerns through meetings and discussions with the staff team. Staff knew how to access advocacy services if they needed them.
There was a quality assurance system, which enabled the provider to monitor the quality of the service provided.
We received positive feedback about the registered manager, staff and the service as a whole. Comments from people, relatives, staff and other professionals indicated there was a positive, person centred culture within the service.