8 September 2022
During an inspection looking at part of the service
Riverside Nursing Home is a residential care home providing personal and nursing care for people aged 65 and over, including people living with dementia. The service is registered to support up to 39 people. At the time of the inspection there were 29 people living at the service.
People’s experience of using this service and what we found
The provider, current management team and the staff team had clearly worked hard to improve the service. Many planned improvements were ongoing.
The provider did not consistently assess, mitigate and monitor the risks people faced to their health and wellbeing.
People’s care needs were assessed. Care was planned, but people’s care plans were not always followed by staff.
The governance systems had been significantly improved however they were not entirely effective and had not identified some shortfalls found at this inspection. We have made a recommendation about reviewing the governance systems currently in use.
People’s medicine management was safe. However, improvements were needed to ensure there were clear instructions for staff to follow in relation to ‘as and when required’ medicines and to ensure medicines had been dated when opened.
Risks relating to infection prevention and control (IPC), including in relation to the COVID-19 pandemic, were assessed and managed. Staff followed recommended IPC practices and safe visiting was supported.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests.
People felt safe and were comfortable and relaxed with staff who supported them. Relatives told us they felt their family members were safe and overall were well cared for. Throughout both inspection visits there were kind and caring interactions between staff and people.
There were enough staff to meet people's needs. The staff team knew people well and they were recruited safely. Staff training and support had been improved. Staff morale and teamwork were good.
Relatives expressed concern about changes in management. They felt the home needed more stability over a period of time. Relatives also had mixed views on involvement, such as knowledge of care plans or in giving feedback about the home. Relatives were generally happy with care provided overall.
There was an open, improving culture being created within the home. People, staff and relatives told us both the management team and staff team were open, approachable and helpful.
The provider, service manager, care consultant and nursing staff all took action in response to our feedback and findings during our visits.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 23 February 2022) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained requires improvement based on the findings of this inspection.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have found breaches in relation to risk management and care planning at this inspection. Please see the safe and effective sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Riverside Nursing Home on our website at www.cqc.org.uk.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.