Riverside View Care Home

Riverside View Care Home is a residential care home providing personal care to up to 59 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 34 people using the service.

People’s experience of using this service and what we found

Medicines were not always managed safely and effectively. We could not be sure that people received their topical medicines or patches as prescribed, guidance for staff on how to administer ‘when required’ medicines lacked detail, and records relating to the administration of ‘when required’ medicines and prescribed thickeners for drinks were not always complete.

The provider did not have a consistently robust governance system in place. Medicines audits had not identified the areas for improvement we found during this inspection. The management team were responsive to our feedback during the inspection and took immediate action to address issues raised.

A registered manager was not in post. The deputy manager had been managing the home recently, with support from the provider’s regional manager and a consultant appointed by the provider. Since the inspection, the provider advised us that a new manager had been appointed and they would be applying to the Care Quality Commission to become the registered manager in due course.

People told us they felt safe living at Riverside View Care Home and they were happy with the care they received. The home was clean and tidy. There were mostly appropriate infection control practices in place, although we saw a small minority of care staff were not ‘bare below the elbow’ (which is good practice for effective infection prevention and control).

Staff were aware of safeguarding arrangements and knew what action to take to keep people safe. Risks to people were identified and detailed assessments were in place, to ensure risks were managed safely. Health and safety checks were up to date. There were enough staff to meet people's needs. Staff were recruited safely and appropriate checks were carried out.

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; the policies and systems in the service supported this practice.

Staff worked effectively alongside other health and social care professionals to ensure people's needs were met and their health was promoted and maintained. There was a positive atmosphere at the home.

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 15 March 2023).

Why we inspected

We received concerns in relation to safeguarding, falls management and medicines administration. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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.

The overall rating for the service has changed from good to requires improvement, based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Riverside View Care Home on our website at www.cqc.org.uk.

Enforcement

We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to medicines management during this inspection.

Please see the action we have told the provider to take at the end of this report.

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.

Riverside View Care Home is a residential care home providing personal care to up to 59 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 55 people using the service. People are supported in 1 adapted building across 2 floors.

People’s experience of using this service and what we found

People told us they felt safe. Risks to people were appropriately assessed and managed. Detailed guidance was available for staff to help them reduce risk to people. Medicines were managed safely, and people received their medicines as prescribed. There were enough staff to keep people safe and staff were recruited safely. The home was clean and tidy and robust infection control procedures were in place.

People’s needs and preferences, including their cultural, religious and ethical requirements were assessed and catered for. People’s individual dietary needs were met. Staff received appropriate training and supervision to ensure they were competent in their roles. Staff worked well with other agencies and healthcare professionals and made timely referrals when needed. The service was designed and decorated in a way which met people’s needs.

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; the policies and systems in the service supported this practice.

People’s care and support plans were person-centred. Staff were knowledgeable about people’s likes and dislikes. People’s communication needs were assessed, and information was available in different formats. People were supported to maintain relationships and take part in activities which were relevant to them. Procedures were in place to ensure any concerns were dealt with appropriately.

Regular quality assurance audits were carried out. The provider and manager were committed to continuous improvement. Lessons learnt were shared with staff. The atmosphere was warm and inviting and there was a person-centred culture.

There had been some recent management changes and this, along with staffing difficulties, had resulted in low staff morale. The provider and manager assured us staff would be supported through ongoing changes and additional staff had been recruited. There were regular meetings for people who used the service and feedback was also sought through questionnaires. Positive feedback was received about the acting manager.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 27 October 2021) and there were two 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 improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended that the provider reviewed best practice guidance around ‘when required’ and variable dose medicines. At this inspection we found improvements had been made around ‘when required’ medicines but further improvements were needed around variable dose medicines. The provider took action immediately following our feedback.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe, Effective, Responsive and Well-led which contain those requirements.

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 changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Riverside View Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Riverside View Care Home is a residential care home providing personal care to up to 59 people, some of whom are living with dementia. At the time of the inspection there were 56 people using the service.

People’s experience of using this service and what we found

Care files did not always have sufficient information to help staff support people safely. We found no evidence that people had been harmed, however, we identified omissions around diabetes, religious and cultural needs, and behaviours which may challenge others.

Senior staff did not always robustly assess, explore or cater for people’s religious, cultural or ethical needs.

People received their medicines as prescribed. However, records for ‘when required’ medicines were not completed fully, and there was a lack of guidance for staff around variable dose medicines. We have made a recommendation around medicines.

Quality assurance was not always effective. Audits had not identified the issues we found, including the omissions in care files, failing to meet people’s religious and cultural needs, and the issues around ‘when required’ and variable dose medicines.

Accidents, incidents and concerns were recorded and investigated. Effective safeguarding systems and procedures were in place. People told us they felt safe. There were enough staff on duty and staff were suitably recruited. Staff had the right skills and training to effectively care for people. The provider had robust procedures and systems in place for preventing and controlling infection.

People were supported to eat and drink enough and were offered help where needed. Staff supported people with their health needs and made appropriate, timely referrals to external health professionals. The design of the premises had been adapted to meet people’s needs.

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; the policies and systems in the service supported this practice.

Staff treated people with kindness, dignity and respect. People were involved in making decisions about their care and encouraged to express their views. People were given choice and staff spoke of the importance of this.

People were given information in a way which they could understand, and technology was used to aid communication. Staff supported people to build and maintain relationships to minimise social isolation. People were supported to take part in activities. There was a complaints policy in place and people felt confident that any concerns would be dealt with. End of life care plans were in place and people were supported to express their wishes about the future.

The service understood its regulatory responsibilities. The service had an open, positive culture and staff told us the service was well-led and they were supported. The registered manager encouraged feedback and staff had regular supervisions and appraisals. The service was receptive to our feedback and immediately took steps to resolve the issues we found.

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

Rating at last inspection

This service has changed provider. The last rating for the service under the previous provider was good (published 3 January 2019).

This service was registered with us with the new provider on 6 August 2020 and this was the first inspection under the new provider.

Why we inspected

This was a planned inspection to assess the standard of care delivered by staff and award a rating.

We have found evidence that the provider needs to make improvements. Please see the full report for more details.

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.

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.

We have identified breaches in relation to person centred care and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.