Riverside View Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last inspection we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Accidents and incidents were recorded, monitored and analysed to reduce the risk of reoccurrence, such as implementing equipment to reduce the risk of people falling. The registered manager identified trends or lessons learned and communicated those with staff. A health professional told us, “The home makes appropriate referrals to the right health professionals to assess residents and inform their care. Following incidents, they seek relevant professional assessment. I have observed them following correct moving and handling techniques and using available equipment to move residents.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. However, they didn’t always make sure there was continuity of care, including when people moved between different services. During the second site visit we identified 2 people’s hospital passports that were not up to date and did not reflect the individual’s care and support needs. Hospital passports are used to share crucial information with other services, such as hospitals, in the event of a person being transferred.

We discussed this with the registered manager who took the necessary action to review every person’s hospital passport and make sure they were updated to reflect their care and support needs. They also informed that they would discuss with all staff responsible for reviewing care files and ensure they always include hospital passports within those reviews going forward, to mitigate future risk.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff supported people to keep them safe. A person told us, “I am safe, yes of course. The care is very good, they (Staff) look after you, any problems they sort them out. They try to make you better.”

Staff knew people well, had completed appropriate training and were aware of how to report any safeguarding issues or concerns. A staff member commented, “It is a way of making sure people are safe from any abuse. If I suspected someone (experiencing) abuse and needing safeguarding, I would report it straight away to the manager.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff assessed and managed risks to people’s health, safety and wellbeing effectively. A relative told us, “They (Staff) noticed [Person] was struggling (to swallow their food). They picked up on it and the SALT team came, wonderful.”

People’s care records contained detailed risk assessments which supported staff to meet

people’s needs whilst minimising the risks.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The premises were safe. There were environmental risk assessments in place including fire, and regular checks and testing of the premises and equipment.

Fire escape routes were mainly free from obstruction. During the first site visit we observed a lever arch file, mobile heater and barrow trolley in one area. We informed the registered manager who took immediate action to remove those items and follow up with staff during the daily flash meeting the following day. However, during the third site visit we observed a lever arch file and mobile heater in the same area again. We discussed this with the registered manager and regional manager, who immediately addressed this with the staff member and arranged for the items to be removed. The registered manager informed they would update their daily walk around audit to specifically include checking fire escape routes, to ensure they remain clear going forward.

People had personal emergency evacuation plans in place that reflected their needs and a grab bag was up to date and accessible to staff in the event of a fire.

The provider did not always make sure there were enough staff to meet people’s needs. We received mixed views from people, relatives, staff and health professionals in relation to staffing levels in the home. People told us, “I use the call bell. It depends if they (Staff) are busy (how long I wait), I don’t complain. They can be pushed dealing with other people; I wait about five minutes. They are very good,” and, “The care is pretty good but they could with more staff. It is hard on the staff and patients as we are not attended to quickly.During the night it is difficult, with so few staff and I make frequent trips to the toilet in the night.”

Health professionals commented, “I do feel that some of the residents have very challenging behaviour and sometimes it feels like there is not enough staff present on the floor,” and, “There are always staff around when we visit. I have to speak with a senior as I need access to the medicines for the people I'm here to visit and they are always available and helpful.”

The registered manager used a dependency tool to determine staffing levels required in the home which took into consideration their dependency needs around all aspects of their care.

Staff told us they received a comprehensive induction when they started employment and felt supported in their roles. A staff member said, “I feel very supported in my role by all staff and management. All are very approachable, and it is important to work as a team. I receive regular appraisals and supervisions, but you don’t have to wait until then if you have any concerns. You can raise them at any time.”

Staff were recruited in a safe way and records confirmed staff had received up to date training, regular supervisions and annual appraisals. The registered manager regularly monitored this to ensure staff were supported in their roles and were equipped with the correct skills and knowledge, to carry out their roles.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff wore appropriate PPE and most staff followed infection prevention and control guidance at all times when supporting people. During site visits we identified 3 staff members who were not ‘bare below the elbow’. We raised this with the registered manager who immediately addressed this with the individual staff members. The registered manager confirmed they had updated their daily walk around document to include checking that staff were bare below the elbow going forward.

The home was found to be clean and tidy. Domestic staff were visible around the home, on both floors cleaning all areas including frequently touched surfaces.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were administered and managed safely. Topical medicines and patches were applied as prescribed and were recorded with sufficient detail. Guidance around ‘when required’ medicines contained sufficient detail to inform staff how, when and why to administer them.

During third site visit we found a small number of medicines that did not have a date of opening recorded on them. We discussed this with the deputy manager who took immediate action to resolve this matter. They also discussed this with senior staff, emphasising the importance of always recording the date of opening on all medicines.

There was no identified impact on people in relation to these issues and there were no other issues identified in relation to medicines. Staff had received up to date medicines training and regularly had their competence assessed. Regular medicine checks and audits were carried out to identify any errors and take appropriate action.