The Rivers

Updated 11 April 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Inspection team:

The inspection was carried out by one adult social care inspector.

Service and service type:

The service is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulated both the premises and the care provided; both were looked at during this inspection.

The home accommodates six people in one adapted building. At the time of the inspection, six people were living in the home.

The service had been developed and designed in line with the principles and values that underpin Registering the Right Support (RRS) and other best practice guidance. This legislation ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The provider was following the principles of the RRS, which reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

Notice of inspection:

This inspection was unannounced.

What we did:

Due to technical problems, the provider was not able to complete a Provider Information Return. This is information providers must send us to give us key information about the service, what it does well and improvements they plan to make. We took the lack of a PIR into account when we inspected the service and made the judgements in this report.

We spoke with two people, one relative, staff and healthcare professionals to help form our judgements. We were unable to speak with some people using the service due to their highly complex needs. We therefore observed the care and support provided and the interaction between staff and people using the Short Observational Framework for Inspection (SOFI). This is a helpful tool to use if we are unable to find out people’s experiences through talking to them, for example if they have dementia or other cognitive impairments.

We spoke with the registered manager, four staff members and one visiting professional. We looked at the following records:

• three people’s care records and associated documents

• three staff files

• previous inspection reports

• staff rotas

• staff training and supervision records

• health and safety paperwork

• accident and incident records

• statement of purpose

• complaints and compliments

• minutes from staff meetings

• a selection of the provider’s policies

• quality audits

• fire risk assessments

• infection control records.

Before our inspection we reviewed all of the information we held about the home, including notifications of incidents that the provider had sent us.

After the inspection, we contacted four healthcare professionals for their views of the service, two of whom replied to us.

Updated 11 April 2019

About the service:

The Rivers is a residential care home that was providing accommodation and personal care to six younger adults with a learning disability or autistic spectrum disorder. The service was registered to care for six people.

The Rivers is a ‘care home’. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and care provided, and both were looked at during this inspection.

People’s experience of using this service:

• Although the registered manager ran a well organised service, the providers audits had not identified the registered manager had not notified CQC when Deprivation of Liberty Safeguards (DoLS) applications had been authorised. During the inspection we spoke with the registered manager to ensure CQC was notified in these cases.

• The provider sought the views of people’s relatives and took opportunities to improve the service. Staff were supervised, supported and clear about what was expected of them. Audits and checks were carried out, so any problem could be identified and rectified.

• The provider had processes in place for recruitment, staffing levels, medicines management, infection control and upkeep of the premises which protected people from unsafe situations and harm.

• Staff understood their responsibilities to protect people from abuse and discrimination. They knew to report any concerns and ensure action was taken. The registered manager worked with the local authority safeguarding adults team to protect people.

• Staff were trained and supported to be skilled and efficient in their roles. They were very happy about the level of training and support they received and showed competence when supporting people.

• The premises provided people with a variety of spaces for their use with relevant facilities to meet their needs. Bedrooms were very individual and age and gender appropriate.

• Staff promoted people’s dignity and privacy. Staff provided person-centred support by listening to people and engaging them at every opportunity. Staff were very kind and caring and people using the service were calm.

• Support plans were detailed and reviewed with the person when possible, staff who supported the person and family members. Staff looked to identify best practise and used this to people’s benefit. Staff worked with and took advice from healthcare professionals. People’s health care needs were met.

• People had a variety of internal activities (such as music and cooking) and external activities which they enjoyed on a regular basis.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidelines. 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.

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

Rating at last inspection:

At the last inspection the service was rated Good (21 September 2016). At this inspection, the overall rating has remained the same.

Why we inspected:

This was a planned inspection to confirm that this service remained Good.