We carried out a review of the data available to us about Rivers Reach on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Rivers Reach, you can give feedback on this service.
Rivers Reach is a care home. Rivers Reach is registered to provide accommodation and personal care for up to five people and predominantly supports people living with a learning disability and mental health needs. At the time of the inspection there were three people living at the service.
The care provider is a national care organisation with locations of care homes across England.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles 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. There were deliberately no identifying signs outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to gain new skills and become more independent. People were actively supported to participate in activities of daily living.
People told us they were happy living at Rivers Reach and felt supported to live their lives. One person told us, “I love living here, it is the best.”
Staff were committed to delivering care in a person-centred way based on people's preferences and wishes. The staff team were knowledgeable about the people living at the service and had built trusting and meaningful relationships with them.
People were cared for in a way that respected their privacy, dignity and promoted their independence. Staff supported people to access the community for social opportunities and voluntary employment.
The provider had systems in place to encourage and respond to any complaints or compliments from people or those close to them. There was regular involvement by families and relatives and external services.
People received the support of external health and social care professionals when required and the service worked in partnership with external professionals, acting on guidance and advice where needed.
Staff were recruited safely, and sufficient numbers were employed to ensure people's care and social needs were met. Staff knew how to keep people safe from harm.
People received their medicines safely and as prescribed. Appropriate arrangements were in place for obtaining, recording, administering and disposing of prescribed medicines.
Staff had received appropriate training and support to enable them to carry out their role safely.
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.
There was a clearly defined management structure and regular oversight and input from senior
management. Staff were positive about the management of the service and told us the registered manager was very supportive and approachable. Any concerns or worries were listened to, addressed and used as opportunities to make continuous improvements to the service.
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 18 January 2017). At this inspection the service remains Good.
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rivers Reach on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Rivers Reach provides accommodation and personal care for up to five people who have learning disabilities. The service is located in Titchfield, Hampshire. At the time of our inspection five people were living at the service.
There was a registered manager in place who had been registered with the Care Quality Commission since 2007. A registered manager is a person who has registered with the Care Quality Commission 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.
Risks to people arising from their health and support needs and the premises were assessed, and plans were in place to minimise them. Risk assessments were regularly reviewed to ensure they met people’s current needs. A number of checks were carried out around the service to ensure that the premises and equipment were safe to use.
There were systems in place to ensure that people received their medication as prescribed.
Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Staff told us they received training to be able to carry out their role. Staff were given effective supervision and a yearly appraisal.
Staff understood safeguarding issues, and felt confident to raise any concerns they had in order to keep people safe.
Staff received training to ensure that they could appropriately support people, and the service used the Care Certificate as the framework for its training. The Care Certificate is an identified set of standards that health and social care workers adhere to in their daily working life. It sets out explicitly the learning outcomes, competences and standards of care that will be expected. Staff had received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) training and clearly understood the requirements of the Act which meant they were working within the law to support people who may lack capacity to make their own decisions. The registered manager understood their responsibilities in relation to the DoLS.
People were supported to maintain a healthy diet, and people’s dietary needs and preferences were catered for. People told us they had a choice of food at the service, and that they enjoyed it.
The service worked with external professionals to support and maintain people’s health. Staff knew how to make referrals to external professionals where additional support was needed. Care plans contained evidence of the involvement of GPs, district nurses and other professionals.
We found there was sufficient staff on duty to support people with their assessed needs and to sit and chat with them. The interactions between people and staff were cheerful and supportive. Staff were kind and respectful; we saw that they were aware of how to respect people’s privacy and dignity. People and their relatives spoke highly of the care they received.
Procedures were in place to support people to access advocacy services should the need arise. One person who used the service advocated against crime, hate and bullying by speaking publically at meetings and conferences.
Care was planned and delivered in way that responded to people’s assessed needs. Plans contained detailed information on people’s personal preferences, and people and their relatives said care reflected those preferences. Care plans were regularly reviewed to ensure they met people’s current needs.
People had access to a wide range of activities, which they told us they enjoyed.
The service had a clear complaints policy that was applied when issues arose. People and their relatives knew how to raise any issues they had.
Staff were able to describe the culture and values of the service, and felt supported by the registered manager in delivering them.
The registered manager and registered provider were a visible presence at the service, and were actively involved in monitoring standards and promoting good practice. Feedback was sought from people, relatives, external professionals and staff to monitor and improve practice. The service had quality assurance systems in place which were used to drive continuous improvements.
We also used this inspection to answer our five key questions; is the service safe, effective, caring, responsive and well-led?
Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service and the staff told us.
Is the service safe?
Individualised care plans detailed the support and care each person required. People confirmed they received the support and care they needed and liked. The home ensured relevant health care professionals were contacted when needed.
The manager and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). At this time no applications had needed to be submitted. Guidance was readily available to support the manager should an application need to be made in the future. The manager told us they regularly checked practices to ensure they did not restrict people in any way. This meant that people were safeguarded as required.
People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We saw the home completed a weekly and monthly audit whereby they checked the stock levels and expiry dates of the medication on site.
Rivers Reach had a recruitment process in place which showed relevant checks were carried out before a person commenced employment.
Is the service effective?
We observed people being offered choices as to when they received support with their personal care and what they wanted to eat for lunch. Staff were observed to support people in a calm and respectful manner. People told us they were involved in decisions about how they were looked after and had choices about how they wished to spend their day.
Staff were knowledgeable about people's personal, behavioural, social and health needs. Staff had signed to confirm they knew the content of people's plans of care and how to put the care plan guidelines into practice.
Is the service caring?
People living at Rivers Reach were very positive about the staff and management.
We saw that people were supported by staff who were kind and attentive. Staff showed patience and gave encouragement when supporting people. They were aware of people's needs and the preferences of people they cared for in how people wanted care to be delivered.
Is the service responsive?
We saw that care plans were reviewed monthly and amended as needs changed.
Records showed that people who used the service were encouraged to be active and be part of the local community. People were able to engage in a wide range of activities.
People said that they had no complaints about the service and that if they did they would speak to the staff or the manager.
Is the service well led?
The home was well managed and there were clear lines of leadership in place, meaning the home was organised and communication was effective.
Annual surveys were sent out to stakeholders including, professionals, staff, people who used the service and their families.
All staff received supervision once every two months and annual appraisals. Staff performance issues were discussed and training needs were identified.