Archived: Riverside Residential Home

Updated 29 January 2019

This inspection took place on 13 December 2018 and was unannounced. The inspection team consisted of two adult social care inspectors and an expert by experience. The expert by experience on this occasion had experience of working in health and social care. One of the inspectors' also visited the home again on 14 December 2018. This visit was announced and was to ensure the manager would be available to meet with us.

Prior to our inspection visit we reviewed the service’s inspection history, current registration status and other notifications the registered person is required to tell us about. Notifications are when registered providers send us information about certain changes, events or incidents that occur within the service. We contacted commissioners of the service and the local authority safeguarding team to ascertain whether they held any information about the service. This information was used to assist with the planning of our inspection and inform our judgements about the service.

We used a number of different methods to help us understand the experiences of people who lived in the home. We spent time in the lounge and dining room areas observing the care and support people received. We spoke with six people who were living in the home and five visiting relatives. We also spoke with the operations manager, manager, three senior care workers, five care workers, the activity organiser, a member of the housekeeping team and briefly, to two agency workers and a visiting health care professional. We reviewed three staff recruitment files, we looked at five people’s care plans in detail and a further three care plans for specific information. We looked also looked at nine people’s medication administration records and a variety of documents which related to the management and governance of the home. Following the inspection we spoke with a further external health care professional.

Updated 29 January 2019

The inspection of Riverside Residential Home took place on 13 and 14 December 2018. We previously inspected the service in March and April 2018, at that time we found the registered provider was not meeting the regulations relating to person centred care, dignity and respect, safe care and treatment, nutrition and hydration, staffing and good governance.

We rated them as requires improvement. The purpose of this inspection was to see if significant improvements had been made and to review the quality of the service currently being provided for people.

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

Riverside Residential Home accommodates a maximum of 50 people; there are two separate units providing accommodation and communal areas, all on the ground floor. The home provides care and support to people who are assessed as having personal care and support needs. Oakwell unit provides care and support to people who are living with dementia. There were 29 people living at the home at the time of the inspection.

The service had a registered manager in place; they were no longer working at the home but had yet to submit their application to the Care Quality Commission to de-register. 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. A new manager had been in post since August 2018, they told us they had begun to complete their application for registration.

Relatives felt their family members were safe.

Care records contained a variety of risk assessments. Where a risk was identified, action was taken to reduce the possibility of future risk.

There was a system in place to ensure the premises and equipment were safe, although we identified two hoist slings which had not been checked in line with current regulations. Fire doors between a corridor and a dining room were wedged open by staff at mealtimes.

The recruitment of staff was safe and there were sufficient staff to meet people’s needs.

Staff who were responsible for the administration of people’s medicines were appropriately trained. Medicines were stored and administered safely. Improvements were needed to the management of creams, the recording of medicine patches and staff’s understanding of the electronic system for managing stock.

Improvements had been made to the cleanliness of the home although we identified three pressure cushions which were soiled and a bedroom which was malodourous.

New staff received an induction although we found some induction records had not been fully completed. There was an ongoing programme of training and management supervision.

People had a choice of food at each meal, staff supported people to choose the meal they wished to eat. Snacks and drinks were available although on the residential unit people did not get a hot drink until 11.30am following breakfast. At tea time, on the residential unit, people were not offered the opportunity to sit at a dining table to eat.

There was a daily ‘flash’ meeting for staff from each department within the home. A daily handover was also provided for staff before they commenced their shift, although not all care workers were present when this began therefore they missed some of the information.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Where people had capacity to consent to the care and support they received, we saw consent forms had not been signed.

People told us staff were caring and kind. It was clear from our conversations with staff, they knew people well. Staff treated people with dignity and respect although there were occasions when people’s confidential information was not kept secure.

An activities organiser was in post. On the day of the inspection two people went out on a trip to a garden centre. In the absence of the activity organiser, there was minimal activity to engage people.

The home was in the process of implementing an electronic system for all aspects of care. The previous paper care records were detailed and person centred but we found the new electronic care records lacked detail. Care records included information about people’s end of life wishes.

Complaints were recorded but we noted the long-term management plans to address one complaint had not been followed.

Feedback at this inspection from people, relatives & staff was positive.

Audits and quality monitoring visits by senior managers were undertaken at regular intervals. Concerns were added to the homes action plan. However, we found the audits had not identified the issues we have raised within this report. We also found some issues that had been addressed on the action plan were still a concern at the inspection. This meant not all changes were fully embedded.

This is the third time the service has been rated Requires Improvement.

We found a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.