Riverview

Updated 3 March 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 15 February 2021 and was announced.

Updated 3 March 2021

About the service

The service was a large home, bigger than most domestic style properties. Riverview is registered to provide accommodation and personal care for up to nine young adults with learning disabilities, and at the time of our inspection there were nine people living there. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the layout of the service. This consisted of six self-contained flats and two rooms.

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.

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

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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 for them to gain new skills and become more independent.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. In 2017 Riverview won a national best practice award for using innovative ways to reduce physical intervention and increase positive outcomes for people. The service used a PBS (positive behaviour support) approach which recognised the impact the environment and negativity had on people’s behaviour, and enabled staff to build a bespoke personalised environment for the individuals they were supporting. This had greatly reduced the stress and anxiety levels of people living at Riverview. Incidences of behaviour that challenges had reduced, and PRN (as and when required) medication had been required on just one occasion in the previous 12 months. A thorough analysis and investigation was completed if things went wrong, and any learning used to further reduce the risk of harm to people.

Without exception, people were supported to achieve their goals. The staff and management team were creative, committed and determined to support people to live independent lives and challenge the barriers to people with autism. The service promoted positive outcomes for people through positive risk taking. As a consequence, people were engaging with their families and local community, and achieving goals which had previously been unthinkable for them.

People were valued and placed at the centre of the service. Staff promoted their privacy and dignity, enabling them to make choices and have as much control and independence as possible. The service used a variety of methods to facilitate this including supporting people with communication, assistive technology, providing information in an accessible format, a consistent staff team who knew people extremely well and one to one ‘Your Voice ‘meetings.

The management team and staff genuinely cared for the people they were supporting. They advocated for them at every opportunity. They were there for them and their families when they were in hospital or at the end of their lives. They ensured people were able to maintain contact with their families, even when they were hundreds of miles away, using Skype so that they could see them.

Staff knew people extremely well and were skilled at responding to their needs. Training was of a high quality and gave staff the skills and knowledge they needed to support people safely and effectively. Their learning was continually reviewed and reflected on, so that they could understand how it linked with their practice. The management team were supported by the provider to continue their own professional development, using their learning to improve their leadership skills and develop the staff team.

The service was exceptionally well led. The providers ethos was strongly promoted and modelled by the management team. They demonstrated a commitment to valuing people as individuals, supporting them to meet their full potential and achieve their individual aspirations. The management team demonstrated an open and transparent management style and were fully engaged with people and staff at the service. Robust quality assurance systems ensured the continued quality and safety of the service and continued to drive improvement. This ultimately improved the outcomes for people living at Riverview.

Since the last inspection, they had continued to move forward and develop what was an already outstanding 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 outstanding (published 3 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor the service until we return to visit in line with our re-inspection programme. If any concerning information is received, we may inspect sooner.