About the service Riverdale is a residential care home providing personal and nursing care to up to 40 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 18 people using the service.
People’s experience of using this service and what we found
Risks to people’s health and safety were not always effectively managed. Incidents were not always appropriately documented or reviewed and people’s care plans and risk assessments did not always contain sufficient detail about how people would like to be supported and how to keep them safe.
The provider’s processes for monitoring the quality and safety of the service had not always been used effectively to highlight concerns in the completion of people’s records or incident reports. Staff had not always been supported to develop the appropriate skills and understanding of how to support people who may be feeling distressed or upset, in a dignified and respectful way.
The service had undergone a number of changes in management since the last inspection and during this period of change there had been an increase in safeguarding concerns relating to staffing and the care people received. The provider continued to liaise with the local authority, documenting lessons learnt and implementing improvements.
There was now a new registered manager in post and people, relatives and staff spoke enthusiastically about their approach and the positive impact they had made in the service. Staff told us they felt able to raise concerns and the culture and morale in the service had improved.
There were enough staff available to meet people’s needs. The provider had recruited more permanent staff and there was greater consistency in people’s support. Staff were safely recruited with the relevant checks completed prior to them starting work.
People and relatives spoke positively about the care provided. 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.
People received their medicines as prescribed and the provider ensured staff were trained and competent to administer medicines prior to supporting people. The provider liaised other healthcare professionals in order to support people’s changing needs, making referrals and seeking support when appropriate.
The provider had implemented safe infection prevention and control processes and ensured relatives and staff were kept up to date with changes in government guidelines throughout the COVID-19 pandemic. The provider sought regular feedback from people, relatives and staff and used this feedback to identify what had been achieved and where improvements were still needed in 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 September 2019).
Why we inspected
We received information of concern in relation to the management of risks to people’s health and safety and the provider’s processes for managing safeguarding concerns. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Riverdale care Home on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to people’s safety and the oversight of the service at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.