Archived: Riverview Community Support Service

Updated 1 November 2018

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

The inspection took place on 24 and 27 September 2018 and it was announced. We told the provider two days before our visit that we would be coming. We gave the provider notice of our inspection as we needed to make sure that someone was at the office in order for us to carry out the inspection.

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

The service provided care and support to ten people living in the supported living scheme and seven people living in the community. We spoke to two people being supported, two relatives, seven staff and the manager.

Before the inspection we checked the information, we held about the service and the provider, such as notifications. A notification is information about important events which the provider is required to send us by law.

The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

Before our inspection on 21 September 2018 we completed our planning tool and reviewed the information we held on the service. We also received feedback from two of the local authorities who have a quality monitoring and

commissioning role with the service. We obtained further feedback from two health and social care professionals.

We reviewed a range of records about people's care and how the service was managed. These included the care records for nine people and this included their medicine administration record (MAR) charts. We examined three staff recruitment records, supervision, staff training and induction records. We checked the audits, policies and procedures and support plans and risk assessments.

Updated 1 November 2018

We carried out this announced inspection between 24th and 27th September 2018. We last inspected this service in October 2018. At that inspection we found the service was meeting all of the fundamental standards that we assessed.

Riverview Community Support Service currently provides personal care to people living in their own homes. The service is managed from offices close to the centre of Kendal. The agency provides domiciliary care to people living in the South Lakes and Furness districts of Cumbria. This service will be ceasing in the near future and the seven clients currently receiving a service have been given notice. It is anticipated that this service will cease by the end of October 2018. Leonard Cheshire will continue to provide a supported living service to a number of people living in Kendal. Supported living services involve a person living in their own home and receiving care and/or support in order to promote their independence. The care they receive is regulated by the Care Quality Commission, but the accommodation is not. People's care and housing are provided under separate contractual agreements. The Care Quality Commission [CQC] does not regulate premises used for supported living; this inspection looked at people's personal care and support.

At our last comprehensive inspection in October 2015 we rated the service as "Good". We however, made recommendations for improvements during this inspection. We noted that risk assessments lacked detail for staff on how to stay safe when dealing with some clients and their visitors. During this inspection, we also noted that all documents were not signed and dated and adequate attention was not paid to staff safety during their shift. Staff training records were not all up to date and in addition no registered manager was in post. As a consequence of these deficiencies people may be at risk of harm or of not receiving appropriate care.

The service does not currently have a registered manager in post. The previous registered manager left the service in March 2018. 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.

Riverview Community Support Service is currently being managed by a registered manager from another Leonard Cheshire Service who therefore has responsibility for two services. We were told a new manager had been appointed and was due to take up post on the 10 October 2018, however when we spoke to the staff they were unaware of this and felt this added to the feeling of unsettlement.

Some staff we spoke with said they felt anxious about the service provided and that morale was low. We observed staff trying to support people in a caring and patient way during the inspection; however, staff told us they felt unsupported and communication the management was poor.

The service was supporting some people with complex needs which had the potential to put staff at risk. Support plans and risk assessments lacked the detail required to ensure staff knew how to mitigate risks and keep themselves safe whilst supporting some people.

We have made a recommendation about this

Some staff files did not contain up to date training records however a separate record is maintained by the administrator that details all the training undertaken by individual staff members.

Support workers were carefully recruited. There was a recruitment procedure and staff records contained evidence that essential checks had been carried out prior to care workers starting work. There were enough support workers deployed to meet people's needs. Any shortfall in staff was covered by agency staff.

Medication was stored safely and staff said they had training in safe ways to support people to take their prescribed medication.

The service had a complaints procedure. People and their representatives knew who to complain to if they had concerns. The service had received a number of concerns from an anonymous source from who / where in recent months. They have been referred appropriately to local safeguarding teams and the management of the service had cooperated in the investigations.

Not all records and correspondence were signed and dated which made it difficult to establish what was current information.

The service responded in an open and transparent way when things went wrong, so that lessons could be learned and improvements made.

People were supported to eat and drink enough. People were actively involved in choosing what they ate and preparing their own meals. Risks to people with complex eating needs were understood by staff.

Staff worked with other external teams and services to ensure people received effective care, support and treatment. People had access to healthcare services, and received appropriate support with their on-going healthcare needs.

Staff provided care and support in a kind and compassionate way.