Rivers Reach

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment, the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Staff knew what incidents to report and how to report them and they told us they were confident there was a culture of safety within the service. The service investigated incidents thoroughly and shared outcomes with relatives and professionals. We saw evidence of change as a result of incidents that had occurred.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. One relative told us, “The transition period was good. The staff came from Rivers Reach and stayed for a full week with my relative to get to know them and their care needs prior to my relative moving into Rivers Reach. The existing staff from the previous provider also visited Rivers Reach to help further with the transition.” One professional told us, “The provider has been very thorough and have met with myself, the person, their relatives, the current provider and involved community Learning disability teams. Information has been requested by the provider in order to ensure all documentation and risk assessments are as robust as possible. In my experience the service is working well with other agencies to ensure people’s needs are met.” We reviewed detailed documents showing how much effort and joint working went into ensuring people had a smooth transition both in and out of the service.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on protecting people’s right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. Staff knew how to protect people from abuse and who they would report any concerns to both internally and externally. The service shared concerns quickly and appropriately. Deprivation of Liberty Safeguards (DoLS) were in place or had been applied for to legally authorise restrictions placed on people to keep them safe. The registered manager was reviewing people’s DoLS to ensure all restrictions were noted and considered. We reviewed evidence of reduction in medicines for people due to the support in place which helped them manage their anxieties.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive, and enabled people to do the things that mattered to them. People moving into the service were assessed for risks associated with their care. The registered manager told us about other agencies they worked with related to specific risks to ensure there was specialist input and joined up working to support the person to manage these risks. Staff supported people to manage risks whilst maintaining their independence by promoting positive risk taking. One staff member told us, “I had so much training when I first started and regarding people we support, it was person centred.”

The service did not always promptly control potential risks in the care environment when they were detected. Concerns with fire protection in a cupboard and for a fire door, identified through a fire service audit had not been acted on prior to our site visit. The registered manager took remedial action during our visit and organised for a contractor to undertake works following our visit. The service made sure equipment, facilities and technology supported the delivery of safe care. For example, firefighting equipment, gas, and electrical testing had been routinely carried out. Staff confirmed they received fire training. One staff member told us, “We have regular fire drills and do discuss fire safety in team meetings. I am confident that I know what to do if there was a fire.”

The service made sure there were enough qualified, skilled, and experienced staff to meet people’s needs. The provider’s recruitment policy described safe recruitment processes however, some recruitment records were not complete. We spoke to the provider about this who told us they would ensure this was in place for all staff moving forward. Staff received effective support, supervision, and development. They worked well together to provide safe care that met people’s individual needs. A relative told us, “The team are well trained and knowledgeable.” Staff told us, there were enough staff to allow them to provide consistent care and they described a comprehensive induction process. They also told us about service specific training which was put in place when a new person moved into the home, to ensure staff understood how best to support the person with any specific needs they had.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The provider had an up to date Infection Prevention and Control (IPC) policy. Staff attended IPC training. We reviewed cleaning schedules which were consistently completed. Most relatives told us they felt the home was clean.

The service made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. They involved people in planning, including when changes happened. Staff supported and involved people to manage their medicines and followed best practice for administering medicines. Staff and the registered manager were able to confidently tell us the process if a medicines error occurred. This included a debrief for staff discussing lessons learned and additional training.