Riverside House

Updated 22 September 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 was planned to check 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.

This inspection took place on 29 August 2018 and was unannounced.

The inspection team included one adult social care inspector and one expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert had experience of people with a learning disability and autism.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed other information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to tell us about within required timescales.

We sought feedback from the local authority commissioning team and Healthwatch. Healthwatch is the consumer champion for health and social care.

During the inspection, we spoke with the registered manager, the area manager and two staff.

We spoke with two people in receipt of a service and three relatives by telephone to seek their views. We had a look around the home and looked in people’s rooms with their permission. We observed staff administering people’s medicine and completed observations of staff interactions with people throughout the day.

We reviewed a range of records. This included three people's care records containing care planning documentation and daily records. We also viewed the records for three staff relating to their recruitment, supervision and appraisal. We reviewed the process used to manage staff training. We viewed records relating to the management of the service, including audit checks, surveys and quality assurance and the provider’s policies and procedures.

Updated 22 September 2018

The inspection took place on 29 August 2018 and was unannounced.

Riverside House 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Riverside House provides accommodation and support to a maximum of 10 younger adults who may have a learning disability or autistic spectrum disorder. At the time of this inspection there were three people using the service full time and two people who used the service for short periods of respite.

At our last inspection in October 2017, we found the provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations for Regulation 12: Safe care and treatment, Regulation 17: Good governance and Regulation18: Staffing. We asked the provider to complete an action plan to show what they would do and by when. At this inspection we found the provider had implemented the actions and was no longer in breach of these regulations.

There was a registered manager in place. 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.

People were assessed and supported to take their medicines safely as prescribed by staff who had been checked as competent and who followed national best practice.

The provider had systems and process in place to ensure staff were appropriately recruited into the service. Staff received appropriate induction, supervision, support and training to acquire and update their skills to meet people’s individual needs and fulfil their roles.

We observed there were enough staff on duty to meet people’s needs. People confirmed they received care and support from regular staff who they knew.

The provider completed a range of checks and audits to maintain and improve the service.

People told us they felt safe living at the home and staff understood how to recognise and report any signs of abuse.

At the time of our inspection, everybody living at the home had been assessed as having capacity under the Mental Capacity Act 2005. Management and staff understood their responsibilities under the MCA and were actively promoting people's independence. People had consented to their care and support and this was recorded in their care plans.

People received information in a format they could understand and were supported to communicate their needs, and these were recorded to ensure they were met.

The provider included people or their representatives in discussions regarding their health and wellbeing. Any positive behaviour support plans were evaluated and included input by appropriate health professionals for effectiveness.

Care plans included information to ensure staff were informed and respectful of people's cultural and spiritual needs.

People were supported to maintain a healthy and balanced diet. Care plans contained details

of people's preferences and any specific dietary needs they had, for example, whether they were diabetic, had any allergies or religious needs.

Staff had a good understanding of people's needs and were kind and caring. They understood the importance of respecting people's dignity and upholding their right to privacy.

There was information available on how to express concerns and complaints. People were encouraged and supported to raise their concerns and processes were in place to ensure these were responded to.

People were supported to live fulfilling and meaningful lives. The provider supported people to obtain skills to take up opportunities of work and attend college.

People discussed the activities and interests they could follow. People who chose to remain at the home participated in daily events. The provider supported people to maintain meaningful relationships and they were protected from social isolation.

The registered manager understood their responsibilities as part of their registration with the CQC and had informed the CQC of significant events in a timely way.

There was a defined staffing structure and all staff understood their responsibilities and when to escalate any concerns.