We carried out a review of the data available to us about Rivermead on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Rivermead, you can give feedback on this service.
Rivermead is a residential care service providing nursing care to 46 people at the time of the inspection. The service can support up to 74 older and younger adults.
The service accommodates people across two separate wings, each of which has separate adapted facilities. People with general nursing needs are cared for on the Westow wing, whilst those who have care needs primarily associated with dementia are cared for on the Malton wing.
People’s experience of using this service and what we found
People told us they felt safe and well supported by staff. The provider followed robust recruitment checks, to employ suitable staff, and there were sufficient staff employed to ensure care and support were carried out in a timely way. People's medicines were managed safely.
Staff received appropriate training to give them the knowledge and skills they required to carry out their roles. This included training on dementia care and on how to protect people from the risk of harm. Staff received supervision to fulfil their roles effectively and had yearly appraisals to monitor their work performance.
People had choice and control of their lives and the staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
There was a planned programme of activities open to everyone including family and friends.
Staff knew about people's individual care needs and care plans were person-centred and up to date. People and relatives gave us positive feedback about the staff and described them as "Excellent, caring and friendly." Staff treated people who used the service with compassion, dignity and respect.
The service was well managed and organised. The management team assessed and monitored the quality of care provided to people. People and staff were asked for their views and their suggestions were used to continuously improve the service.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 24 June 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Rivermead is a nursing home that can provide care and accommodation for up to 69 older people. At the time of this inspection 63 people were using the service. The service is located in Norton, which has local amenities. Norton is very close to the market town of Malton, which has more services and rail links. The home has two distinct units. Those people with general nursing needs are cared for on the Westow unit, whilst those who have care needs primarily associated with dementia are cared for on the Malton unit.
There was a registered manager at the service who registered with CQC in December 2011. 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.
We found that people were protected from the risk of avoidable harm or abuse because the registered provider had effective systems in place to manage any safeguarding issues. Care workers received training on safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.
The registered provider had systems and processes to record and learn from accidents and incidents that identified trends and helped prevent re-occurrence.
Systems and processes were in place that helped to identify risks associated with the service’s environment and when providing care and support with people. Associated care plans enabled people to live at the service in line with their wishes and preferences with minimal restrictions in place.
Where people required support with their medicines this was done safely and people received their medicines as prescribed. Medicines were stored securely and staff competencies in this area were monitored by management.
Systems and processes were in place that ensured sufficient numbers of suitably trained and competent care workers were on duty to meet and respond to people’s needs and provide additional one to one support throughout the day. Pre-employment checks on employees were completed that helped to minimise the risk of unsuitable people from working with adults who are at risk.
Staff received a thorough induction when they joined the service and competency assessments were completed at regular intervals to ensure they were providing appropriate support. Staff received regular supervisions and appraisal where support, guidance and opportunities to develop were discussed.
Care workers had received training and understood the requirements of The Mental Capacity Act 2005 and the registered provider was following this legislation. Applications to deprive a person of their liberty had been submitted to the local authority when required.
People usually consented to care and support from care workers by verbally agreeing to it. Records included provision for people or their representative to sign their agreement to the care and support they received.
People were supported with a wide choice of food at meal times. Any special food requirements were catered for and people spoke positively about the meals on offer. Snacks and hot and cold drinks were available for people throughout the day. Staff were available to offer support with meals where needed.
People were supported to maintain their health and we saw evidence of close working relationships with other professionals. This was documented in people’s care records. Staff were deployed effectively which was demonstrated in how swiftly they responded to people’s requests.
All members of staff demonstrated a clear understanding of people’s individual needs and preferences and the importance of encouraging people to remain as independent as possible. They were caring and put people at the centre of everything they did. We saw staff treating people with dignity and respect and people we spoke with confirmed this.
A range of activities, to meet both people’s individual requests and as a group, were provided on a daily basis. People spoke with enthusiasm about these activities and we found that activities were well attended at the service.
People told us they felt well supported and able to raise issues with the management team, should they be unhappy. We observed a warm and friendly atmosphere in the home
The registered manager continuously monitored the quality and safety of the service. Where shortfalls were identified, action was taken. Feedback was sought from people, relatives, visiting professionals and staff through questionnaires and regular meetings. The registered manager used this information to implement improvements at the service.
Links with the local community were well established and Rivermead had taken part in research projects with local universities, the Clinical Commissioning Group and local NHS trusts. The registered provider held memberships in a number of recognised bodies that looked at driving improvements within health and social care.
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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
We inspected Rivermead on 13 August 2014 and the visit was unannounced. On the day of our inspection there were 59 people living at the home.
Our last inspection took place on 17 January 2014 and, at that time; we found the service was not meeting the regulations relating to staffing. We asked them to make improvements. The provider sent us an action plan telling us what they were going to do to make sure they were meeting the regulations. On this visit we checked and found improvements had been made.
Rivermead is a nursing home currently providing care for up to a maximum of 69 older people. The home has three distinct units. Those with general nursing needs are cared for on one wing, whilst those who have care needs primarily associated with dementia are on another which is divided into two separate units.
The service had a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
We saw there were systems in place to protect people from the risk of harm. Risk was managed in a manner to minimise any restriction on people who used the service.
People were supported by sufficient numbers of qualified, skilled and experienced staff. Staff felt supported by their manager. Procedures were in place for the recruitment and selection of staff and appropriate checks had been carried out prior to the staff starting work.
We saw documented evidence that staff accessed other healthcare professionals in a timely fashion.
We observed staff providing care and support in a caring and respectful manner.
The provider had a robust system to monitor and assess the quality of service provision. Good practice was encouraged and where practice could be improved, this was addressed.
During this visit people told us they were well cared for and said that staff were very kind. A relative said "The home have been really supportive, staff are really interactive with people and they see to my relatives personal care needs promptly." Overall we found that people's care and welfare needs were now being met.
We spent time on each of the units and spoke with all of the staff on duty. Staff on each of the units raised concern about staffing numbers at night and said that this impacted on how care was delivered. We found that there were not sufficient staff on duty at night to provide care to people safely.
Some of the records viewed were detailed and contained sufficient information about how people's care needs should be met by staff. However, some records were not up to date and in some cases information was not recorded appropriately.
We also looked at how people were cared for. We found that some people's assessed care needs were not always met. Some people were not receiving the care and support they required to keep them clean and comfortable. We have asked the provider to improve on this outcome for people who live at Rivermead.
The people we spoke with told us they were well cared for. We received comments from people living at the home, relatives and a visiting GP who told us "They (the staff) care very much. I would be very keen for one of my relatives to be cared for here it is first class" and "I have been here for a while, the care is good."Care records contained detailed information about how people's needs should be met.
People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People told us that they felt safe and able to raise concerns.
People expressed concerns about staffing levels and the observations carried out during our inspection concluded that there were not always sufficient staff to ensure the health, safety and welfare of people. All of the people we spoke with confirmed that they liked the staff and that they were helpful and caring but that they were busy.
The home had systems to monitor the service and to gain feedback from people living and working at the home. People told us that they were able to attend meetings to express their views and opinions.
People had care plans and risk assessments in place which helped staff to understand and meet people's needs. A person we spoke to said 'My health is looked after.' We saw that people maintained their independence, where possible.
There were policies and procedures in place that helped to protect people from abuse. Issues raised were referred to the local authority's safeguarding of vulnerable adults team for further investigation or advice. This helped to protect and safeguard people.
We saw that staff received training and supervision to ensure that they had the skills they needed to be able to look after people safely. A member of staff said 'We are trained to look after people.' This training was updated periodically to help to maintain the staff's skills.
We saw that people were able to make complaints and give their comments about the services provided for them. We saw evidence that any issues raised were acted upon. This helped to ensure that people remained happy with the service that they received.