River Meadows

Updated 14 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors and an Expert by Experience completed this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

River Meadows is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. River Meadows is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 15 people and 3 relatives about their experience of the care provided. We carried out observations in communal areas to help us understand the experience of people who could not talk with us. We spoke with 8 members of staff including the registered manager, the regional manager, a senior care assistant, 4 care assistants and a member of the housekeeping team. We also spoke with 3 external healthcare professionals.

We reviewed a range of records. This included 4 people's care records in full and specific aspects of 2 other care plans. We looked at 3 people’s medicine records. We looked at 2 staff files in relation to recruitment. A variety of records relating to the management of the service were also reviewed.

Updated 14 July 2023

About the service

River Meadows is a residential home which provides care over three floors to older people including people who have dementia. River Meadows is registered to provide care for 41 people. At the time of our inspection visit there were 34 people living at the home.

People’s experience of using this service and what we found

The provider had systems to assess risks to people before undertaking their care and support. However, we found examples where risks had not been sufficiently monitored or recorded to effectively mitigate that risk. People received their medicines as prescribed, but records to support good medicines administration practices needed to be improved.

There were enough staff to provide safe care. Healthcare professionals told us staff were always available to support their visits which ensured effective communication and sharing of information. Staff understood their safeguarding responsibilities and the registered manager understood their responsibility to follow local safeguarding protocols when required.

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. Staff supported people’s communication by giving people information in a way they would understand.

Staff were responsive to people’s individual needs, although care plans did not always contain detailed information to help staff support people’s emotional needs. There was a lack of physical and emotional stimulation for people but plans were being made to encourage more engagement and activities people enjoyed.

The registered manager understood the needs of the people living in the home, advocated on their behalf and was committed to improving the quality of care people received. However, checks and audits had not always identified when improvements were needed and governance systems were not consistently effective in supporting the management team to improve and maintain standards of care.

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 21 October 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We looked at the key questions of Safe, Responsive and Well-led.

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 . This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for River Meadows on our website at www.cqc.org.uk.

Enforcement

We have identified a breach in relation to Regulation 17 (Good governance).

We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full 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.