CQC report explained · a residential care home
What the CQC found at Rivendell and Lorien (Marsh Lane)
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found effective safeguarding arrangements, regular risk reviews, safe medicines processes and a well-maintained environment. Staff knew how to reduce risks and there were enough staff to support people.
- Effective?
- Good
- People's needs were assessed and reviewed, and staff worked with health professionals. Staff had relevant training and supported people with healthcare, nutrition, communication and mobility.
- Caring?
- Good
- People were treated with dignity and respect and were supported to make choices and remain as independent as possible. Inspectors observed positive, caring relationships between people and staff.
- Responsive?
- Good
- Care plans described people's individual needs, preferences and communication methods. People were supported with hobbies, community activities and family relationships, although no end-of-life plans were in place.
- Well-led?
- Good
- The home had experienced leadership, regular checks and clear lines of responsibility. Staff felt listened to, and managers used incidents and feedback to improve care.
What inspectors found, April 2019
Rivendell and Lorien (Marsh Lane) was rated Good; inspectors found safe, kind and personalised care, but no end-of-life plans were in place.
The inspection took place on 2 April 2019 and was announced 48 hours in advance. One inspector reviewed information held by the CQC, care and medicine records, staff files and quality checks. They also spoke with four family members, the manager, four staff members and one health professional.
The home supported 10 people with learning and physical disabilities across two bungalows. Inspectors found that people were safe, treated with dignity and supported by staff who understood their needs. Care was personalised, people were helped to make choices and staff supported health, independence and community activities.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating as the previous inspection, published on 11 October 2016. The report says safeguarding procedures had been improved since that inspection.
The main shortfall was that there were no end-of-life plans setting out people's last wishes. The inspector recommended that the home consider good practice guidance on end-of-life planning.
Safe, individual support
Staff understood people's risks and needs, and risk assessments were regularly reviewed. The home also had appropriate arrangements for emergency medicines and protective equipment.
“People were protected from the risks of unsafe care. Risk assessments were carried out with measures identified to further reduce risks for people.” from the report
Kind and respectful relationships
Families and inspectors saw people being treated with dignity and compassion. Staff knew how each person communicated and supported their independence.
“People received care from staff who developed positive, caring and compassionate relationships with them.” from the report
Personalised care and choice
Care plans included detailed information about people's routines, preferences and communication. People were supported to take part in activities, make choices and develop independence.
“People's care plans were detailed about their individual needs and preferences, and were reviewed and updated as their needs changed.” from the report
Learning from the previous inspection
The home had improved its safeguarding guidance after the previous inspection. Staff were clear about when and how to report concerns.
“Since then the service had reviewed their procedures and updated guidance in line with national guidelines.” from the report
No end-of-life plans
needs fixingThe home had not recorded people's last wishes in end-of-life plans. The inspector recommended using good practice guidance to improve this.
“There were no end of life plans in place which would support staff to identify what peoples last wishes were.” from the report
- 01How will you make sure my relative's end-of-life wishes are discussed, recorded and kept up to date?
- 02How would staff recognise and communicate with my relative if they use signs, facial expressions or their own vocabulary?
- 03What risks would be assessed before my relative moved in, and how often would those assessments be reviewed?
- 04How would you support my relative to take part in activities, family visits and ordinary community life?
- 05What training and supervision would staff receive for my relative's specific health and support needs?
This was a scheduled inspection covering the premises and care provided, with all five CQC questions assessed; the previous overall rating was Good. This explanation was written from the published report of 30 April 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2016
Rivendell and Lorien (Marsh Lane) was rated Good, but inspectors found that safeguarding concerns were not always reported.
This was an unannounced inspection on 18 August 2016. One inspector spoke with people living at the home, relatives and staff. They also observed care and checked care records, medicines, staff recruitment, training and quality checks.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were rated Good. Safe was rated Requires Improvement because a possible safeguarding concern had not been reported to the local authority.
Inspectors found enough staff, safe recruitment, suitable training and safe medicines practice. They also found kind, personalised care, good support with health and nutrition, activities that people enjoyed and a supportive management culture.
Kind, personalised care
Staff took time to understand people's histories, preferences and communication styles. Inspectors saw warmth, compassion and respect during care.
“During our inspection we observed staff interacting with people with warmth and compassion.” from the report
Good support with health
People had detailed risk assessments and were supported to access doctors and other health professionals when needed.
“Records we looked at confirmed that people were supported to maintain good health and to attend any medical appointments they were sent” from the report
Activities and relationships
People were supported to follow hobbies, use community services and keep in touch with friends and relatives.
“We also found that staff would strive to keep people engaged with others outside of the home and people had regular access to the community.” from the report
Supportive leadership
Inspectors found clear leadership, staff support and systems for checking the quality and safety of the home.
“We saw that there were both internal and external systems in place to monitor the quality and safety of the service” from the report
Safeguarding was not always recognised
seriousUnexplained bruising was recorded, but staff did not report it as a possible safeguarding alert. The manager accepted that it should have been reported.
“staff had not always recognised the need to raise a safeguarding alert with the local authority” from the report
- 01What changes were made after the inspection to ensure unexplained injuries are reported as safeguarding concerns?
- 02How do managers check that staff act on their safeguarding training in practice?
- 03How are people's individual risks, such as choking, seizures and drowning, reviewed when their needs change?
- 04How will you involve our relative and us in care planning and regular reviews?
- 05How are activities, community visits and contact with family matched to each person's preferences?
This was an unannounced inspection of the overall quality of the home and all five key questions, with the previous August 2013 inspection noted as meeting all essential standards. This explanation was written from the published report of 11 October 2016 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Rivendell and Lorien (Marsh Lane)
2 rated inspections over 3 years: the service has held its Good rating throughout.
- April 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Rivendell and Lorien (Marsh Lane) →
- October 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Rivendell and Lorien (Marsh Lane) →
- September 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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