CQC report explained · a residential care home
What the CQC found at Rivermead
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2020
Rated Requires Improvement; inspectors found safe, kind care but activities, personalisation and some management checks were not good enough.
This was an unannounced inspection on 8 and 10 January 2020. Inspectors spoke with people, relatives, staff and health professionals. They observed care and reviewed care, medicine, staff and management records.
People were protected from abuse and avoidable harm. There were enough staff, medicines were handled safely, and staff were trained. People were treated with kindness, dignity and respect, and their choices and independence were supported.
The main problems were that people did not always receive meaningful activities or enough personal interaction. Some people waited a long time for meals, and parts of the building were tired or worn. A flooring hazard was fixed during the inspection, but environmental checks had not found it beforehand.
The overall rating Requires Improvement. Safe, Effective and Caring were rated Good. Responsive remained Requires Improvement, while Well-led fell from Good to Requires Improvement. The provider was asked to review the activities programme.
People felt safe
People and relatives said they felt safe. Staff understood how to recognise and respond to abuse and risks.
“People felt safe using the service.” from the report
Kind and respectful care
Staff communicated warmly, respected privacy and dignity, and supported people to make choices and remain independent.
“People were treated with respect, care and dignity.” from the report
Good staff training
Staff received induction, refresher and specialist training, including dementia care, and were confident in their roles.
“All the staff had received the training they required to effectively do their jobs.” from the report
Support with health needs
The home worked with health professionals and recorded visits to help update care plans and risk assessments.
“Staff were working alongside other agencies, such as the local GP surgery who had arranged a weekly day visit to the home” from the report
Limited meaningful activities
needs fixingActivities were sometimes short, limited or not suited to people's interests. Some people had few opportunities to go for walks, garden or take part in activities they enjoyed.
“We found that these activities were sometimes limited, and many people did not participate in these.” from the report
Too little interaction
needs fixingPeople were sometimes left in communal areas for long periods with little staff interaction. One person became anxious while waiting for help and was not reassured during the wait.
“People were often left for long periods of time with little or no staff interaction.” from the report
Worn environment
seriousSome areas were tired and needed redecoration. A lifted floor was found near the bedroom of a person at risk of falls and was fixed by the second inspection day, but it had not been identified by the home's checks.
“Systems in place were not effective in monitoring the environment of the home and identifying possible hazards within the home.” from the report
Long waits at mealtimes
needs fixingSome people waited a long time for meals and were left at dining tables without interaction or stimulation. The food itself was described as good quality and the report said this did not affect its temperature or quality.
“some people would be left waiting for meals for long periods of times at the dining tables” from the report
Delayed improvements
needs fixingThe provider had plans to renovate tired areas, but had not given clear timescales. Improvements to activities had also not been fully addressed since the previous inspection.
“there was no clear information when the provider would be completing this work to improve standards of living for people.” from the report
- 01What meaningful activities are now available for people with different interests, including gardening, walking and community activities?
- 02How do you make sure people are not left for long periods without staff interaction or reassurance?
- 03What has been done to improve waiting times at meals and keep people engaged while they wait?
- 04Have the tired and worn areas been redecorated, and what regular checks now identify flooring or other hazards?
- 05What changes have been made to care assessments so they record each person's preferences, wishes and activity needs?
This was an unannounced inspection of the care and premises, covering all five CQC questions; Safe, Effective and Caring stayed Good, Responsive stayed Requires Improvement and Well-led fell to Requires Improvement. This explanation was written from the published report of 21 February 2020 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, July 2017
Rated Good overall, but inspectors found that activities and personal interests were not supported consistently.
Inspectors visited without notice on 23 June 2017. They spoke with people living at the home, relatives, staff, managers and a visiting GP. They reviewed care records, staff recruitment and training records, and the home's quality checks.
The home was judged Good for safety, effectiveness, caring and leadership. People were kept safe, medicines were managed properly, staff were trained, health needs were met, and staff treated people with kindness, dignity and respect.
The home was rated Requires Improvement for being responsive. Inspectors found that activities were not regular or varied enough, and some people spent long periods without support to take part in activities or interests. The home was trying to improve this, including recruiting an activities coordinator and developing more personalised information about each person.
The overall rating remained Good, the same as at the previous inspection on 20 July 2015. This means the home met the required standard overall, but improvements were needed in how it supported people's individual interests and stimulation.
People were kept safe
Inspectors found safeguarding, risk assessment, staffing and medicine systems that supported people's safety.
“People were supported to stay safe. Staff members were knowledgeable about abuse and the requirement to report any incidents and accidents which took place.” from the report
Kind and respectful care
Staff knew people well and inspectors observed kind, compassionate interactions. People's privacy and dignity were respected.
“Staff were kind and compassionate when they spoke with people and used gentle touch, eye contact and body language to help people feel comfortable and valued.” from the report
Staff skills and health support
Staff received induction, training and supervision. The home supported people's food, medical appointments and changing health needs.
“Staff members received training and support which enabled them to perform their roles.” from the report
Open management
The home had a positive culture, involved people and relatives in its development, and used audits and feedback to improve.
“The provider had a number of quality assurance procedures in place to monitor and improve the quality of care at the service.” from the report
Too little stimulation
needs fixingActivities were not regular or varied enough to meet everyone's interests. Some people spent extended periods without staff support to take part in activities.
“We also observed extended periods of time where people were not supported by staff members and therefore did not have the opportunity to engage in activities and stimulation.” from the report
Activities were not always personalised
needs fixingSome activities were general rather than based on individual hobbies and preferences. Records did not always show regular activities or how involved people had been.
“People's care and support was not always person-centred and reflective of their individual needs, interests and preferences.” from the report
Activities coordinator vacancy
needs fixingThe activities coordinator post was vacant at the time of inspection. The home was trying to increase activities and improve person-centred planning.
“They explained that there was a vacant activities coordinators post at the service, which they were working to recruit to.” from the report
- 01What regular activities are now available, and how are they matched to each resident's hobbies and interests?
- 02Has the activities coordinator vacancy been filled, and who is responsible for activities now?
- 03How do you make sure people are not left for long periods without meaningful activity or stimulation?
- 04How do you record whether residents took part in activities and whether they enjoyed or benefited from them?
- 05What progress has been made with the planned 'my file' for each resident?
This was an unannounced inspection covering all five key questions and the overall rating, with the previous overall rating from 2015 remaining Good. This explanation was written from the published report of 27 July 2017 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 Rivermead
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- February 2020Requires improvementcurrent ratingdown from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- August 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- April 2014
Registered with the Care Quality Commission on 7 April 2014.
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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