CQC report explained · a nursing home
What the CQC found at Rivermead
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe and well supported. Recruitment checks, staffing levels, medicines systems, equipment and infection control were found to be safe.
- Effective?
- Good
- People's needs and preferences were assessed, and staff had suitable training and supervision. People had access to food, drinks and healthcare, and the home followed the Mental Capacity Act principles.
- Caring?
- Good
- Staff treated people with compassion, dignity and respect, and involved them in decisions. This rating had fallen from Outstanding because changes in management, staffing and dementia care had affected care quality.
- Responsive?
- Good
- Care records were detailed and up to date, and care was adjusted when people's needs changed. Activities, family contact, complaints handling and end of life support were found to meet people's needs.
- Well-led?
- Good
- The home was described as welcoming, friendly and well managed. Leaders monitored quality, listened to people and staff, and used feedback and incidents to improve care.
What inspectors found, January 2020
Rivermead was rated Good; inspectors found safe, kind and well-organised care, although the caring rating fell from Outstanding.
The inspection was unannounced and took place on 3 and 9 December 2019. The inspection team spoke with people living in the home, relatives and staff. They also checked care records, medicines records, recruitment files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, suitable training and care plans that reflected people's needs.
People and relatives described staff positively. Inspectors found that people were treated with dignity, had choices about their care and could take part in activities. The home was clean, and its management team monitored quality and used feedback to make improvements.
The overall rating stayed Good since the previous inspection. However, Caring fell from Outstanding to Good after changes in management, staffing and the approach to dementia care affected the quality of care. The provider had recognised this and was taking action.
Safe staffing and medicines
Inspectors found enough staff to provide care on time, support activities and help people attend appointments. Medicines were managed safely.
“There were sufficient staff on duty to meet people's needs, to enable people to take part in social activities and to attend medical appointments.” from the report
Person-centred care
Care plans were detailed, current and changed when people's needs changed. Staff understood what mattered to people and respected their wishes.
“People received person-centred care; staff had a detailed understanding of their needs and what was important to them.” from the report
Respect and choice
People were involved in decisions about their care and were supported to remain independent where possible. Inspectors found that staff maintained privacy and dignity.
“People were routinely involved in decisions about their care; staff sought people's consent and supported them to have choice and control over all aspects of their support.” from the report
Activities and family contact
The home offered planned and one-to-one activities, welcomed relatives and supported people's religious needs.
“People enjoyed the social activities arranged for them. Activities were based on what people wanted on the day, although there were also weekly planned activities.” from the report
Quality monitoring
The management team carried out regular checks, listened to feedback and used incidents and concerns to improve the service.
“Regular checks were completed by the staff and management team to make sure people were safe and happy with the service they received.” from the report
Caring rating had fallen
needs fixingCaring was rated Good rather than Outstanding at this inspection. Inspectors linked this to changes in management, staffing and the approach to dementia care, although they found good interactions during the visit.
“At the last inspection this key question was rated as outstanding. At this inspection this key question has deteriorated to good.” from the report
Accessible information still developing
minorThe home had started providing information in formats people could understand, but the manager said this work would be developed further.
“The provider had started to make information for people available in formats they could understand. The manager said they would develop this further over the next year.” from the report
Recent staff turnover
minorA relative reported significant staff turnover during the previous six months. They also said staffing appeared to have improved by the time of the inspection.
“There has been a big staff turnover in the last six months, but they seem to have got it right now; [Name] is well looked after.” from the report
- 01How have the recent changes in management and staffing affected care, especially for people living with dementia?
- 02What bespoke dementia training have staff completed, and how is its effect on care being checked?
- 03How will you provide information in formats that each person can understand?
- 04What has been done to reduce staff turnover since the previous six months?
- 05How are people's views and relatives' feedback used to improve care?
This was an unannounced planned inspection covering all five CQC questions, including both the care and the premises. This explanation was written from the published report of 23 January 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, June 2017
Rivermead was rated Good overall, with Outstanding caring, although topical medicine records were not always complete.
Inspectors visited on 22 March 2017 without warning and returned on 23 March 2017 with the home's knowledge. They reviewed care and medicine records, staff files, policies and quality records. They also spoke with people living there, relatives and staff, and observed care.
They found people were safe, supported by enough trained staff and given medicines safely. The home supported people's health, nutrition, choices and independence. Care plans were personal, activities were varied, and people and relatives spoke positively about the care.
Caring was rated Outstanding. The other four areas, Safe, Effective, Responsive and Well-led, were rated Good. Inspectors found one recording shortfall for topical medicines and one complaint was still being dealt with.
Kind and respectful care
Staff built strong relationships with people and treated them with compassion, dignity and respect. People were supported to remain independent where possible.
“During the inspection we spent time in communal areas observing interactions between staff and people who used the service.” from the report
Individual care
Care plans included personal histories, interests, routines and preferences. Life history books helped staff understand people and have meaningful conversations.
“Life history books that we viewed contained an excellent amount of detail, photographs and experiences and staff told us how this had impacted on the support that they provided.” from the report
End of life support
Inspectors saw compassionate and dignified end of life care. Relatives were supported, and the person's known wishes were followed.
“We observed staff providing compassionate and dignified care.” from the report
Activities and relationships
The home offered daily activities, trips and opportunities based on people's interests. Relatives could visit at any time and were involved in care decisions.
“People were encouraged to participate in activities of their choosing both as groups and on their own.” from the report
Staffing and training
Inspectors found enough staff on duty and evidence that staff had suitable training, supervision and competency checks.
“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” from the report
Topical medicine records
needs fixingStaff did not always record when creams and lotions had been applied. The registered manager said this would be addressed with staff.
“Records showed that staff were not always recording when topical medicines had been applied.” from the report
One unresolved complaint
needs fixingFour complaints had been made in the previous 12 months. Three were resolved quickly, but one was still being dealt with by the provider when inspectors visited.
“One complaint was still outstanding and being dealt with by the registered provider.” from the report
- 01How do you now check that creams and lotions are recorded every time they are applied?
- 02Was the complaint that was outstanding at the inspection resolved, and what action was taken?
- 03How do you make sure staffing levels are adjusted when people's needs change?
- 04How are people's personal histories, routines and preferences used in their daily care?
- 05How are relatives involved in decisions about a person's health, care and end of life wishes?
This was a two-day comprehensive inspection covering all five areas: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 24 June 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 held its Good rating throughout.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 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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