CQC report explained · a residential care home
What the CQC found at Rivermere Retirement and Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Inspectors found enough staff, safe medicines systems, assessed risks, maintained equipment and effective infection control arrangements. The home had improved its use of agency staff and its records for creams and ointments.
- Effective?
- Good
- Staff received training and support, although some training delayed by the pandemic was still being rolled out. People's dietary needs were assessed, weights were monitored and professional advice was obtained when needed.
- Caring?
- Good
- This key question was not assessed at this targeted inspection.
- Responsive?
- Good
- This key question was not assessed at this targeted inspection.
- Well-led?
- Good
- Inspectors found that managers had acted on identified shortfalls and that staff, residents and relatives felt listened to and supported. The home sought feedback and worked with health and social care professionals.
What inspectors found, February 2021
Inspected but not rated; inspectors found improvements in staffing, medicines, safety and infection control, while the previous overall rating remained Good.
This was an unannounced targeted inspection on 8 January 2021. Inspectors checked concerns about staffing levels, risk management, infection control, nutrition and how the home was managed. They spoke with 10 staff, two residents and eight relatives, and reviewed care, medicines, staffing and infection control records.
Inspectors found enough staff to meet people's needs, with regular agency staff now working as part of the team. Medicines were managed safely, risks were assessed, the building was maintained and infection control arrangements were in place. People had suitable food and drink, with professional advice used when people's weight changed.
The home was inspected but not rated at this visit. The previous overall rating was Good, published in January 2018, and remained Good because this inspection did not cover the whole service or reassess every part of each key question.
Staffing had improved
The home had four permanent agency staff working within the team. Inspectors saw staff respond promptly to call bells and found staffing was adjusted to people's needs.
“There were four permanent agency staff who worked as part of the staff team.” from the report
Medicines were better controlled
The electronic medicines system, audits and alerts helped the home identify missed or unsigned medicines. The previously recommended dating of opened creams and ointments had been completed.
“all such medicines were now dated when opened.” from the report
Risks and emergencies were managed
Care plans covered risks such as falls, choking, poor nutrition and skin breakdown. Equipment, fire systems and personal emergency evacuation plans were checked.
“Risks to people's safety had been assessed and minimised to eliminate avoidable harm.” from the report
Positive feedback about care and management
Residents and relatives said the home was well run, staff knew people well and people were treated with respect. Feedback also described good communication with relatives.
“People and their relatives told us that the service was well run and that they would recommend it to other people.” from the report
Food and nutrition were monitored
People's food and drink needs and preferences were recorded. Weights were monitored and referrals to health professionals were made when needed.
“People's dietary needs and preferences continued to be met.” from the report
Some training had been delayed
needs fixingTraining delayed during the pandemic had been identified and was being rolled out. Families may want to check whether all required training is now complete.
“Staff training that had been delayed due to the pandemic, had been identified and was being rolled out.” from the report
Resident involvement in recruitment was paused
minorThere were plans for residents to help with recruiting new staff, but this had been put on hold because of the pandemic.
“There were plans to involve people with the recruitment of new staff, but this had been put on hold due to the pandemic.” from the report
- 01Has all staff training that was delayed during the pandemic now been completed?
- 02How are staffing levels adjusted when people's needs change or recruitment is still ongoing?
- 03How are residents and relatives currently involved in recruiting new staff?
- 04How will you tell families if the CQC receives new concerns or decides to inspect sooner?
- 05How are medicines audits used to identify and correct any problems?
This was a targeted inspection of specific concerns about staffing, risk management, infection control, nutrition and management; it did not reassess the full service or the Caring and Responsive key questions, and the previous Good ratings carried over. This explanation was written from the published report of 6 February 2021 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, January 2018
Overall Good, but Safe Requires Improvement; inspectors found kind, responsive care alongside staffing and medicines-record concerns.
Inspectors visited unannounced on 18 October 2017. They spoke with people, relatives and staff, observed care, and checked care plans, medicines, recruitment records, complaints and quality checks.
People generally felt safe and well cared for. Inspectors found enough staff on the day, safe recruitment, suitable training, good healthcare support, kind staff and personalised care. The home was clean and well maintained.
Safe was rated Requires Improvement because the home relied heavily on agency staff, one safeguarding matter was handled through the complaints process first, and topical medicines were not dated when opened. The other four areas were rated Good. The overall rating was Good, and the home had acted on recommendations from the February 2017 inspection.
Kind and respectful care
Inspectors saw staff treating people with patience and kindness. Staff knew people well and supported their dignity and choices.
“Staff were patient when providing support and ensured it was at an appropriate pace for each person so that they did not feel rushed.” from the report
Staff training
The training programme had been rolled out since the previous inspection. Staff received induction, shadowing, supervision and opportunities to gain qualifications.
“Staff were able to demonstrate how they had used the training they had completed to improve their practice.” from the report
Health and nutrition support
People’s health needs were recorded and reviewed. Dietary needs and preferences were assessed, with specialist advice followed where needed.
“People were provided with a varied diet and were enabled to choose what they ate and drank.” from the report
Personalised support
Care plans included people’s routines, interests and specific needs, including for people living with dementia. Staff offered both group and one-to-one activities.
“People's care plans showed staff had considered the causes of anxiety and frustration for people.” from the report
Heavy use of agency staff
needs fixingThere were staff vacancies and continued high use of agency workers. Inspectors recommended continued recruitment to reduce reliance on agency staff, although the home reported improvement after the inspection.
“We recommend that the registered provider continue to recruit to vacant posts to ensure a reduction in the use of agency staff.” from the report
Safeguarding reporting
seriousOne safeguarding allegation was investigated under the complaints process rather than the safeguarding policy. It was reported during the inspection and later found to be unsubstantiated.
“We recommend that the manager review the complaints system to ensure that it identifies any potential safeguarding matters.” from the report
Topical medicines records
needs fixingCreams and ointments were not dated when opened. This made it harder to confirm the correct disposal date.
“Creams and ointments were not being dated when opened.” from the report
Care plan reviews
needs fixingCare planning had improved, but it was not fully completed for everyone. Inspectors said reviews should explain more clearly how successful each plan had been and its effect on wellbeing.
“This had not yet been completed for everyone using the service.” from the report
Activities at some times
minorThe activities programme was broad, but some people said there was less going on at weekends. Inspectors recommended continuing to seek feedback and improve activities.
“There is not much going on at weekends.” from the report
- 01How many permanent care staff are now in post, and how much agency cover is currently being used?
- 02What process is now used to identify and report possible safeguarding concerns?
- 03How are creams and ointments dated when opened, and how is their disposal date checked?
- 04Have all residents’ care plans now been fully reviewed and updated with the person’s response and wellbeing outcomes?
- 05What activities are available at weekends, and how are residents’ views used to improve them?
This was an unannounced inspection of the overall service and all five CQC questions; the previous inspection in February 2017 had rated the service Requires Improvement. This explanation was written from the published report of 25 January 2018 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 Rivermere Retirement and Care Home
7 rated inspections over 3 years: the service has improved, from Inadequate to Good.
- February 2021Inspected but not ratedcurrent ratingSafe: Inspected but not ratedEffective: Inspected but not ratedWell-led: Inspected but not rated
Read what inspectors found at Rivermere Retirement and Care Home →
- January 2018Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Rivermere Retirement and Care Home →
- April 2017Requires improvementup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2016Inadequatestayed InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2016Inadequatestayed InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2016Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- July 2015Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2015InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- June 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 December 2010.
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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