CQC report explained · a residential care home
What the CQC found at Rivers
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were kept safe through safeguarding procedures, risk assessments, suitable staffing and safe medicine management. The home took action when one person's aggression created risks for others.
- Effective?
- Requires improvement
- People's care and support generally met their needs, and staff were trained. However, best-interest decisions and consent records were not always in place for transport charges.
- Caring?
- Good
- Staff treated people with kindness, compassion, dignity and respect. People were involved in decisions about their daily routines and care.
- Responsive?
- Good
- Care was personalised and people could choose activities, maintain family relationships and access the community. This rating had fallen from Outstanding at the previous inspection.
- Well-led?
- Good
- The manager and staff were described as committed and supportive. The home had quality checks, acted on incidents and worked with health and social care professionals.
What inspectors found, February 2020
Rated Good overall; inspectors found safe, caring support, but consent and transport charging needed improvement.
This was a planned inspection in January 2020. One inspector visited without notice on 8 January and returned with notice on 9 January. They spoke with people, staff and a health professional, observed care and handovers, and checked care, medicine, staff and management records.
The home was rated Good overall. Safe, Caring, Responsive and Well-led were rated Good. Effective was rated Requires Improvement because the home did not always record best-interest decisions or consent for transport charges.
People were described as safe and treated with kindness and respect. Staff supported people to make choices, develop skills, join activities and keep in touch with relatives. The home had six residents at the inspection.
Safe staffing and risk management
There were enough staff, and the team knew the people living in the home well. Staff and managers acted quickly to reduce risks when incidents occurred.
“There were enough staff employed to support the six people who lived at the care home.” from the report
Kind and respectful support
People had positive relationships with staff. Inspectors saw attentive and friendly interactions, with privacy and dignity respected.
“There were many positive interactions between people and staff.” from the report
Choice and independence
People helped plan meals, chose activities and worked towards longer-term goals such as employment or moving to more independent living.
“People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.” from the report
Good partnership working
The home worked with health services, advocates, social care and other agencies to support people's health, safety and longer-term needs.
“The registered manager and staff worked in partnership with other professionals and agencies, such as GPs, mental health teams, advocates and community health services” from the report
Transport charges and consent
needs fixingThe home had introduced charges for use of its vehicle, but records did not always show that people had agreed to them or that the charges were in their best interests.
“There was no evidence they had consented to pay the additional transport charges implemented by the provider.” from the report
Best-interest records
needs fixingBest-interest decisions were not always recorded when people could not make particular decisions themselves. The provider said it would improve its process.
“People's best interests were not always identified by the provider; and best interest decision processes were not always in place.” from the report
Some medicine records
minorMedicines were managed safely overall, but inspectors found a minor recording error. Refresher training was planned for some staff.
“The registered manager told us they would provide refresher training for some care staff, on how to accurately complete medication records” from the report
- 01What has changed in the transport cost recovery policy since the inspection?
- 02How will you check that transport charges are agreed by each person or made in their best interests?
- 03How do you make sure best-interest decisions are recorded and reviewed?
- 04What refresher training has been completed on medication records, and how are records checked now?
- 05How will you maintain the person's choice, independence and community activities in daily care?
This was a comprehensive inspection covering all five key questions, with Safe, Caring, Responsive and Well-led rated Good and Effective rated Requires Improvement. This explanation was written from the published report of 27 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; inspectors found outstandingly responsive, person-centred support alongside good safety, effectiveness, care and management.
The inspection was unannounced and comprehensive. One inspector visited on 30 March 2017. They spoke with people living at the home, relatives, staff and managers, and checked care plans, medicine records, staff files and other records.
The home was rated Good overall. Safe, Effective, Caring and Well-led were all rated Good. The home was rated Outstanding for Responsive care, because support was highly personal and helped people build independence, confidence and meaningful lives.
Inspectors found that people felt safe, received their medicines as prescribed and had enough staff support. Staff understood people's needs, respected their choices and treated them with kindness. The home had systems for listening to people, handling concerns and checking the quality of care.
Personalised support
Staff understood people's individual needs and shaped care around their choices, preferences and ambitions.
“People received a high standard of individualised person centred care from staff who had an excellent understanding of their needs.” from the report
Building independence
People were supported to develop confidence and independence through activities, work, education, fitness and managing parts of daily life.
“The registered manager and the staff showed a clear commitment to promoting people's independence and helping them to gain the confidence to achieving their goals.” from the report
Listening to people's views
People were involved in care planning and regular meetings. Their views influenced activities, menus and improvements to the home.
“We saw from the minutes of the meetings that people's views were considered and actions taken about the issues raised, such as menu choices and social activities.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you identify and support my relative's personal goals, interests and preferred daily routine?
- 02What activities, education, work or community opportunities could my relative take part in?
- 03How would my relative be involved in writing and reviewing their care plan?
- 04How would you support my relative to develop independence, confidence and family contact?
- 05How can my relative or our family raise a concern, and how would you keep us informed of the outcome?
This was an unannounced comprehensive inspection covering all five CQC questions; the report says the home retained its previous overall Good rating. This explanation was written from the published report of 8 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 Rivers
3 rated inspections over 4 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 20 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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