CQC report explained · a nursing home
What the CQC found at Riverview Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2019
Rated Good; inspectors found safe, kind and personalised care, but records about people's decision-making needed improvement.
Inspectors visited without advance notice on 5 and 12 November 2019. They spoke with people, relatives, staff and health professionals. They observed care and reviewed care, medicine, staff and management records.
The home was rated Good overall. Safe, caring, responsive and well-led were rated Good. Inspectors found people were treated kindly, their needs were understood, medicines were managed safely and the home had improved its activities and communal areas.
Effective was rated Requires Improvement. Records did not always clearly show people's capacity, best-interest decisions and the involvement of people or their representatives. Some care plans also needed more detail. The home had improved since the previous inspection and was no longer in breach of Regulation 17.
Kind, personal care
Staff knew people well and provided warm, respectful support. Inspectors saw people being offered choices and reassurance.
“People's care needs were assessed, and they received good quality person centred care from staff who understood their needs well.” from the report
Safety and medicines
Risks were assessed and reviewed, staffing levels were maintained, and medicine systems were organised. Staff had relevant training and competency checks.
“Medication systems were organised, and people were receiving their medication when they should.” from the report
Improved environment
The refurbished home included dementia-friendly activity spaces, a tea room and a sensory area. People had more choices about where to spend time.
“The changes provided people with a wider range of choices and opportunities.” from the report
Activities and relationships
The home offered individual and group activities, outings and support to follow people's faith. Inspectors saw staff helping people take part in meaningful activities.
“Recent activities included an outing to Gay Pride, a barge trip and visits from entertainers.” from the report
Supportive leadership
Staff described the management team as supportive and approachable. Audits were used to identify and address issues.
“The registered manager provided people with leadership and promoted an inclusive and supportive team culture.” from the report
Decision-making records
needs fixingRecords did not always clearly explain people's capacity or show how best-interest decisions were made. Inspectors said this needed to be embedded across the whole home.
“Where people lacked capacity to make decisions for themselves clearer information about their capacity and showing decisions had been made in their best interests needed to be recorded.” from the report
Care plan detail
needs fixingSome care plans needed more information about what could make people anxious and how staff should respond. Oral health plans also needed more detail.
“Some care plans could be improved by including more detail.” from the report
- 01How do you now record a person's capacity and show that best-interest decisions involved the person and their representatives?
- 02What has been done to add detail about triggers and calming approaches to people's care plans?
- 03How detailed are your current instructions for as-required medicines, and how do you check they are followed consistently?
- 04What improvements have been made to people's oral health plans since this inspection?
- 05How do you make sure activities remain individualised and enjoyable for people living with dementia?
This was an unannounced planned inspection based on the previous rating and covered all five key questions, including the premises and care provided. This explanation was written from the published report of 26 November 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, November 2018
Rated Requires Improvement; inspectors found major progress since Special Measures, but care records, dignity and quality checks were still not reliable enough.
Inspectors visited the home without warning on 5 and 12 September 2018. They spoke with people living there, relatives, staff and health professionals. They observed care and mealtimes, reviewed care and medicine records, checked staff files and looked around the building.
The home had improved since the previous inspection, when it was rated Inadequate and placed in Special Measures. Inspectors found enough staff, safe medicines, a clean home and more flexible routines. They also found kind care, activities and better dementia-friendly areas.
However, risk assessments and best-interest decisions were not always clearly recorded. One person’s dignity was not maintained promptly after they had become wet. Mealtimes were not always well organised, the patio had uneven paving and some moving equipment was unsuitable.
The home remained in breach of Regulation 17 because its checks did not reliably identify and fix these problems. The overall rating was Requires Improvement. The home was no longer in Special Measures, but inspectors said it needed to show that improvements could be sustained.
Staffing and safeguarding
Inspectors found enough staff to respond promptly and staff knew how to recognise and report safeguarding concerns. Recruitment checks were completed before new staff started.
“There were enough staff on duty to keep people safe.” from the report
Safe medicines
Medicine records were well completed, stock was checked and protocols supported the safe use of medicines given when needed.
“Medicines were safely managed.” from the report
Kind interactions
People and relatives spoke positively about staff. Inspectors observed staff comforting people, talking with them and offering choices.
“We observed in the most part staff were kind and caring and comforted people when they became distressed.” from the report
Activities and flexible care
The home offered activities such as music, games, pet therapy and a themed café. Daily routines had become more flexible and centred on people’s preferences.
“Daily routines were more flexible and centred on the needs and preferences of people who used the service.” from the report
Improvement since the last inspection
The home made improvements across all areas and was no longer rated Inadequate or in Special Measures.
“During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions.” from the report
Quality checks missed problems
seriousThe home’s monitoring systems did not reliably identify problems with risk records, moving equipment, consent records and care plans. This was a breach of Regulation 17.
“This showed us the providers systems for assessing and monitoring the quality and safety of the services provided were not always operated effectively.” from the report
Risk and moving equipment records
seriousOne care record contained contradictory manual-handling information. Records did not always show who had assessed whether equipment was suitable, and some slide sheets were the wrong size.
“Some staff said that slide sheets in people's rooms were unsuitable as they were the wrong size.” from the report
Dignity and mealtimes
needs fixingInspectors saw one person left wet for 55 minutes after urinating on the floor. On one inspection day, people waited a long time for food, and some became anxious or left the dining room.
“It was 55 minutes later that staff noticed the person was wet.” from the report
Consent records
seriousThe home generally acted in people’s best interests, but capacity assessments and best-interest decisions were not consistently recorded. There was limited evidence for some restrictive devices.
“However, this was not always supported by the records.” from the report
Uneven patio
needs fixingThe patio had uneven paving that created a trip hazard. Staff were expected to support people whenever they used the area until it was made safe.
“Although there had not been any falls in this area the uneven surface created a trip hazard.” from the report
- 01How do you now check that every risk assessment names the person who completed it and contains consistent moving and handling information?
- 02What action has been taken to make sure the patio is safe and that suitable slide sheets and other moving equipment are available?
- 03How are mental capacity assessments and best-interest decisions recorded for bed rails, sensor mats and other restrictive devices?
- 04What has changed to make mealtimes more organised and to avoid long gaps between meals?
- 05How will you maintain enough permanent nursing staff and continuity of care if the home becomes fuller?
This was an unannounced comprehensive inspection covering all five key questions, the building and the care provided. This explanation was written from the published report of 15 November 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 Riverview Nursing Home
6 rated inspections over 4 years: the service has held its Good rating throughout.
- November 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- March 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- September 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2016Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- February 2012
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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