CQC report explained · a residential care home
What the CQC found at The Rivers
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found effective safeguarding, risk management, staffing, recruitment, medicines and infection control. Staff knew how to report abuse, accidents and other concerns.
- Effective?
- Good
- People's needs and goals were assessed and reviewed. Staff had relevant training, supported people's health and nutrition, and followed the Mental Capacity Act and authorised safeguards.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people's preferences and supported communication, choice, relationships and independence.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed with people and relatives where possible. People had accessible ways to express views, make complaints and take part in varied activities.
- Well-led?
- Good
- The home was organised, staff felt supported and people and relatives were involved. However, provider audits had not identified missed DoLS notifications to CQC, which were made during the inspection.
What inspectors found, April 2019
The Rivers was rated Good overall; inspectors found kind, personalised care, with a missed notification to CQC corrected during the inspection.
This was an unannounced planned inspection on 14 March 2019. One inspector looked at the home, its care and its records. The inspection covered all five CQC questions.
The home supported six younger adults with learning disabilities or autism. Inspectors found people were safe, treated kindly and supported to make choices. Care plans were detailed, staff were trained, and people enjoyed activities and time in the community.
The provider's checks had not identified that the manager had missed notifying CQC when some Deprivation of Liberty Safeguards applications were authorised. This was discussed during the inspection and the required notifications were then made.
The home was rated Good in every area: Safe, Effective, Caring, Responsive and Well-led. This was unchanged from the previous Good rating in September 2016.
Kind and respectful care
Staff built positive relationships and treated people with dignity. They used people's preferred ways of communicating and supported their choices.
“Staff showed genuine concern for people and were keen to ensure people's rights were upheld” from the report
Personalised support
Care plans described individual routines, needs, preferences and goals. Staff knew people well and helped them develop skills and independence.
“Care plans were personalised and detailed daily routines specific to each person.” from the report
Safety and staffing
Inspectors found appropriate risk assessments, safety checks, recruitment procedures and staffing levels. Medicines systems were organised and people received medicines when they should.
“Staff told us there were always enough staff on duty.” from the report
Activities and independence
People were supported to choose activities inside and outside the home. The home also helped people prepare for more independent living.
“A range of activities were available, including time in a hydrotherapy pool.” from the report
Staff support and learning
Staff received induction, training, supervision and appraisals. The provider used feedback and incidents to improve the service.
“Staff told us, "We talk about lessons learned in team meetings, and talk about what we can do to improve things.” from the report
Missed CQC notifications
needs fixingProvider audits had not identified that authorised DoLS applications had not been notified to CQC. The manager made the required notifications during the inspection.
“the providers audits had not identified the registered manager had not notified CQC when DoLS applications had been authorised.” from the report
- 01How do you now check that all authorised DoLS applications are notified to CQC on time?
- 02How will you involve my relative and our family in reviewing their care plan and goals?
- 03What activities and opportunities for independence would be suitable for my relative?
- 04How would you support my relative to communicate choices or concerns if they cannot express them verbally?
- 05How do you check that staffing levels remain suitable for residents' needs, appointments and activities?
This was an unannounced planned inspection covering the home and all five CQC questions; some people could not be interviewed because of their complex needs, and the provider could not complete its information return because of technical problems. This explanation was written from the published report of 11 April 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, September 2016
The Rivers was rated Good; inspectors found safe, kind and personalised care, with management arrangements changing at the time.
Inspectors visited without warning on 12 and 13 April 2016. They spoke with people, relatives, staff and managers, observed care and checked support plans, recruitment files and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines management, suitable training, respectful care and detailed support plans.
People were supported to make choices, build independence, join activities and access healthcare. Staff understood different ways people communicated and responded to their needs.
There was no registered manager when inspectors visited. The manager was due to leave shortly afterwards, and the provider planned to use a temporary manager while recruiting a replacement. The previous inspection in April 2014 found no concerns.
Enough staff
Inspectors saw staffing levels that met people's needs and allowed for spontaneous activities. The provider also had arrangements to cover sickness and other gaps.
“There were enough staff deployed at the service to ensure people's needs were met and to allow for spontaneous activities.” from the report
Kind and respectful care
Staff knew people well and supported them in a relaxed, respectful way. They respected privacy and gave people time and choice.
“People were supported by caring staff who treated them with dignity and respect in a family style atmosphere.” from the report
Personalised support
Support plans explained people's needs, goals and preferred ways of receiving support. Staff used consistent approaches and helped people develop independence.
“Support plans were seen to be written in a person centred way and described what each person needed, what was to be achieved for the person and what actions were needed to achieve this.” from the report
Activities and independence
People were supported to take part in college, shopping, cooking, community activities and other interests. Relatives said people's skills and independence had improved.
“People had also been supported to be part of the wider community, independently where possible, which some relatives felt they would not have been able promote in the same way.” from the report
No registered manager
needs fixingThe home did not have a registered manager during the inspection. The manager was due to leave, so the provider planned temporary management while recruiting a replacement.
“The service did not have a registered manager.” from the report
Communal areas needed decoration
minorThe provider had identified that the lounge and corridors looked worn. Decoration was being planned to avoid distress or disruption to people.
“The provider's monthly visit record had identified that the lounge and corridor areas were looking rather worn and were in need of decoration to improve the environment for people.” from the report
- 01Who is the registered manager now, and what management arrangements are in place if that changes?
- 02What happened with the medicines incidents mentioned in the report, and is the two-person medicines checking system still used?
- 03Have the lounge and corridor decoration works been completed?
- 04How will staff support my relative's particular communication method and choices?
- 05How will my relative be supported to develop independence and take part in activities outside the home?
This was an unannounced inspection covering all five CQC questions, based on observations, discussions with people, relatives, staff and managers, and checks of care and management records. This explanation was written from the published report of 21 September 2016 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 The Rivers
2 rated inspections over 3 years: the service has held its Good rating throughout.
- April 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 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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