Rivelin Care Home provides accommodation and personal care for older people, including people living with dementia related conditions. The home is situated in Cleethorpes, in North East Lincolnshire. There are various communal areas including a dining room and three lounges. All bedrooms are for single occupancy; some have en-suite facilities. Rivelin Care Home is close to the sea front and to local amenities. 36 people were residing at the home at the time of the inspection visit.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection carried out on 25 March 2015, the service was rated overall as good. We had rated the service as ‘Requires Improvement’ under the effective domain as some improvements were required to ensure the service complied with the Mental Capacity Act. At this inspection we found all improvements had been made.

At this inspection visit carried out in June 2017, we found the service the service met the fundamental standards. People and relatives spoke extremely positively about the quality of service provided. We found there was a warm, welcoming and vibrant atmosphere at the home.

There was a strong emphasis on promoting dignity in care. We found that dignity was at the centre of all care provision. Dignity champions had received additional training and skills in their specific areas. Skills were then shared within the staff team to create more positive outcomes for people who used the service. People who lived at the home were encouraged to think about dignity and how it affected them and feedback in meetings where improvements could be made. Dignity champion training had also been extended to relatives of people who lived at the home in order for them to contribute to how dignity was ensured at the home. We observed dignity being respected at all times during our inspection visit.

People who lived at the home and relatives praised the caring nature of staff and the owner of the home. Staff were constantly referred to as ‘kind’ and ‘caring.’ Relatives told us staff often went the extra mile. We observed positive interactions between people and staff which confirmed that care provision was of a high quality.

People and relatives praised the activities made available and told us there was plenty to do. The service adopted a person centred approach to the provision of activities to ensure people’s personal interests were pursued. There was a focus on developing and maintaining independence.

We saw there was an open and transparent culture within Rivelin. Prompts were set around the building reminding people of the importance of feeding back their experiences of care delivery People and relatives told us they were encouraged to raise any concerns and complaints. We saw evidence of this occurring. Relatives told us they were confident any concerns raised would be dealt with efficiently and professionally should they arise.

Care plans emphasised the importance of promoting independence and empowering people. There was a welcoming, homely atmosphere within the home where visitors were encouraged. Relatives compared the home to a family unit where people were happy and had a sense of belonging.

There was emphasis on creating positive health outcomes for people who used the service. Healthcare needs were proactively met. Relatives told us people’s wellbeing had improved since they started living at the home. They praised the ways in which people’s quality of life had increased.

Relatives praised the ways in which they were included at the home. They told us they were able to join in activities, attend meetings and were also empowered to have say in which

We spoke with five people who lived in the home. Everyone spoke positively about the care they received. They told us they liked living in the home and confirmed they were well supported to make choices and decisions about their care. One person said, "I’m pleased I moved here, the care is excellent.”

Everyone told us they were treated with dignity and respect by staff. One person told us, "The staff know me well, they treat me very well." Another person said,”The staff are nice, they don’t boss you about.”

We spent 30 minutes over the lunch time period watching people having their meal. We saw staff managed to support people efficiently and sensitively. We saw they interacted well with people and at an appropriate pace. People were offered choices about what they would like to eat and the atmosphere in the dining room was relaxed.

We looked around the premises and found people who used the service were protected against the risks of unsafe or unsuitable premises because of adequate maintenance. People spoken with told us they liked their home. One person said, “My room is comfortable and very cosy, just how I like it.”

We found staff were recruited appropriately and checks were carried out before staff worked in the home.

People had opportunities to comment on the service through regular meetings and surveys. People told us they felt comfortable about making suggestions and talking about concerns.

We spoke with two people who lived at the home and a relative. They told us that they were satisfied with the care provided by care staff. One person told us, "The staff are good here" and the relative said, "Staff are excellent. They keep me informed of my relative’s well-being and are always helpful”.

We saw that the topic of dignity had been given high priority at the home and that most staff had undertaken training on dignity awareness. A notice board displayed information for staff on how to promote dignity and a dignity champion had been appointed. However, we were concerned about people not receiving appropriate support in the dining room and felt that this did not respect their dignity.

People told us that they felt safe living at the home and the discussions we had with staff evidenced that they had a good understanding of the principles of safeguarding vulnerable adults from abuse.

Staff received training to provide them with the knowledge and skills they needed to support the people who lived at the home. Staff told us that they were well supported by the manager.

We checked complaints information at the home and saw that any complaints made were investigated thoroughly and that appropriate corrective action had been taken.

Rivelin Care Home is registered to provide residential and personal care for up to 39 older people who may have dementia related conditions. Accommodation is provided over two floors with both stairs and lift access to the first floor. The home is located in a sea side town and is close to local amenities such as the sea front, library, shops and restaurants.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

This inspection was unannounced and took place over two days. The previous inspection of the service took place on 7 May 2013 and was found to be compliant with all of the regulations inspected.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered provider had followed the correct process to submit applications to the local authority for a DoLS where it was identified this was required to keep them safe. At the time of the inspection four people who used the service had DoLS authorisations in place and the service was waiting for further assessments to be carried out.

Staff supported people to make their own decisions and choices where possible about the care they received. When people were unable to make their own decisions staff mostly followed the correct procedures and involved relatives and other professionals when important decisions about care had to be made.

People were happy and felt safe living in the home. They were treated with respect and dignity and staff displayed a warm and sensitive approach when supporting them. The same respectful and warm approach was extended to people’s relatives and visitors.

Staff knew how to identify and report any safeguarding concerns, and also knew of other agencies they could contact if they felt concerns were not being addressed.

People had the opportunity to share their views and opinions and were involved in planning and reviewing their care. They understood how to raise any complaints or issues they had and were confident the right actions would be taken to resolve issues. One person said, “I haven’t any concerns but I know they would be dealt with properly, I trust the managers to deal with things.”

People were provided with a varied diet that took account of their likes, dislikes and preferences. People told us the meals were good and we saw a choice of food and drink was offered throughout the day. Comments included, “Lovely meals” and “You can ask for anything and they will make it for you, the cook is very good.”

People had access to appropriate healthcare professionals and support services. Safe systems were in place to manage medicines and people told us they received their medicines on time.

People praised the staff for their kindness and were satisfied with the care they received. We saw staff engaged with people at every opportunity. Staff had a good knowledge and understanding of people’s needs and worked together as a team.

Staff were recruited, trained and supported to meet people’s needs appropriately. There were enough staff on each shift to meet people’s needs. They understood how to manage risks and protect people from avoidable harm.

A varied programme of entertainment and activities was available; we saw people enjoyed taking part in a quiz, manicures, film afternoon, carpet bowls, shopping trips and flower arranging.

Checks were made on the quality of the service and people’s views were obtained through meetings and questionnaires.