The rivers is a care home providing accommodation, care and support for up to 6 people who have learning difficulties and and/or mental health needs.

At the last inspection the service was rated Good. At this inspection we found the service retained an overall rating of Good with an outstanding rating in providing responsive care.

People continued to be protected from the risk of abuse and felt safe. Staff had a good understanding of their roles and responsibilities if they suspected abuse was happening. The registered manager shared information with the local authority when needed.

People received their medicines as prescribed and the management of medicines was safe.

People continue to be supported by sufficient numbers of staff who had received adequate training for their role.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported these practices.

People were protected from the risks of inadequate nutrition. Specialist diets were provided if needed. Referrals were made to health care professionals when needed.

People who used the service, or their representatives, were encouraged to contribute to the planning of their care. People were treated in a caring and respectful manner and staff delivered support in a relaxed and considerate manner.

People received a high standard of individualised person centred care from staff who had an excellent understanding of their needs. They were supported to take part in a wide range of social activities of their choice that placed a strong emphasis on building independence and self-esteem. These included personal fitness regimes, voluntary work schemes and college courses.

People who used the service, or their representatives, were encouraged to be involved in decisions and systems were in place to monitor the quality of service provision. People also felt they could report any concerns to the management team and felt they would be taken seriously

Further information is in the detailed findings below

We performed the unannounced inspection on 26 August 2015. Rivers is run and managed by Voyage 1 limited. The service provides accommodation and personal care for up to six adults (under 65 years) with learning disabilities and/or mental health needs. On the day of our inspection six people were using the service.

The service had a registered manager in place at the time of our inspection. 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 and associated Regulations about how the service is run.

The last inspection we undertook was on 27 November 2013, the service was compliant in all areas inspected. During this inspection we found people were protected from the risk of abuse and staff had a good understanding of their roles and responsibilities if they suspected abuse was happening. The registered manager shared information with the local authority and ourselves when needed.

Risks to individuals were managed appropriately and staffing levels were sufficient to support people’s needs, people received care and support when required.

Medicines were given as prescribed and the management of medicines was safe.

People were encouraged to make independent decisions and staff were aware of legislation to protect people who lacked capacity when decisions were made in their best interests. We also found staff were aware of the principles within the Mental Capacity Act 2005 (MCA) and had not deprived people of their liberty without applying for the required authorisation.

People were protected from the risks of inadequate nutrition and referrals were made to health care professionals when needed.

People who used the service, or their representatives, were encouraged to contribute to the planning of their care and were treated in a caring and respectful manner. Staff delivered support in a relaxed and considerate manner.

People’s behaviour patterns were monitored regularly to allow staff to provide the most appropriate support for each individual.

Systems were in place to monitor the quality of service provision and people felt they could report any concerns to the management team, and they would be taken seriously.

On the day of our inspection there were six people living at the home. We spoke in detail with two people who used the service, one family member, one external professional, two members of staff and the manager. In addition to this we spoke with people who used the service and staff throughout our visit as well as making observations. We looked at the care records of two people who used the service.

People spoke positively about the service and the staff. One person said, “It’s good overall.” Another person said “I sort of like living here, staff talk nicely to me.” A family member told us, “It is the best place they (relative) have ever lived, I give it top marks.” A professional from the community mental health team told us “The home is receptive to new ideas.” They also said, “The home is very person centred.”

The manager told us that every person had a service user handbook and person centred support plan. People and their families were involved in how the care and support was delivered.

People’s needs were assessed and person centred support plans were developed. Individual risk assessments were undertaken. Identified control measures were incorporated into support plans to manage and reduce risk.

Systems were in place for cleanliness and infection control. We saw audits which identified planned improvements. We also saw schedules and checks of cleaning activities..

We found that robust systems were in place that ensured appropriate levels of staffing were maintained. The provider supported staff with training needs.

A complaints procedure was in place. At the time of the inspection no complaints had been received.

During our visit we spoke with two people who used the service, three care staff, and the manager of the service. We also spoke with a quality assurance manager over the phone and with three relatives of people who used the service.

All of the relatives we spoke with told us they were happy with the care and support their family members received. One relative told us, “They [staff] are good at keeping me informed.” Another told us, “I am happy with everything and confident they [staff] are meeting [family member’s name] needs.”

Relatives told us that staff supported their family member’s health and personal care needs and took prompt action to get them medical attention when it was needed. They also said that staff always treated their family members with respect.

Staff we spoke with told us the provider was good in terms of ensuring that staff training was up-to-date and that they really enjoyed working at the service, some of which had worked there for a number of years.

Relatives told us they had always been happy with the care and support they witnessed on their visits and have never had any concerns.