The inspection took place on 29 August 2018 and was unannounced.

Riverside House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Riverside House provides accommodation and support to a maximum of 10 younger adults who may have a learning disability or autistic spectrum disorder. At the time of this inspection there were three people using the service full time and two people who used the service for short periods of respite.

At our last inspection in October 2017, we found the provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations for Regulation 12: Safe care and treatment, Regulation 17: Good governance and Regulation18: Staffing. We asked the provider to complete an action plan to show what they would do and by when. At this inspection we found the provider had implemented the actions and was no longer in breach of these regulations.

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.

People were assessed and supported to take their medicines safely as prescribed by staff who had been checked as competent and who followed national best practice.

The provider had systems and process in place to ensure staff were appropriately recruited into the service. Staff received appropriate induction, supervision, support and training to acquire and update their skills to meet people’s individual needs and fulfil their roles.

We observed there were enough staff on duty to meet people’s needs. People confirmed they received care and support from regular staff who they knew.

The provider completed a range of checks and audits to maintain and improve the service.

People told us they felt safe living at the home and staff understood how to recognise and report any signs of abuse.

At the time of our inspection, everybody living at the home had been assessed as having capacity under the Mental Capacity Act 2005. Management and staff understood their responsibilities under the MCA and were actively promoting people's independence. People had consented to their care and support and this was recorded in their care plans.

People received information in a format they could understand and were supported to communicate their needs, and these were recorded to ensure they were met.

The provider included people or their representatives in discussions regarding their health and wellbeing. Any positive behaviour support plans were evaluated and included input by appropriate health professionals for effectiveness.

Care plans included information to ensure staff were informed and respectful of people's cultural and spiritual needs.

People were supported to maintain a healthy and balanced diet. Care plans contained details

of people's preferences and any specific dietary needs they had, for example, whether they were diabetic, had any allergies or religious needs.

Staff had a good understanding of people's needs and were kind and caring. They understood the importance of respecting people's dignity and upholding their right to privacy.

There was information available on how to express concerns and complaints. People were encouraged and supported to raise their

The inspection took place on 10 October 2017 and was unannounced.

We previously inspected this service on 5 November 2015. The service was rated ‘Good’ overall with ‘Requires Improvement’ in Well-Led. This was because the provider did not have an effective system in place to assess, monitor and improve the quality and safety of the service provided. This was a breach of Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following our inspection, we asked the provider to send us an action plan to describe the measures they intended to implement to meet with the breaches of legal requirements. At this inspection, we checked and found the provider had not completed all the actions and remained in breach of this regulation.

Riverside House is a residential care home which provides accommodation and support to a maximum of 10 younger adults who may have a learning disability or autistic spectrum disorder. The service is on the edge of the town centre in Goole, East Yorkshire. At the time of the inspection, there were five people using the service full time and two people who used the service for periods of respite.

We were supported at the inspection by 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.

The provider failed to follow their own policy and procedures to ensure, where people received support with their medicines, that care workers responsible for this activity had received up-to-date training and were regularly assessed to ensure they were competent. Guidelines for the management of medicines were not followed, which put people at increased risk of not receiving their medicines as prescribed.

The provider had failed to follow their policy and procedure to ensure care workers received regular, appropriate supervision and appraisal of their performance in their role to ensure any training, learning and development needs were identified, planned for and supported.

We found people who used the service were not assured a quality service because there was not effective system in place to assess, monitor and improve the quality and safety of the services provided in the carrying on of the regulated activity (including the quality of the experience of service users in receiving those services).

People were protected from avoidable harm and abuse by care workers who had received training in safeguarding from abuse and understood how to escalate their concerns for further investigation. The provider ensured all concerns were recorded and evaluated to help prevent re-occurrence to keep people safe.

Checks were completed in and around the home environment to ensure the safety of everybody who used the home. Risk assessments had been completed and were in place to ensure people received care and support without unnecessary restrictions.

Care workers discussed how they maintained people's confidentiality and when to raise any concerns.

The provider ensured there were sufficient care workers on duty to meet and respond to people’s individual needs. Recruitment checks were completed which helped the provider to make safer recruiting decisions and minimise the risk of unsuitable people working with adults who may be vulnerable.

The registered manager understood their responsibilities as part of their registration with the CQC and had informed the CQC of significant events in a timely way. There was a defined staffing structure and all staff understood their responsibilities and when to escalate any concerns.

People were supported to prepare food and were encouraged to eat healthily. People had access to other health professionals where this was required to help

The inspection of Riverside House took place on 05 November 2015 and was unannounced. At the last inspection in January 2014 the service was meeting all of the regulations we assessed.

Riverside House is a residential care home that provides accommodation and support to a maximum of ten adults who may have a learning disability or autistic spectrum disorder. The service is on the edge of the town centre in Goole, East Yorkshire. At the time of the inspection there were five people using the service.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager in post. 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.

People that used the service were protected from the risks of harm or abuse because there were safeguarding systems in place for staff to follow. We saw that staff were trained in safeguarding adults from abuse and they were aware of their responsibilities to make referrals to the local authority safeguarding adults’ team.

We found that people were protected from discrimination of any kind on the grounds of disability because the service upheld their rights and ensured people were represented by advocates or were equipped to represent themselves. Risks to people were reduced because of the risk assessment and management systems in place to protect them.

There were sufficient staff to safely care for people and we found that staff were appropriately vetted to work with vulnerable people before their employment began. People were protected from receiving the wrong medicines because medication management systems were safely followed.

We found that people were supported by trained and competent staff that received induction to their roles, were supervised by the registered manager and took part in an appraisal scheme, to ensure they were the right staff to care for vulnerable adults.

People and staff communicated well and staff sought consent from people before any support was given. People’s rights were protected because the principles of the Mental Capacity Act were followed and upheld.

We saw that people’s nutritional needs were met, but sometimes the foods they chose to eat were not always as healthy as they could be and so sometimes people made unwise food choices. People’s health care needs were met by monitoring needs and attending appointments whenever necessary and advice given by health care professionals was followed to ensure people’s optimum health.

People enjoyed premises that were suitable for purpose, were adequately furnished and decorated and offered satisfactory comfort. The premises were maintained in line with health and safety requirements.

We found that people were cared for and supported by kind and caring staff that also exercised a firm approach when needed to ensure people were appropriately guided to safer lifestyles. Staff offered advice and guidance to assist people to lead a fulfilling life. People were supported to undertake activities of their choosing.

People’s general wellbeing was monitored and efforts were made to assist them to improve their mental and physical health. People experienced high levels of privacy and dignity, which meant they were respected as individuals.

We saw that people had person-centred care plans to instruct staff on how best to meet their needs. These were well written and reviewed regularly.

People were able to complain if necessary, which meant their issues were satisfactorily resolved.

There was no effective quality assurance system in place to help drive improvement. This was a breach of regulation. You can see what action we have told to the provider to take at the end of the full version of this report.

People experienced a positive culture at the service and the service aims and objectives were clearly stated within the ‘statement of purpose’.  Records held on people that used the service and staff and for the running of the service were appropriately kept and maintained and they were safely stored.

People received care in a manner that respected their choices and decisions. Two people who used the service said they got on well with the staff and were happy with their care.

People were cared for in a clean and hygienic environment. Two people who spoke with us said they had their own rooms and were supported by the staff to complete domestic tasks such as laundry and room cleaning.

The home was designed to meet the needs of people who lived there and the provider ensured the environment was regularly maintained, safe and fit for purpose.

Robust employment and recruitment practices were in place which ensured that staff had the skills, experience and qualifications for the work to be performed.

The provider had an effective quality assurance system in place and people’s views and opinions of the service were listened to and acted on where necessary.

We spoke briefly on the telephone to people who used this service, as they were out at college whilst we were inspecting. We were unable to speak to relatives of the people who used the service, so we gathered evidence of people’s experience of the service by reviewing their care records and other associated paperwork and talking to the manager.

People who used the service told us they had confidence in the staff and were, “Well looked after”.

People told us they were enabled to take part in activities of their choosing and that their comments were listened to and acted upon.