We inspected Riverside House on 24 April 2017. The inspection was unannounced and carried out by one inspector. Our last inspection took place on the 30 September 2015 during which we found that people’s care plans did not always clearly state how people would be supported to achieve their goals.

Riverside House is a forensic mental health service that provides accommodation, supervision and support for nine males with complex mental health needs. At the time of the inspection there were nine people living in the home. The home was laid out over three floors, with shared communal bathrooms, lounge and kitchen. The manager’s office is housed in the communal garden and the staff office is located in the premises. The home does not have a lift and there is CCTV on site in communal areas.

The service had a registered manager who was present during the day of the 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 2008 and associated Regulations about how the service is run.

Clear guidance was in place to make certain the likelihood of potential risks was reduced and there was a planned multi - agency approach to monitoring and responding to risk. Risk assessments were reviewed when there had been a change in people’s circumstances. Safeguarding practices was followed to protect people from abuse and staff understood how to protect people from harm. Care was delivered by staff who had received specific training and skills that were reflective of the needs of people who lived in the home.

Staff were deployed to support people when this was needed and background checks were carried out to assess the suitability of employees before they began work. Medicines were managed safely and staff had obtained the necessary training to administer these. Referrals were made to health professionals when there were concerns about people’s healthcare needs. People’s nutritional requirements were met and they were encouraged by staff to eat a well - balanced and healthy diet.

Environmental checks were carried out on the premises and people were updated on matters affecting the home. Care plans were personalised and showed how people attained their achievements and participated in the interests that suited them. Positive interventions were sought when people needed support and advice. People were aware of who to raise their concerns with and complaints were investigated and responded to within a reasonable timescale.

Staff used the least restrictive measures when people’s capacity required assessments under the Mental Capacity Act (MCA) 2005. Deprivation of Liberty Safeguards (DoLS) authorisations were in place for two people and the conditions of these were adhered to. Easy read information was accessible for people and their confidential records were safely stored. People had access to their own personal records when they chose.

People’s independence was encouraged to enable them to take steps to make their own decisions and choices. Staff sought to engage people and when this was refused, their decisions were respected. They listened to people’s views and sought their opinions and ideas through the use of surveys; however these had not been evaluated. Staff ensured people’s privacy was respected and advocates were used so people’s views could be heard.

Staff were committed to delivering quality care and people felt confident about the ability of staff to support them when this was needed. The registered manager established good links with partner agencies, and people and staff spoke positively about the registered manager’s ability to provide good care. Quality assurance systems were in place to effectively improve the quality of care delivered.

We inspected Riverside House on 24 April 2017. The inspection was unannounced and carried out by one inspector. Our last inspection took place on the 30 September 2015 during which we found that people’s care plans did not always clearly state how people would be supported to achieve their goals.

Riverside House is a forensic mental health service that provides accommodation, supervision and support for nine males with complex mental health needs. At the time of the inspection there were nine people living in the home. The home was laid out over three floors, with shared communal bathrooms, lounge and kitchen. The manager’s office is housed in the communal garden and the staff office is located in the premises. The home does not have a lift and there is CCTV on site in communal areas.

The service had a registered manager who was present during the day of the 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 2008 and associated Regulations about how the service is run.

Clear guidance was in place to make certain the likelihood of potential risks was reduced and there was a planned multi - agency approach to monitoring and responding to risk. Risk assessments were reviewed when there had been a change in people’s circumstances. Safeguarding practices was followed to protect people from abuse and staff understood how to protect people from harm. Care was delivered by staff who had received specific training and skills that were reflective of the needs of people who lived in the home.

Staff were deployed to support people when this was needed and background checks were carried out to assess the suitability of employees before they began work. Medicines were managed safely and staff had obtained the necessary training to administer these. Referrals were made to health professionals when there were concerns about people’s healthcare needs. People’s nutritional requirements were met and they were encouraged by staff to eat a well - balanced and healthy diet.

Environmental checks were carried out on the premises and people were updated on matters affecting the home. Care plans were personalised and showed how people attained their achievements and participated in the interests that suited them. Positive interventions were sought when people needed support and advice. People were aware of who to raise their concerns with and complaints were investigated and responded to within a reasonable timescale.

Staff used the least restrictive measures when people’s capacity required assessments under the Mental Capacity Act (MCA) 2005. Deprivation of Liberty Safeguards (DoLS) authorisations were in place for two people and the conditions of these were adhered to. Easy read information was accessible for people and their confidential records were safely stored. People had access to their own personal records when they chose.

People’s independence was encouraged to enable them to take steps to make their own decisions and choices. Staff sought to engage people and when this was refused, their decisions were respected. They listened to people’s views and sought their opinions and ideas through the use of surveys; however these had not been evaluated. Staff ensured people’s privacy was respected and advocates were used so people’s views could be heard.

Staff were committed to delivering quality care and people felt confident about the ability of staff to support them when this was needed. The registered manager established good links with partner agencies, and people and staff spoke positively about the registered manager’s ability to provide good care. Quality assurance systems were in place to effectively improve the quality of care delivered.

We spoke with two people who lived in the home who said they liked living in the home and that staff supported them with their needs. People were asked for their consent before they received care and support. People told us that they received support according to their wishes. People were helped to re-acquire skills to become more independent. People living in the home had significantly improved their independent skills. The service encouraged people to eat healthily.The provider worked in co-operation with other professionals to protect the health, safety and welfare of people who used the service. There was an effective complaints system and staff addressed any issues raised by people in the service.

People who used the service told us they were happy living in the home. They said staff were friendly, supportive and helpful to them. The service encouraged people to be independent and supported people to lead varied and active lives of their choice. People were respected and involved in decisions affecting them. The service worked effectively with other professionals to meet the needs of people who had mental health issues. We found there were sufficient numbers of staff who were appropriately vetted and suitably skilled and experienced to work with people. Staff said they received good training and supervision which supported them when working with people.

People were generally happy at Riverside House and felt involved in decisions about their care. Most people felt Riverside House was the right place for them at this point in their lives.

People felt their interests and beliefs were respected. One person sometimes felt the need to follow certain religious practices around food and food preparation. The home supported this although this person felt that perhaps more could be done.

One issue that several people raised was about unacceptable behaviour, such as abusive shouting, by some people using the service. This seemed to have improved recently and people had some confidence ithat the staff were managing this situation.

People were positive about the staff and particularly the manager. People said they felt safe and able to raise any concerns. We saw evidence that people’s concerns were taken seriously and acted on. We saw the staff acting quickly to support one person who was becoming unwell.