Rivermere retirement and care home is jointly managed by Willowbrook healthcare (which is part of the Brand Avery and is known operationally as Avery) and WT UK Opco 2 ltd.

The service is required to have a registered manager as part of the conditions of their registration. A registered manager is a person who has registered with the CQC 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. Willowbrook healthcare had a registered manager in post who was registered with the Care Quality Commission (CQC). WT UK Opco 2 ltd did not have a registered manager in post who was registered with the Care Quality Commission (CQC). However, in terms of day to day management of the service there was a registered manager in post. WT UK OPCO ltd took steps, following the inspection, to resolve this issue.

This inspection was carried out on 18 October 2017. The service was registered to provide accommodation with care to older people and those living with dementia. At the time of our inspection there were 49 people using the service. The service was structured into two units. The assisted living unit was located across two floors for older people and the memory care unit was located on the top floor for those who were living with dementia. There were 13 people living on the memory care floor.

This was the first inspection of this registered provider since they were registered for this location.

People told us they felt safe using the service and had their needs met. Staff knew what action they needed to take to keep people safe. Risks to people’s safety had been assessed and minimised to eliminate avoidable harm. One potential safeguarding matter had been reported through the complaints procedure rather than using the safeguarding policy. This was resolved during the inspection. We made a recommendation about this for future practice. The premises and equipment had been well maintained and there were effective systems in place to respond to emergencies. The service was kept clean and hygienic to reduce the risk of infection. People were supported to manage their medicines safely. We made a recommendation about the system for disposing of topical medicines (creams and lotions).

There were enough staff working in the service to meet people’s needs. There were staff vacancies in the service that were being covered by agency staff. The registered manager had an ongoing recruitment plan to fill the vacancies. We made a recommendation about this. Staff recruitment procedures were robust and ensured that staff were safe and suitable to work in the service. Staff received training that ensured they were skilled and competent to meet people’s needs. There were opportunities for staff to develop their skills through qualifications. Staff were supported through supervision meetings and team meetings.

People had enough to eat and drink to meet their needs and they were enabled to make choices about their meals. They had care plans that ensured their health needs were met. People were supported to access relevant healthcare professionals and advice given was followed by staff.

People were asked for their consent to care before it was provided. Where people lacked capacity to make their own decisions the principles of the Mental Capacity Act 2005 were followed. People’s right to liberty was upheld and staff understood their responsibilities to ensure people’s human rights were upheld. The service had an effective policy for ensuring care provided did not discriminate in any way.

People received flexible and personalised care. They had been involved in developing and reviewing their care plans. People told us that their care was based around their preferred routines. Consideration had been given to the specific needs of people living with dementia w