This inspection took place on 18 and 27 April and 1 May 2018. The first day of the inspection was unannounced. This meant the provider did not know we would be visiting.

This was the first inspection since the location registered with a new provider in March 2017. 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. There were 46 beds and 44 people living in the home at the time of the inspection.

A registered manager was in post who as on extended leave at the time of the inspection. Their post was being covered by an interim manager who supported us during the inspection. They are referred to as ‘the manager” in the remainder of the report.

We checked the management of medicines and found records did not always provide clear instructions about how people’s medicines should be administered. Homely medicines were not always recorded.

There were ample staff present during the inspection but we found deployment was not always effective. People and staff told us things could be chaotic, and staff said they would like more direction. We have made a recommendation that the provider monitors the deployment of staff.

Safeguarding procedures were available and staff were aware of these. We found they were not always followed and the manager told us staff would be reminded of the correct procedure should they have any concerns of a safeguarding nature.

Accidents and incidents to people were recorded and monitored. Risks to people were assessed and measures put in place to mitigate these. We found that some records were not up to date or there was conflicting information about the risks posed to some people.

A falls analysis had resulted in action being taken to support one person and the number of falls recorded had reduced as the result of this intervention.

Safe recruitment processes were followed to help ensure people were cared for by staff that had been correctly vetted.

Maintenance records were well organised and up to date. We saw checks to the safety of the premises were carried out regularly and procedures to control the spread of infection were followed by staff. A number of improvements had been made to the building.

People were nicely supported at mealtimes by staff who gently encouraged people to eat. Most people told us they enjoyed the food. Records relating to food and fluid intake and dietary needs had gaps and omissions. People’s weights were monitored and where they were found to be losing weight advice was sought form their GP or dietician.

The service was not always operating within the principles of the Mental Capacity Act [MCA] and the regional manager had identified gaps in staff knowledge and issues with care records which they were addressing. We have made a recommendation to monitor the consistency of the quality of care planning and application of the MCA.

Staff received regular training. There were some training gaps but plans were in place to address these. Some new staff told us they felt the induction could have prepared them better for working in the home. We passed this back to the manager to enable them to review this with staff.

The health needs of people were met. They had access to a number of health professionals.

There had been a number of improvements to the environment which had been redecorated and new flooring laid.

We observed numerous kind and caring interactions between staff and people. People and relatives gave us positive feedback about the staff.

At times the privacy and dignity of people was compromised through the language staff used which was not always person centred. Some information about people including personal care needs was publicly displayed which also compromised their dignity.

Care plans were in place but these varied in quality and det