Inspection on 20/09/05 for Rivington Park Nursing Home

This inspection was carried out on 20th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Rivington Park Nursing Home 08/02/07

Rivington Park Nursing Home 09/02/06

Rivington Park Nursing Home 07/12/04

Rivington Park Nursing Home 20/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Rivington Park Nursing Home 206 Eaves Lane Chorley Lancashire PR6 0ET Lead Inspector Della Lovell Announced Inspection 20th September 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rivington Park Nursing Home Address 206 Eaves Lane Chorley Lancashire PR6 0ET Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01257 269029 Phloubateer Limited Mrs Elizabeth Clara Greenwood Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The home is registered for a maximum of 25 service users to inlcude: Up to 25 service users in the category OP (Old Age, not falling within any other category). The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 7th December 2004 Date of last inspection Brief Description of the Service: Rivington Park is a purpose built home in Eaves Lanes, close to Chorley town centre and well provided by public transport. Eaves Lane has a variety of shops which are all easily accessible from Rivington Park Nursing Home. The home is registered to care for up to 25 service users with a range of physical and social needs, requiring nursing care. The accommodation presently comprises of a number of single rooms and three shared rooms. The three shared rooms are all on the ground floor and have en suite facilities. The home has two floors which can be accessed by a passenger lift. Each floor has its own lounge and dining area and service users are able to use whichever lounge suits them or, if they prefer, spend time in their own rooms. The home provides a variety of social activities and maintains links with the local community. Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over one day in September 2005. The inspection involved discussion with the people who lived and worked at the home and visiting family members and an examination of records. What the service does well: What has improved since the last inspection? What they could do better: On the day of the inspection both staff and a relative expressed concerns about the staffing levels at Rivington Park. The home should undertake a thorough review of the staffing levels taking into consideration the dependency needs of the current service users living in the home. The registered manager must ensure that the agreed minimum staffing levels are adhered to. The lines of accountability and support from external management is unclear and the unannounced visit by the registered provider required under regulation 26 was taking place. This must be addressed and regular meeting for the Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 6 registered manager should be made available where issues relating to staffing and other concerns could be discussed. A number of staff still required updates with regards to moving and handling and food hygiene certificates. Three staff had an NVQ Level 2 qualification. The registered manager was aware of the need to ensure 50 of the staff have an NVQ qualification a programme should be put in place to address this. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home had a thorough assessment procedure which ensures service users needs are assessed and met. EVIDENCE: The home had a good admission procedure to ensure service users needs are assessed and planned for. Observation of service users files showed that all new service users are admitted only on the basis of a full assessment and for individuals referred through social services the registered manager had obtained a local authority assessment. The registered manager is a qualified experienced nurse and carries out the pre admission assessments, which ensures that an appropriately trained person had done the assessment. One relative told the inspector that the home had visited her family member prior to admission and since admission there had been some general improvements in their health. Two family’s told the inspector that the staff were very hard working and caring and felt that their relatives needs were being met but staff did not seem to have to time to spend to sit or talk with service users. Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 10 Each service users had an individual care plan, which provided comprehensive information and detail to ensure that service users health, personal and social care needs can be fully met. EVIDENCE: Each service user had an individual plan of care, which sets out in detail the action that is needed to be taken by the nursing and care staff to meet their needs. Each service user had a daily record sheet, which recorded the care given and any significant events. Care plans are reviewed each month and one relative told the inspector that they were given the opportunity to be involved in the process. The files of three service users were viewed in detail as part of the inspection process. Each service users file contained various records / charts for monitoring and recording any health care intervention. These records were up to date and provided detailed information. Two service users files contain specific information relating to the community nurse and the tissue viability nurse and one file showed a significant improvement from the treatment being received. One relative said that the Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 10 staff are respectful to her mum and the inspector saw examples of staff caring and speaking to service users in a sensitive manner. Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 The home has an open visiting policy which ensures that service users maintain contact with the community and their families. EVIDENCE: A number of relatives where in the home at the time of the visit. One relative said that they are encouraged to visit and there were no restrictions on visiting times. One relative told the inspector that they often take their family member to their bedroom in the evening and watch television with them. Another relative was seen taking her family member out. There was information on service users files that community health & social professionals visit the home on a regular basis and one service user said the hairdresser visits every fortnight. Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home had a complaints policy and procedure in place, which ensures that all complaints would be acknowledged and investigated. Arrangements for the protection of service users ensures the safety of service users. EVIDENCE: The home had a complaints policy and procedure in place, which is made available to all service users and their families. One relative and service user spoken to said they had no complaints about the standard of care and the conduct of the staff but knew who they could speak to about any concerns. However on the day of the inspection one relative raised concerns with the registered manager and inspector regards to the homes staffing levels. The registered manager must ensure that this is recorded and action taken appropriately. The home had a procedure in place for dealing with allegations of abuse and staff were made aware of the home policy and procedure. The manager told the inspector that the policies and procedures are left out for staff to read. At the time of the visit there was no allegations of abuse at the home. Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The home was clean, comfortable and homely and provided an environment that was suitable for its stated purpose. EVIDENCE: The home was accessible to all service users. Ramps allowed easy access to the outside and a passenger lift provided access to the first floor. Rivington Park only has a small garden/patio area to the rear, this was seen to been tidy and maintained providing a pleasant area for service users to enjoy if they wished. One relative said that it had been nice to sit out with her family member in the good weather. The new provider still has not replaced the old sign at the front of the home since taking the home over two years ago which does not provide the correct name of the provider. A number of bedrooms had been decorated since the last inspection a programme was in place to re-decorate rooms as they become vacant. The inspector noticed that the stairway leading to upstairs had also been tastefully re-decorated. The home was clean and tidy and one relative said that she visits the home very regular and the home is always kept clean and there is never any smells. The home has limited storage, a fire officers report made recommendations that the home must build a storage cupboard under the Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 14 stairways if they need to store wheel chairs there. Wheelchairs were seen stored in this area, the registered person must ensure that adequate and appropriate storage is made available. Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 29 and 30 The policies and procedure for recruitment of staff provide safeguards for the protection of service users. Staff at the home are provided with training, however a number of staff were now in need of up dates to ensure they are fully competent in the job they do. EVIDENCE: The home had a recruitment procedure in place, which ensured the Protection of Vulnerable Adults. Personnel files showed that a thorough recruitment and selection process had taken place and all new staff had undertaken induction training. The inspector noted that one CRB on an existing staff file had been used from a previous employer. The registered manager was reminded about the none portability of CRB’s. Since the last inspection the registered manager had developed a training matrix in the home, which clearly showed what training staff had undertaken and what training was needed. Certificates were seen on the staff files. A number of staff still required updates with regards to moving and handling and food hygiene certificates. Three staff had an NVQ Level 2 qualification. The registered manager was aware of the need to ensure 50 of the staff have an NVQ qualification. On the day of the visit service users were seen well cared for and staff were attentive to service users needs. The care staff are supervised and mentored by the registered nurse on the each duty shift. However the inspector noted that the needs of the service users in home varied and a number of service users were cared for in bed. One relative told the inspector that she felt that there was a shortage of staff in the home and that staff in the home were always extremely busy caring for Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 16 the service user and that they don’t have any time to sit and talk to the service users. The relative told the inspector that while staff are putting service users to bed, service users are left unattended in the lounge. On one occasion an incident occurred and the relative had to call for staff. On another occasion the relative said that one service user required the toilet and staff were busy attending to other service users. Staff spoken to were unhappy with the current staffing level, one staff member said that they do not have enough time and often have to withdraw from some of their work to prioritise other areas of work. This way of working was having an adverse reaction on staff morale and staff expressed their concerns. Staff said that they didn’t feel they have enough time to spend with service user. The inspector was told that both the activity coordinator, cook and laundry person are used to support the care staff when needed. The registered manager told the inspector that the staff had been working extra to cover holiday times. The staff rota showed that care staff hours in the home had not always been covered. It was not clear on the day whether or not the registered manager had the authority to use agency staff and there was no clear protocol in place for the registered manager to express her concern with regards to home current staffing levels with the registered provider. The inspector noted that the dependency needs of the service users were high and staffing levels should reflect this. It is a requirement from this inspection that the registered person undertakes a thorough review of the staffing levels and dependency needs of the service user. The registered manager must ensure that the agreed minimum staffing levels are maintained until the review has taken place. Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, The home is managed by an experienced manager who is fit to be in charge. However the lines of accountability and guidance from external management was unclear, which does not support the manager in the day to day running of the home. EVIDENCE: The registered manager is a trained nurse with many years experience of working in a care home. Since the last inspection the registered manager has commenced her training for the Registered Managers Award. Relatives and staff spoke positively about the manager. One relative said that the manager works really hard to ensure services users are well cared for. Staff said that the manager was supportive and would always listen to them but felt that staffing levels in the home had not been addressed. On the day of the visit the operational manager for the company was in attendance and told the inspector that she did not undertake the unannounced Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 18 monthly Regulation 26 visits on behalf of the provider. There was no evidence that the registered provider attends the home in accordance to the regulation. This remains an outstanding requirement from previous inspections. A letter will be sent to the provider with regards to this matter. Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X X X X Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 13.4(a)(c) 23(2)(L) Standard Regulation Requirement Timescale for action OP19 The registered person must provide an action plan, which will ensure that wheelchairs are stored in accordance with the Fire Officers report. (Timescale 30/10/05 of 31.9.04 and 31/3/05 not met) The registered person must review the staffing levels in the home in line with the 30/10/05 dependency needs of the current service users living there. The registered person must ensure that the home is staffed 30/10/05 in accordance with the agreed minimum staffing levels The registered person must ensure that the Commission for Social Care Inspection receive a monthly report in accordance with Regulation 26 of the 30/10/05 Care Homes Regulations 2001(Time scale of 31.5.04 not met & 30/10/05 not met) The registered person must ensure 30/10/05 that all new staff are confirmed in post DS0000043352.V251732.R01.S.doc Version 5.0 Page 21 2 18(1)(a) Op27 3 18(1) 4 26 (4)(c) OP31 (5)(a)(b)(c) op27 5 19(1) OP29 Rivington Park Nursing Home Schedule 2 6 following completion of a satisfactory CRB disclosure. The registered person must ensure that staff receive training, which equips them to meet the assessed needs of the service users accommodated and ensures safe working practices. This includes 30/10/05 moving and handling, first aid and food hygiene training. (Timescale of 31.9.04 not met and 31/3/05 not met) 18 (1) (c) (i) 13(4)(c) 13(5) OP30OP38 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP9 OP26 OP28 OP31 Good Practice Recommendations Prescriptions should be seen by the home prior to being dispensed. The registered should ensure that the service and facilities comply with the Water Supply (Water Fitting) Regulations 1999. The registered person must make appropriate arrangements to ensure staff are appropriately qualified to NVQ Level 2 by 2005. The registered person should ensure that the manager has a management qualification by 2005 Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Chorley Local Office Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rivington Park Nursing Home DS0000043352.V251732.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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