Inspection on 08/02/07 for Rivington Park Nursing Home

This inspection was carried out on 8th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rivington Park Nursing Home 09/02/06

Rivington Park Nursing Home 20/09/05

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 Mrs Felicity Lacey Unannounced Inspection 09:30 8 February 2007 th 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.V322688.R01.S.doc Version 5.2 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.V322688.R01.S.doc Version 5.2 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.V322688.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The home is registered for a maximum of 25 service users to include: 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. 9th February 2006 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. The fees at this home at the time of this inspection were ranging from £313 to £420. Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit, which contributed, to this inspection report took place unannounced. The visit was carried out by two inspectors who spoke with residents, the manager, staff and a visitor. The premises were toured. Case records and other documentation were viewed. 10 comment cards were received from residents, 1 from a relative and 10 comment cards were completed by GP’s. The inspection was also informed by a Pre Inspection Questionnaire which was completed by the registered manager. What the service does well: The service provides nursing care for up to 25 people. The comments received included: ‘My mother is always given the best care and attention’ ‘I find the care of my husband is very good and all the staff are really wonderful, friendly and helpful. No complaints.’ ‘A good friendly and homely place.’ ‘Staff are all very nice.’ ‘I am very happy living here, I have no complaints.’ ‘My impression is the care, especially the senior nursing staff, are excellent’ (GP comment) The residents are assisted and supported in way which respect their privacy and dignity and in line with their individual care needs. The residents were very positive about the food and meals at the home. The residents were all positive about the staff of the home, and felt that they were committed to providing a good standard of care. They commented that the manager is always approachable and readily available. The health needs of residents are monitored and the staff are active in involving specialist health professionals when needed, for example the tissue viability nurse has been involved recently. Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 6 There are regular activities and entertainment for residents to enjoy and residents preferences about taking part are respected. Relatives are welcomed into the home and are involved were appropriate in the planning of the care their relative needs. The manager has encouraged staff to undertake National Vocational Qualifications. The staff consider the manager to be supportive and committed to providing good quality care at the home. What has improved since the last inspection? What they could do better: The recording of the receipt and administration of medication needs to be improved. The home does offer health and safety training and a days induction for new staff, this should be improved by providing a more structured and in depth induction. The manager explained that this is currently being introduced. Staffing levels have been difficult to maintain at times and it is important that as the needs of residents change this is reflected in the staffing arrangements. The introduction of a new shift system has begun to help with staffing and has provided more care staff during the day. However staff time remains pressured. The manager currently undertakes all aspects of the administration and management of the home, she also works as a member of the care staff. The demands of the manager’s role should be considered, as currently some management tasks are not being carried out due to time pressures, for example formal supervision of staff. Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 8 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.V322688.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process at the home ensures that the residents individual needs can be met at Rivington Park. EVIDENCE: Four residents case files were looked at, these contained comprehensive information gathered at the time of admission to the home. The managers own assessment formed the basis of the on going care plan. The information was supported by social work and health assessments. Files also contained assessments carried out by the Primary Care Trust regarding the level of nursing care required. All service users had signed contracts on file, some contracts contained a breakdown of the fees payable. The manager should ensure that this is clear on all contracts. Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health needs of residents are met and this ensures that welfare is promoted. EVIDENCE: The residents care plans seen clearly identified the needs of the individual and how these should be met. The residents spoken with felt that the staff understood their needs and provided support and assistance in a way that respected privacy and dignity. Residents and their representatives were involved in reviewing the care plan and the home actively encouraged this. The manager oversees all reviews. The health needs of residents where documented and monitored. Residents were confident in the health care they received. There was evidence of the involvement of specialist health advisers were needed, for example evidence of the input of the tissue viability nurse, physio and continence adviser was recorded on individual files. The manager ensured that residents had the equipment they required, such as pressure relieving mattresses. Nutritional Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 11 screening is undertaken on admission and records are maintained of nutrition as required in the residents care plan. Residents have access to regular hearing and sight tests. 10 GPs completed comment cards which confirmed that the home worked in partnership with the local health services, that residents were seen in private, and specialist advise is acted upon. The arrangements for the storage and administration of medication were looked at. The home has a dedicated medication room in which all medicines are stored. The home must ensure that hand written transcriptions on the MAR sheet should be signed and countersigned. The records of variable dose medication must be clearly maintained to show the number of tablets given. All other records seen were completed correctly. Residents have the option of selfmedicating. The privacy and dignity of residents is respected at the home. Residents are able to receive their guests in private. There are three double rooms, which are en-suite. These rooms are shared by agreement and privacy screening is provided. Resident’s preferences are respected, for example the term of address preferred by the resident is used. Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The activities and events at the home allow residents to continue to enjoy their own leisure interests. The residents have a wholesome and appealing diet. EVIDENCE: There is a range of activities on offer at the home. A dedicated member of staff provides activities each weekday, for example she had recently held a session that encouraged residents to reminisce about their memories of holidays. Residents who take part in the organised activities thought they were enjoyable. The home also has visiting entertainers and occasional trips out. Residents are able to continue to enjoy their own hobbies. The social background and interests of residents is not always routinely written down, however staff had a good understanding of resident’s interests. There is a plan to introduce new care planning and assessment documentation and this will prompt a more in depth consideration of social history and interests. Arrangements are made at the home to ensure that residents are able to continue to practice the religion of their own choice. Visits by local clergy are arranged and details are on the notice board. Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 13 Residents are able to receive visitors at any reasonable time. A visitor confirmed that she was always made to feel welcome, and that she could visit when ever she wished. There was information displayed in the home encouraging relatives to become involved in the planning of care, where appropriate. Residents are encouraged to express their views and to exercise personal choice. Details of local advocacy services are prominently displayed in the home and are contained in the Service User Guide. Residents are advised of their right to view their personal records and are reminded of this right by a poster displayed at the home. The residents spoken with thought the meals were very good. Attention is paid to individual likes and dislikes. Special diets are catered for. Liquefied diets are presented in an appealing way. Some residents did not know what was on the menu for lunch, and the manager will make sure that all residents who do not read the menu notice are told of the menu options each day. At teatime a wide range of foods are offered. The manager will remind staff to make sure that the way in which they refer to the residents who require assistance with their meals is respectful, as staff were heard referring to this group of people as the ‘feeds’. The manager will also make sure that all meals are served warm as in some cases the meal and pudding were being served at the same time, this can mean that some food is cold by the time the resident is ready to eat it. Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints policy ensures that residents are able to raise concerns. EVIDENCE: The home has a complaints procedure that is contained in the service user guide and on display on the notice board. The pre inspection questionnaire indicates that no complaints have been received since the last inspection. The residents spoken with said they felt able to raise any concerns with the manager. Staff spoken with confirmed that they knew how to respond to any concerns raised. Staff spoken with had an understanding of adult protection issues and knew what to do in any case of suspected abuse or mistreatment. Staff have access to a DVD training package and those staff who have completed National Vocational Qualification have received additional training in Adult Protection. Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and clean this ensures that residents have a pleasant place in which to live. EVIDENCE: The home is located near to local shop and in easy reach of Chorley town centre. There has been on going maintenance and renewal. A formal plan has been drawn up by the manager that is to be agreed with the provider as part of the business plan. Home was clean and tidy. There was a variety of seating and settings in which to spend time. There is a small outdoor paved area, which is accessible by a ramp. The garden is equipped with furniture. There are infection control measures in place. As recommended at the last inspection the home has now ensured that it complies with the Water Supply (Water Fittings) Regulations 1999. Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes recruitment policy protects the welfare of residents. Staffing levels are in need of constant review to ensure that the changing needs of residents can be met. EVIDENCE: The staffing of the home is arranged to ensure that there are more staff on duty at peak times. The rota has been rearranged to provide more staff during the morning period. A dedicated activity person is employed during the week. The manager explained that there have been problems with staff shortages over the past months but these now seem to be resolved. The residents spoken with felt that staff were readily available to assist with personal care and health needs, however the staff were very busy and had little time to spend chatting to residents. The manager is aware of the need to ensure that staff ratios reflect the needs of residents and these can change quickly. Staff spoken with confirmed that they had been encouraged to undertake National Vocational Qualifications. Currently 7 out of 18 care staff have achieved a National Vocational Qualification at level 2 or above. The recruitment process is thorough and underpinned by a commitment to equal opportunities. The files seen contained the required references and checks. All members of staff had the required Criminal Record Bureau Disclosure. It is important that recruitment checks are completed for all staff Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 17 including bank staff, as one file showed that for a period a member of staff had worked without a disclosure check being completed. Staff training is on going and the induction programme is an area that should be developed. The manager is aware of this but has found that it is difficult to find the time needed to plan and implement the training required consistently, as she continues to be part of the care team rota and the trained nurse on duty as well as being responsible for the management and administration at the home. Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in way that involved residents and responds to their views. Health and safety policies are in place, which ensure the safety of residents. EVIDENCE: The registered manager has many years experience in the provision of nursing care. Residents, relatives and staff thought highly of her and the way in which she manages the home. The manager has embarked on the Registered Managers Award, but has currently put this on hold due to the demands on her time involved in the day-to-day operation of the home. She is supported in her role by an operations manager and by an established staff team. The opinions of residents, relatives and stakeholders are sought through surveys. The outcomes of the most recent resident and relatives survey were Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 19 on display on the notice board. The home has Investors in People Award. The company is working with an external consultant to devise a business plan. The policies and procedures have been reviewed and updated as part of this process. The registered provider is required to complete visits to the home under regulation 26 of the Care Homes Regulations 2001. In this way the company can demonstrate that it has carried out regular monitoring visits during which the views of residents and staff have been sought, and can show the action taken and progress towards addressing any issues raised. A copy of the Regulation 26 report should be given to the manager and made available to the Commission for Social Care Inspection. The residents maintain control over their own money or have a representative appointed to act on their behalf. Resident’s personal allowances are kept at the home and any transactions are recorded and signed and countersigned by a senior member of staff. Money is stored securely. A register of valuables has been established following the last inspection visit. The Pre inspection questionnaire detailed the health and safety checks that have been carried out. Some of these checks were spot checked during the site visit and found to be accurate. Staff are made aware of safe working practices through training and risk assessments which cover identified hazards. Accidents are recorded and the manager was advised to ensure that these records were maintained in line with Data Protection requirements. Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 20 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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? 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. 2. Standard OP9 OP9 Regulation 13(2) 13(2) Requirement All handwritten transcriptions must be signed and countersigned. The administration of variable dose medication must be accurately recorded. Timescale for action 09/02/07 09/02/07 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. Refer to Standard OP31 Good Practice Recommendations The registered person should ensure that the manager has a management qualification by 2005 The registered person must ensure that 50 of the care staff are appropriately qualified to NVQ Level 2 Staff induction and foundation training should be provided. 2. 3 OP28 OP30 Rivington Park Nursing Home DS0000043352.V322688.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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