CARE HOMES FOR OLDER PEOPLE
Rivington Park Nursing Home 206 Eaves Lane Chorley Lancashire PR6 0ET Lead Inspector
Della Lovell Unannounced Inspection 9th February 2006 11:30 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.V282996.R01.S.doc Version 5.1 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.V282996.R01.S.doc Version 5.1 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.V282996.R01.S.doc Version 5.1 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. 20th September 2005 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.V282996.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over one day in February 2006. The inspection involved a discussion with the people that lived and worked at the home and relatives visiting. The inspector examined records and toured the building. What the service does well: What has improved since the last inspection? What they could do better:
Although the home is clean and tidy it could do with some refurbishment and redecorating. The inspector noted that some of the chairs in the main lounge are in need of replacing and the wooden dining tables and chairs were marked and scratched. The registered person should develop a redecoration and refurbishment programme to ensure that action is taken where needed.
Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 Page 6 The home did not have a disposal of waste medicines contract in place. It is a requirement from this inspection that a contract is put in place within the next two weeks and the registered person should ensure that advice is obtained from an appropriate health care professional with regards non prescribed medication administered to service users. The registered person needs to ensure that all new service users are provided with copy of their terms and condition. 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.V282996.R01.S.doc Version 5.1 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.V282996.R01.S.doc Version 5.1 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: Two service users case files were looked at. One was a recent admission to the home. The home had undertaken a full and comprehensive assessment of this service users needs and the service user had been involved in this process. At the time of the inspection the new service user had not received her contract from the home. The registered provider must ensure at contract is issued at the point of admission. Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 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 9 Resident’s health and personal care is met by the home’s care planning process. The homes medication procedure ensures the safety of service users. However the home must ensure that medication is disposed of in the correct way. EVIDENCE: The files of two service users were looked at. One service user had recently been admitted to the home. The second service users had lived at the home for approximately 18 months and had a number of health care needs. The assessment and care plan covered all the list identified in Standard 2.2 of the National Minimum Standard. There were clear instructions on the care plan for staff on how to met the assessed needs and there was information on the care plan with regards to specialised mattress for pressure care and intervention from external professionals. There was evidence from the file that there had been a significant improvement from the care and treatment provided by the staff at Rivington Park. Alongside the care plan there were a number of risk assessments, which took into consideration mobility and the service users individual environment. A daily record was kept which recorded the care given and any significant events. Staff spoken to were fully aware of the service users needs. One
Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 Page 10 relative visiting the home said that she was very happy with the care provided to her relative. Policies and procedures for medicines management were in place and reflected current practice. The registered manager ensures that prescriptions are seen by the home before going to the Pharmacist. Medication Administration Record charts were examined and found to be clear and accurate with no gaps. Storage of medication was appropriate, clean and tidy and the trolley was secured when not in use. Stock control appeared to be good, with no discontinued or out of date medication present. At the time of the inspection non-prescribed cough linctus, which was not on the homes “homely” remedies list was being administered to a service users. There was no evidence that advice had been sought from an appropriate health care professional with regards to this. The registered person must review the list of homely remedies and ensure that advice is obtained with regards to the suitability for the individual service user. The home did not have a disposal of waste medicines contract in place. However the registered manager said the new operational manager had been employed and this had been arranged. It is a requirement from this inspection that a contract is put in place within the next two weeks. Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 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): 12,14 and 15 The homes procedures enable service users to exercise choice and control over their lives and service users find the lifestyle experienced in the home matches their expectations. Service users receive a wholesome appealing balanced diet. EVIDENCE: Service users or their families manage the finances. The home provides a lockable storage area in all the bedrooms and payments are generally made via a relative. The home holds a small amount of money for some service users. All written records were seen maintained and up to date. Observations made confirmed service users have control over their own lives. Breakfast was staggered as service users got up and during the day service users were seen either in their own rooms or communal areas. A tour of the premises confirmed service users had been allowed to bring their own personal possessions with them on admission to the home. On the day of the visit service users interests had been recorded on their file, there was a list on the notice board of social events and the monthly news letter was available. One service users said that although she remains in bed most of the time she never feels lonely and enjoys the homes news letter coming round. The service user told the inspector that the all the staff were excellent and a member of staff always comes into her room to make sure she is alright.
Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 Page 12 All service users were seen to be enjoying their lunch. Service users and staff confirmed that choices are provided if anyone doesn’t like what is on the menu. All service users spoken too said that the food was very good. The inspector noted that the majority of service users required a high level of support, on the day of the visit eleven service users required assistance with their lunch. All service users were assisted individually and was seen unhurried by the care and nursing staff. The inspector observed that those assisted with their meals in the bedrooms had a soft diet of a wholesome meal that was well presented. All service users said that they were happy, comfortable and all felt that they were well cared for by the staff. Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 Page 13 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): These standards were not assessed. EVIDENCE: Theses standards were assessed at the last inspection and the inspector noted that there is no outstanding requirements or recommendations. Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 Page 14 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 The home was clean and tidy, which ensures service users are comfortable. However some improvements are needed to ensure service users live in a wellmaintained environment. EVIDENCE: Since the last inspection the registered manager ensures that wheelchairs are not stored under the stairway as required by the Lancashire Fire and Rescue Service and CSCI. The home is kept warm clean and tidy and carpets are cleaned when needed. A new washing machine had recently been purchased and a number of new beds including a specialised nursing bed. Service users all said that they were comfortable in the home and that they had all they wanted. During a tour of the home the inspector noted that some parts of the home are in need of redecorating and refurbishment. Some of the chairs in the main lounge are in need of replacing and the wooden dining tables and chairs are marked and scratched. The registered manager informed the inspector that some new chairs had been ordered and if suitable more would be purchased.
Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 Page 15 The registered person is advised to develop a refurbishment and redecoration programme to ensure that action is taken where needed. A handy person attends to all small maintenance in the home. Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 The policies and procedure for recruitment of staff provide safeguards for the protection of service users. Staff levels were in accordance with the minimum levels however further consideration is needed to ensure that service users needs are continued to be met. EVIDENCE: Since the last inspection the registered manager has ensued that the agreed minimum staffing levels are met. However the needs of the service users in the home remain high. The registered manager is currently recruiting new staff and a proposed change of shift pattern is currently being negotiated with the staff team and service provider. The registered person told the inspector that the changes would increase the number of staff on duty at peak times of activity. The home had a recruit policy and procedure in place, which ensured the Protection of Vulnerable Adults. The file of one newly appointed staff member was looked at. All the appropriate checked had been undertaken by the home prior to the staff member starting and an induction programme was in place to ensure the staff member was competent and confident to do the role of a carer. There was evidence from the training matrix that a number of staff are working towards their NVQ Level 2 in Care Qualification. The registered person must ensure that 50 of the care staff are appropriately qualified to NVQ Level 2. Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 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): 33,35 and 38 The home is well managed and run in the best interests of the residents Health and safety policies and procedures were in place which ensures the safety of service users. EVIDENCE: Since the last inspection the registered manager has organised updates for staff training. A number of staff had been on moving and handling and food hygiene and the registered person had developed a matrix to monitor staff requirements and progress. There was evidence that one new staff had completed an induction programme and staff told the inspector that they are provided with on going training to ensure they are competent in their job. The home appropriately records all accidents and there are a number of environmental risk assessments in place. The registered manager was advised to review the homes fire risk assessment to ensure that it is kept up to date.
Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 Page 18 Service users or their families manage the finances. The home provides a lockable storage area in all the bedrooms and fee payments are generally made via a relative or direct debit. The homes records service users belongings brought into the home. The registered manager was advised to obtain a register, which would provide a suitable format for recording service users valuables. The home holds a small amount of money for some service users. All written records were seen maintained. All certificates with regards to maintenance of equipment were seen and were up to date. At the time of the inspection the registered manager informed the inspector that she is working towards her Registered Managers Award and hopes to finish it soon. Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 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 2 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x X 3 X 3 X X 3 Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? no 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 Standard OP2 Regulation 5.1(c) Timescale for action The registered person must 28/02/06 ensure that all service users are provided with a terms and condition at the point of admission. The registered person must 28/02/06 ensure that the home has a contract in place for the safe disposal of medicines. Requirement 2 OP9 13.2 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 OP9 Good Practice Recommendations The registered person should ensure that advice is obtained from an appropriate health care professional for individual service users with regards to administering homely remedies. The registered person is advised to develop a refurbishment and redecoration programme to ensure that action is taken where needed. The registered should ensure that the service and facilities comply with the Water Supply (Water Fitting) Regulations
DS0000043352.V282996.R01.S.doc Version 5.1 Page 21 2 3. OP19 OP26 Rivington Park Nursing Home 4 5 6. 7 8 OP27 OP28 OP31 OP35 OP38 1999. The registered person should continually review the staffing levels in the home in line with the dependency needs of the current service users living there. The registered person must ensure that 50 of the care staff are appropriately qualified to NVQ Level 2 The registered person should ensure that the manager has a management qualification by 2005 The registered person should obtain a register for recording service users valuables. The registered person should review the homes fire risk assessment to ensure that it is kept up to date. Rivington Park Nursing Home DS0000043352.V282996.R01.S.doc Version 5.1 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: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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