Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 05/07/07 for Rivington View Nursing Home

Also see our care home review for Rivington View Nursing Home for more information

This inspection was carried out on 5th July 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents spoke positively about the care they receive at the home. The home is maintained to a good standard and residents are able to access all areas of the home that are designated for their use. Comments made by residents to the inspector included `the staff speak to us nicely and look after us all very well`, `this is a lovely home and the staff are kind and helpful`, `they do everything they can to help you in a very caring way`.

What has improved since the last inspection?

Most staff have been provided with appropriate training that enable them to recognise the signs of abuse should it arise (and arrangements were in place for remaining staff to be provided with such training in the near future). This can only help protect residents as much as possible. The way social and recreational activities are provided for residents have been reviewed and improved. The requirements made at the last inspection have been complied with.

CARE HOMES FOR OLDER PEOPLE Rivington View Nursing Home Albert Street Horwich Bolton Lancashire BL6 7AW Lead Inspector Mike Murphy Unannounced Inspection 5th July 2007 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 View Nursing Home DS0000005695.V337579.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 View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rivington View Nursing Home Address Albert Street Horwich Bolton Lancashire BL6 7AW 01204 694325 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) Rivington View Limited Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability (6) of places Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 33 services users to include: up to 33 service users in the category of OP (Older People); up to 6 service users in the category of PD (Physical Disability under 65 years of age) The service should at all times employ a suitable qualified and experienced Manager who is registered by the CSCI 26th May 2006 2. Date of last inspection Brief Description of the Service: Rivington View is a privately owned care home providing 24 hour care for up to 33 older people, most of whom need nursing care. Within that number, the home can accommodate up to 6 younger persons who are physically disabled. A qualified nurse is on duty at all times. Rivington View is a purpose built, two-storey home, situated in the centre of Horwich, close to bus routes, shops, and other community facilities. The home has 21 single bedrooms and 6 doubles. There is a lounge on each floor, a dining room and a meeting room on the ground floor, and bathrooms and toilets on both floors. The home is fitted with suitable adaptations and equipment such as a passenger lift, assisted baths, portable hoists, and grab rails. In addition to nursing and care staff, the home also employs cooks, kitchen assistants, domestic assistants, and a maintenance worker. Fees are from £345.54 to £825.00 per week - information supplied by the home at the time of this inspection. Please contact the home for further details. Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 5 Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection, which the home did not know was going to take place, was the first conducted since May 2006. The inspection was conducted on the 5th July 2007 between 930am and 3.30pm. And included discussion with residents and relatives, the registered owner, the deputy manager and staff, inspection of the premises, inspection of records maintained by the home in relation to how residents are cared for, supported and protected. Views have also been expressed in comment cards returned to the CSCI prior to the inspection and these are also reflected in the report. What the service does well: What has improved since the last inspection? What they could do better: The recruitment procedure must ensure that all newly employed staff have a CRB and POVA first check – it is not permissible to rely on checks conducted by a previous employer. Also the quality assurance processes should be developed to ensure that resident’s views on how good a service is provided to them are established and how the practices and procedures operated to run the home can be improved. Rivington View Nursing Home DS0000005695.V337579.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 View Nursing Home DS0000005695.V337579.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 View Nursing Home DS0000005695.V337579.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): 3. Standard 6 does not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have their health and care needs assessed before their admission to the home and this gives an assurance both to residents, relatives and staff, that a person is only admitted if the home can meet their needs. EVIDENCE: The pre-admission assessment records of 3 recently admitted residents were inspected. Prior to residents being admitted to the home an assessment of the prospective resident’s needs is carried out in consultation with the resident, their relatives and relevant health and social care professionals such as doctors and social workers. The purpose of such an assessment is to assist the prospective resident (and their relatives) in their considerations of how appropriate a placement at the home would be and enable the nurse conducting the assessment to determine if the home will be able to meet the Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 10 prospective resident’s needs appropriately. The initial assessment helps to form the basis of the plan of care to be followed following admission to the home. It is however recommended that the way staff record the pre-admission assessment is reviewed to ensure that a consistent process is operated for all prospective residents. Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 11 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): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, personal and social care needs of residents were being addressed appropriately. EVIDENCE: The care records of three residents were inspected. These contained care plans that were initially based on the pre-admission assessment that is referred to earlier in this report. Care plans addressed the health and personal care needs of residents in a clear, detailed, well-organised way and were evaluated at least monthly. Risk assessments, that seek to protect resident’s health and welfare are also recorded in respect of residents skin integrity (assessing the risk of pressure sores), mobility (including the risk of potential falls and fractures), nutrition, (including regular weight monitoring) and other areas of potential risk for individual residents were also assessed at least monthly. All residents are registered with a local GP and it was evident that all were enabled to access opticians, chiropodists, dentists, district nurses and other Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 12 specialist services as individual residents needed. Pre-inspection comment cards completed by relatives and discussion with relatives on the day of inspection indicated that they are kept informed of all changes in their relation’s health. The practices for the receipt, recording, storage, handling, administration and disposal of resident’s medicines were appropriate and safe. The qualified nurses are responsible for all aspects of managing medication in the home. Some of the qualified nurses have recently undertaken medication related update training. Discussion with residents and staff (and responses in Pre-inspection comment cards completed by residents and relatives) revealed that residents were treated with respect and that their right to privacy was upheld. Comments made included; ‘the staff speak to us nicely and look after us all very well’, ‘this is a lovely home and the staff are kind and helpful’, ‘they do everything they can to help you in a very caring way’. Staff interacted very positively with residents and treated them with respect, protected their dignity and assisted them appropriately throughout the day of this inspection. Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 13 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): 11,12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are being supported by staff to participate in social activities and are able to retain the ability to make personal choices. There was general satisfaction with meals provision at the home. EVIDENCE: Discussion with residents and relatives (and observations made on the day of inspection) indicate that the routines of daily life in the home are as flexible as possible in a group setting. Residents stated that they are able to choose what time they get up and go to bed, what activities to engage in and feel that staff inform and consult them about the care and support they need. Clearly this is very important in enabling residents to retain as much control over their life as possible. The arrangements for providing social and leisure activities are satisfactory. Staff support residents in engaging in social and leisure activities and the inspector was informed that arrangements are being made for an external arts and crafts instructor to conduct sessions at the home. Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 14 Care records reflect resident’s social and leisure interests. While social inclusion is encouraged, individual choices and preferences are taken into account. Those who choose to spend time in their own rooms may do so. Residents wishing to maintain their religious links are encouraged to do so. The home has an open visiting policy. There are no restrictions on the time people visit. Evidence of this was highlighted in the visitor’s book where entries showed residents friends and relatives visiting at different times during the day and evening. The only time restrictions would be imposed is when requested by residents. Relatives spoken to during the inspection said they were always made welcome at the home and were able to see their relatives in the privacy of their own room or in a quieter lounge area. Residents spoken to expressed satisfaction with care provided and organisation of life at the home. Observation of care practice and information in care plans indicated residents are encouraged to make choices. For example in respect to where they spend their day. While some residents chose to sit in the lounge a number were observed to spend their time in their own rooms. This was further illustrated in care plans. Meals are cooked on site in the home’s kitchen. Menus are varied and balanced and provide choice. Meals are served in a spacious dining room. This is an appropriately furnished room that provides a comfortable and pleasant area for residents to have their meals. Residents’ meal times are as reasonable and as flexible as they can be in a communal setting. Lunch was observed on the day of inspection. This was a hot and substantial meal and staff assisted and served residents their meals appropriately. Discussion with residents revealed a general satisfaction with the meals provided. Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 15 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): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives felt comfortable enough to and knew how to make a complaint, knowing that their views are taken seriously and acted upon. Written guidance and training arrangements ensure that staff members have a good knowledge of abuse and protection arrangements and safeguards were in place to protect the welfare of residents. EVIDENCE: The complaints procedure was prominently displayed in the home and included details of how to contact the CSCI if it was felt necessary by the complainant. Relatives said in Pre-inspection comment cards and on the day of inspection that any concerns or worries brought to the attention of senior staff are responded to quickly and don’t become formal complaints. A complaints log is maintained – there were no entries at the time of inspection. Policies and practices aimed at protecting residents from abuse are in place. Also Bolton’s Inter agency protection procedure is held on site. Staff spoken to confirmed that they had received adult protection training (this was also reflected in training records maintained by the home) and were aware of the whistle-blowing policy. The inspector was informed that staff who have not had an update to their adult protection training were schedule to receive this by the end of July 2007. Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 16 Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 17 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): 19,20,24,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home appeared to be structurally well maintained throughout and provides a suitable and comfortable environment for the care of residents. EVIDENCE: Rivington View care home was clean, free of malodour and appeared to be well maintained, providing suitable accommodation for residents to be cared for and supported. Lounge and dining areas were appropriately and comfortably furnished, adequately decorated, and suitably heated and ventilated. Resident’s bedrooms (9 were inspected on this occasion) were clean, warm, suitably furnished/equipped and personalised with resident’s own possessions. Residents stated they were happy with the accommodation provided. Comments made included ‘ my room is kept clean and I am able to come and go from it as I please’, ‘my room is warm and very comfortable and when my Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 18 family come to visit we either use my room or the lounge upstairs which is quieter and more private’, ‘my mum’s room is always clean and tidy, the bed is changed regularly and we were encouraged to bring some of mum’s own stuff in to make her room more homely for her’. Laundry arrangements are appropriate and residents spoken to were happy with these arrangements. Appropriate measures were in place to help prevent the spread of infection. For example suitable hand washing and disposal of waste material facilities were in place. Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 19 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): 27,28,29,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The recruitment, provision and training of staff employed at the home are in the main being managed appropriately. This is important to ensure that residents are being cared for adequately and appropriately by staff who are able to deliver this support safely and competently. EVIDENCE: Examination of the duty rotas and a discussion with the deputy matron, nursing and care staff, relatives and residents showed that there was enough staff on duty to meet the residents’ needs (there were 28 residents at the home at the time of this inspection). Inspection of 3 staff personnel files revealed that these contained an application form (including health declaration and detailed work history), 2 written references, a Criminal Records Bureau check (including a ‘POVA first’ check), proof of identity and evidence of induction training and further training. However 1 of the CRB checks had been conducted by the individual’s last employer. CRB certificates and POVA first checks are not portable and therefore need to be completed for all new employees recruited. This was discussed with the deputy manager and proprietor at the time of inspection. NVQ training in health and social care is being provided for care staff (currently approximately 25 of care staff have achieved an NVQ 2 qualification or Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 20 above). Also a wide range of appropriate and ongoing training in moving and handling, abuse, basic food hygiene, fire safety and other relevant topics are provided to staff at the home. Training provided to individual staff is recorded in detail and reviewed at frequent intervals. Staff spoken to felt their training needs were being addressed. And many felt this made them more competent and felt more valued in their work. Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 21 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): 31,33,35,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst current management arrangements are adequate a manager needs to be recruited who can be proposed to the CSCI as the registered manager as legally required. EVIDENCE: The previous registered manager left Rivington view in January 2007. The registered proprietor informed the inspector that their recruitment process has not produced a suitable candidate. The registered provider was advised to review the criteria required for a person to be submitted to the CSCI as a potential registered manager and reminded of their legal obligation (under the Care Standards Act 2000) to appoint an individual to manage the care home. Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 22 Currently the home is being managed by the deputy manager supported by the proprietor, administrator and senior nurses. At the time of inspection the home was being adequately managed. Discussion with residents, their relatives and staff indicate that the deputy manager operates an ‘open door’ policy that enables any issues to be easily discussed with her. Those spoken to felt comfortable to do so. The inspector is of the view that the home is run in the best interests of the residents. However discussion with the deputy manager revealed that an effective quality assurance programme needs to be developed that assesses the quality of the services provided and the systems operated by the home. This can only improve the quality of care and support provided to residents. Measures were in place to ensure that residents’ financial interests are safeguarded. Residents are encouraged to control their own money. However where they are unable (or choose not to) personal allowances are managed by the home. The arrangements for this were secure and appropriately documented. The health, safety and welfare of residents and others are promoted and protected. For example staff are provided with regular training and appropriate equipment to ensure resident’s moving and handling needs are met – and example of this would be for a resident who needs to be safely moved with the aid of a hoist. Fire safety training is regularly provided. Information provided by the home indicates that gas and electrical safety inspections/servicing. The passenger lift that enable residents and others to access all areas of the home has been serviced as has all hoisting equipment used in the home. All significant events in the home – including accidents and illness and monitoring visits by the home’s owners – are recorded and reported (as required legally) to the CSCI. Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 23 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 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 24 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 OP29 Regulation 19 Requirement That you write to the CSCI to confirm that the recruitment procedure operated at the home ensures a CRB and POVA ‘first’ checks are requested by yourself for all new employees – and do not rely on checks done by a previous employer. That you establish and maintain a system for evaluating the quality of the services provided at Rivington view. Timescale for action 31/08/07 2 OP33 24 31/08/07 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 OP3 Good Practice Recommendations It is however recommended that the way staff record the pre-admission assessment is reviewed to ensure that a DS0000005695.V337579.R01.S.doc Version 5.2 Page 25 Rivington View Nursing Home consistent process is operated for all prospective residents. Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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. Extracts may not be used or reproduced without the express permission of CSCI Rivington View Nursing Home DS0000005695.V337579.R01.S.doc Version 5.2 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!