Care Home: Rivington Park Nursing Home

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What the care home does well All people who contributed their views to this inspection were positive about the standards of care and the atmosphere at Rivington Park. The people who live there consider the staff to be kind, hardworking and respectful. The health care needs of people are identified and met. The staff of the home involve other health care professionals, such as the Speech Therapist, Physiotherapist and Consultants as necessary. Visitors to the home were very satisfied with the standards of care and cleanliness at Rivington Park. Visitors felt welcomed by staff and appreciated the opportunity to spend time enjoying social events with their relative or friends who live at the home. Comments included: `This is one of the finest places there is.` `Its like heaven here...when I came in I didn`t know what it would be like but I have not regretted it. They were all lined up to meet me when I first came in and I settled straight away.` `Staff are lovely.``It`s very clean, the staff are lovely, its homely and everyone is happy-what more could you ask for.` (Visitor) `If I was placing a relative in a local care nursing home at present I would probably choose this one.` (G.P comment) People living at the home and involved in providing support are asked their views through daily contact with staff and also by the regular completion of a quality survey. In this way any areas for improvement can be identified. What has improved since the last inspection? A new manager has come into post since the last inspection and she has already implemented some systems to bring about improvements, for example in up dating the care planning systems in place, auditing equipment for safety and identifying priorities for expenditure on the building. There have been improvements to the records of administration of medication to ensure that variable doses are accurately recorded. All hand written transcripts are now signed and counter signed. 18 fire doors have been replaced at the home in line with the fire risk assessment. A number of new profiling beds have been purchased, and the people who have these beds find them much better that the previous beds. Induction and foundation training has been developed for new staff members. A series of information videos covering important topics such as confidentiality, Adult Protection and Medication are available and these are considered very helpful by the staff who have used them. All but two members of care staff have achieved or are undertaking the National Vocational Qualification in Care at level 2 or above. What the care home could do better: The care plans seen provided good basic information but there were instances where detail was lacking, for example one plan indicated that physiotherapy was required however there were no details of how this was to be provided or of any instruction of advise given by the physiotherapist or consultant. In another case the amount of thickener to be used in drinks had been changed, this had been altered on one record and had been recorded in notes, however when the care plan was reviewed the information was not updated, and when asked a member of staff was asked the previous amount was still being added.Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 7It is important that care plans contain information that is accurate and up to date this ensured that the care and support given is consistent and in line with the persons identified health and personal care needs. The care plans were not always signed by the person using the home or their representative. Involvement in care planning is encouraged and signing and dating of plans should be included in this to demonstrate that the care plan has been agreed and show who has contributed to decisions about the care provided. A date should always be place to show how long the plan has been in force. Care plans were being reviewed and this process could be improved by ensuring that a statement about the progress of the plan is recorded, in this way the effectiveness of the care plan can be demonstrated. The Medication Administration Record must be completed accurately. There were a number of gaps with no explanation, and a medication record had been completed before the medication had been given. It is essential that the reason for any medication not being given is recorded and all medication that has been given is accurately recorded. The manager plans to introduce a regular audit and this should ensure that any omissions are identified and dealt with in line with the home medication policy. The staffing levels at Rivington Park should be improved. The rota showed that there have been times when the number of carers on duty has fallen below the level that is needed to meet the needs of people at the home. The manager acknowledged this has been a problem and that she has on occasion had to step in to cover shifts. Whilst those who live at Rivington Park appreciate the attitude and dedication of the staff, the effect of the times when the home is staffed below the minimum levels to meet the needs of the people at the home is evident. Comments received included`The staff work too hard...they do not skip work when they are short staffed but they do look tired.` `(The home could improve) with help in periods of staff shortages.` In discussion with people who live at the home and staff members, the impact of being a member of staff short is significant. There is a high proportion of people who require assistance from two carers in most activities of daily living, and the layout of the home, over two floors, presents further demands when considering staffing levels and ensuring that peoples needs are consistent met and their welfare and safety promoted. The manager is aware to the need to ensure that the staffing levels of the home are consistent maintained and has begun to introduce ways of ensuring that staff absences are managed and strategies are put in place to avoid prolonged periods of short staffing. CARE HOMES FOR OLDER PEOPLE Rivington Park Nursing Home 206 Eaves Lane Chorley Lancashire PR6 0ET Lead Inspector Mrs Felicity Lacey Unannounced Inspection 11th December 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 Park Nursing Home DS0000043352.V351737.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.V351737.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.V351737.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. 8th February 2007 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 that 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 that 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.V351737.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of this unannounced site visit there were 25 people resident at the home. Information was gained from the Annual Quality Assurance Assessment completed by the manager. Questionnaires inviting feedback about Rivington Park were sent to a selection of individuals who have connections with the home. People living at the home, visitors and staff were spoken with during the visit to Rivington Park. Records and documentation were viewed. Care plans and medication practices were considered by an inspector who is a qualified nurse. Time was spent observing staff and the people living at the home, engaged in daily activities. The inspector was joined by an ‘expert by experience’ for part of this visit. (An ‘expert by experience’ is a person who because of a shared experience of using or needing a service, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in the home.) The ‘expert by experience’ spent time in the communal areas of the home, talking to those living there and then provided feedback to the inspector, which is incorporated into this report. What the service does well: All people who contributed their views to this inspection were positive about the standards of care and the atmosphere at Rivington Park. The people who live there consider the staff to be kind, hardworking and respectful. The health care needs of people are identified and met. The staff of the home involve other health care professionals, such as the Speech Therapist, Physiotherapist and Consultants as necessary. Visitors to the home were very satisfied with the standards of care and cleanliness at Rivington Park. Visitors felt welcomed by staff and appreciated the opportunity to spend time enjoying social events with their relative or friends who live at the home. Comments included: ‘This is one of the finest places there is.’ ‘Its like heaven here…when I came in I didn’t know what it would be like but I have not regretted it. They were all lined up to meet me when I first came in and I settled straight away.’ ‘Staff are lovely.’ Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 6 ‘It’s very clean, the staff are lovely, its homely and everyone is happy-what more could you ask for.’ (Visitor) ‘If I was placing a relative in a local care nursing home at present I would probably choose this one.’ (G.P comment) People living at the home and involved in providing support are asked their views through daily contact with staff and also by the regular completion of a quality survey. In this way any areas for improvement can be identified. What has improved since the last inspection? What they could do better: The care plans seen provided good basic information but there were instances where detail was lacking, for example one plan indicated that physiotherapy was required however there were no details of how this was to be provided or of any instruction of advise given by the physiotherapist or consultant. In another case the amount of thickener to be used in drinks had been changed, this had been altered on one record and had been recorded in notes, however when the care plan was reviewed the information was not updated, and when asked a member of staff was asked the previous amount was still being added. Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 7 It is important that care plans contain information that is accurate and up to date this ensured that the care and support given is consistent and in line with the persons identified health and personal care needs. The care plans were not always signed by the person using the home or their representative. Involvement in care planning is encouraged and signing and dating of plans should be included in this to demonstrate that the care plan has been agreed and show who has contributed to decisions about the care provided. A date should always be place to show how long the plan has been in force. Care plans were being reviewed and this process could be improved by ensuring that a statement about the progress of the plan is recorded, in this way the effectiveness of the care plan can be demonstrated. The Medication Administration Record must be completed accurately. There were a number of gaps with no explanation, and a medication record had been completed before the medication had been given. It is essential that the reason for any medication not being given is recorded and all medication that has been given is accurately recorded. The manager plans to introduce a regular audit and this should ensure that any omissions are identified and dealt with in line with the home medication policy. The staffing levels at Rivington Park should be improved. The rota showed that there have been times when the number of carers on duty has fallen below the level that is needed to meet the needs of people at the home. The manager acknowledged this has been a problem and that she has on occasion had to step in to cover shifts. Whilst those who live at Rivington Park appreciate the attitude and dedication of the staff, the effect of the times when the home is staffed below the minimum levels to meet the needs of the people at the home is evident. Comments received included‘The staff work too hard…they do not skip work when they are short staffed but they do look tired.’ ‘(The home could improve) with help in periods of staff shortages.’ In discussion with people who live at the home and staff members, the impact of being a member of staff short is significant. There is a high proportion of people who require assistance from two carers in most activities of daily living, and the layout of the home, over two floors, presents further demands when considering staffing levels and ensuring that peoples needs are consistent met and their welfare and safety promoted. The manager is aware to the need to ensure that the staffing levels of the home are consistent maintained and has begun to introduce ways of ensuring that staff absences are managed and strategies are put in place to avoid prolonged periods of short staffing. Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 8 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.V351737.R01.S.doc Version 5.2 Page 9 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.V351737.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. The preadmission assessment procedures ensure that the health and personal care support needs of people admitted to the service are understood and can be met by the staff of Rivington Park. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a comprehensive pre admission assessment process in place which ensures that the needs of all prospective people who may be admitted to the home are understood and can be met at Rivington Park. People or their representatives are encouraged to visit the home before making a decision, and a trial period is offered. A relative spoken with during the inspection explained that she had visited the home on a number of occasions before deciding that Rivington Park would meet her husbands needs, and she said that this was a difficult decision but that she had not regretted her choice. Information is made available in a Service User Guide which covers key areas, through providing clear and accessible information it is hoped that an informed choice can be made about moving to Rivington Park. Rivington Park Nursing Home DS0000043352.V351737.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, 10 Quality in this outcome area is good. The health needs of people living at Rivington Park are understood and medication procedures in the home have been improved this promotes the welfare of people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans seen provided good basic information. Each person had an individual care plan folder which was divided into sections; admission; assessments; care plans; progress notes and supplementary information. The care plans sampled contained useful information and demonstrated that the health needs of people were understood and advice was sought from other health professional as needed, for example the speech therapist and tissue viability nurse had been consulted. People spoken with felt that their care needs were understood and their health needs met. There are some people who have complex health needs and are unable to communicate their preferences; the staff had understanding of the range of communication methods used by people. The low turn over of staff ensures that good relationships and knowledge of individual needs underpin continuity of care. Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 12 However there were instances where detail was lacking from care plans, for example one plan indicated that physiotherapy was required however there were no details of how this was to be provided or of any instruction of advise given by the physiotherapist or consultant. In another case the amount of thickener to be used in drinks had been changed, this had been altered on one record and had been recorded in notes, however when the care plan was reviewed the information was not updated, and when a member of staff was asked the previous amount was still being added. It is important that care plans contain information that is accurate and up to date, this ensures that the care and support given by all staff is consistent and in line with the persons identified health and personal care needs. The care plans were not always signed by the person using the home or their representative. Involvement in care planning is encouraged; signing and dating of plans should be included in this to demonstrate that the care plan has been agreed and show who has contributed to decisions about the care provided. A date should always be place to show how long the plan has been in force. Care plans were being reviewed and this process could be improved by ensuring that a statement about the progress of the plan is recorded, in this way the effectiveness of the care plan can be demonstrated. The storage arrangements for medication at Rivington Park were satisfactory. There have been improvements to the records of administration of medication to ensure that variable doses are accurately recorded. All hand written transcripts are now signed and counter signed. Staff responsible for the administration of medication have undertaken relevant training. Examination of the Medication Administration Record showed there were a number of gaps with no explanation, and in one instance the medication record had been completed before the medication had been given. It is essential that the reason for any medication not being given is recorded and all medication that has been given is accurately recorded. The manager plans to introduce a regular audit and this should ensure that any omissions are identified and appropriate action taken. Medication should only be used for the person it has been prescribed for, in one instance a homely remedy was needed and there was no stock, consequently another persons prescribed medication had been used. The homely remedies should be checked regularly to ensure that those held are in date and there is enough stock to meet the assessed needs of people living at the home. The people spoken with and who gave their views felt that privacy and dignity was promoted at the home. Staff respect the preferences of the people living at the home, for example by using their preferred form of address. Visitors are able to see their friend or relative in private. Consultations take place in the privacy of the person’s own room. There are three shared rooms at Rivington Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 13 Park which have en suite facilities. Rooms are shared by agreement and privacy screening is provided. Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 14 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): 12, 13, 14, 15 Quality in this outcome area is good. The activities and events held at the home are planned with the needs of the people who live at Rivington Park in mind, this ensures that families and friends can continue to enjoy social occasions with their loved one. Information about the interests, preferences and spiritual needs of people living at the home is gathered and in this way their well being is promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an activity co coordinator at the home who gathers information about individual interest and preferences. The ‘Expert by experience’ found that people continued to enjoy their hobbies and that their interests were reflected in the ways in which their rooms were personalised. There are some people who continue to enjoy knitting and crafts; one person had a knitted nativity scene in her room, which had been done by a lady living at the home. Some people are confined to their rooms and the opportunity for any social activity is quite limited, the activity co coordinator is looking at ways to provide social opportunities. There was a list of events on display, which included a range of Christmas events, including visits from representatives from local churches. Relatives and friends are made very welcome and encouraged to attend events and celebrate Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 15 special occasions at the home. The relatives and friends spoken with during the visit valued this involvement. All birthdays are celebrated, and the cook makes a cake and staff make an effort to make the day special. The time that staff have available to spend with people living at the home can be limited at times of staff shortages, it is important to recognise the impact of this as many people have high dependency needs and contact can be limited to times when health or personal care tasks are being carried out. Given this limitation the staff were considered by people living at the home to be dedicated and very kind. The ‘Expert by experience’ concluded that ‘life can be very hard when mobility is limited but I did not see an unhappy resident during my visit which is a testament to attentive care.’ The food and meals served at the home were considered to be good and tasty. The cook is aware of individual needs and likes and dislikes. Staff were observed assisting people at meal times and did this in a sensitive way, many people take meals in their own rooms. Dietary intake and nutrition are monitored at the home. Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 16 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, 18 Quality in this outcome area is good. The complaints and protection policies of the home are understood by people living there and staff and this promotes and protects welfare. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living at the home and their relatives and friends were confident that the staff of the home would deal with any concern that may arise. There have been no formal complaints made to the home or to the Commission for Social Care Inspection over the past year. The complaints policy is displayed and is detailed in individual contracts. Adult safeguarding and Whistleblowing procedures are in place which provide guidance for staff. The staff spoken with had a clear understanding these policies. Staff undertake training in Adult Protection, including the use of videos to provide understanding of good practice. The use of videos ensures that night staff are also able to access training materials. Staff spoken with confirmed that they found these additional training materials useful. Rivington Park Nursing Home DS0000043352.V351737.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, 22, 26 Quality in this outcome area is good. The environment is clean and safe for the people living at Rivington Park. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been improvements to the safety of the building by the replacement of fire doors. There are plans to redecorate and refurbish the home, which although very clean was described as ‘looking tired’ by a person living at the home. The home has a variety of communal spaces, which are used by some people living at the home, however many people remain in their own rooms because of their complex health needs and through personal preference. The lounges were quite cold at the time of the visit to the home, and the temperature in these areas should be monitored to ensure that they are warm enough. There is a range of different types of seating and the home is equipped with handrails and raised toilet seats to promote independent mobility and to provide assistance. There have been a number of profiling beds purchased, air Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 18 mattresses and a hospital bed these have improved the range of beds available for people. The home was very clean and odour free. There are domestic and laundry staff employed. A number of people commented on the high standard of cleanliness at Rivington Park. All staff have undertaken infection control and management training. Protective clothing and infection control measures were seen to be in use at the time of the visit to the home. Rivington Park Nursing Home DS0000043352.V351737.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. The attitude of the staff is good however the numbers of staff needed to meet the assessed needs of people at the home should be consistently provided to ensure that the safety and well being of people at the home are promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Annual Quality Assurance Assessment indicated that turnover of senior staff of the company had impacted on implementation of improvements, however at a local level staff turnover was low. The staff are held in high regard by people who live at the home and by their relatives and friends. Surveys received indicated that the staff were competent and caring. There is a qualified nurse on duty at all times, and support is provided by Care Assistants. On a number of occasions there has been a short fall in the required staffing and this means that staff are very pressured in completing the tasks required. Although on occasions this short fall is made up by the manager taking the place of a member of staff, this is not a satisfactory long term solution. The impact of staff shortages were commented on by people living at the home, their representatives and the staff of the home. There is a high proportion of people who require assistance from two carers in most activities of daily living, and the layout of the home, over two floors, presents further demands when considering staffing levels and ensuring that peoples needs are consistent met and their welfare and safety promoted. The manager has implemented an Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 20 absence management strategy and the home is currently recruiting additional staff. The home must be staffed to meet the assessed needs of the people living there at all times. The ratio of care staff with a National Vocational Qualification remains at below the recommended 50 , however there have been positive efforts to ensure that these ratios will improve. Currently six staff hold a National Vocational Qualification at level 2 or above, and a further seven staff are working towards this qualification. Staff spoken with felt that the company valued training and that they were supported and encouraged to add to their skills. The recruitment practices of the home are followed and this ensures that all required checks are completed prior to employment at the home. There is a system in place to check that all qualified nurses have current PIN numbers. There have been improvements to the induction in place for new staff. A checklist is in use which covers both immediate and practical health and safety information, and also covers the value base of good care and areas of good practice. The checklist is completed over a number of months and provides the basis for further learning and personal development. Rivington Park Nursing Home DS0000043352.V351737.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 good. The newly appointed manager has ideas for improving on the existing good practice at the home and has actively sought the opinion of those people living at the home, this ensures that the home is run in the best interest of the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The current registered manager has remained employed at Rivington Park, but a new manager is now in post who is currently completing the registration process. The new manager is an experienced nurse and understands the demands and duties of operating a care home with nursing. She plans to introduce a training matrix and a serried of audits to ensure that quality is maintained and health and operational issues are monitored. The company operates a number of other care homes with nursing and a regular management meeting has been introduced to provide support and an opportunity to share good practice. Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 22 There opinions of people living at the home, their representatives and other stakeholders are regularly sought, and the information gathered is considered to inform any necessary improvements. The latest survey showed high levels of satisfaction with the service provided. The home has achieved Investors in People an external quality award; this demonstrates a commitment to staff development and training. The home is regularly visited by a representative of the company, who conducts a visit in line with regulation 26 of the Care Homes Regulations. In these ways quality and standards at the home are monitored and maintained, and areas for improvement identified. People living at Rivington Park retain control over their own finances or appoint a representative to act on their behalf. The Personal Allowances of some people are kept at the home and all transactions are recorded, signed and countersigned. Money is stored securely. A register of valuables is maintained. The Annual Quality Assurance Assessment indicated that health and safety checks have been completed, and equipment serviced as required. The manager has begun an audit of all equipment at the home and ensures that any remedial work required is carried out. Staff are made aware of safe working practice through training and risk assessments that cover activities and identified hazards. Rivington Park Nursing Home DS0000043352.V351737.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 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 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.V351737.R01.S.doc Version 5.2 Page 24 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 3 Standard OP9 OP9 OP27 Regulation 13(2) 13(2) 18(1)(a) Requirement Medication administration records at the home must be completed accurately. People living at the home must not be given medication prescribed for another person. The registered person must ensure that at all times suitably qualified, competent and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of people living at the home. Timescale for action 12/12/07 12/12/07 12/12/07 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 OP7 Good Practice Recommendations Care plans should be update and accurate. Reviews of care plans should indicate the effectiveness of the current plan. When ever possible the care plan should be signed by the person using the service or their representative. DS0000043352.V351737.R01.S.doc Version 5.2 Page 25 Rivington Park Nursing Home 2. OP28 The registered person must ensure that 50 of the care staff are appropriately qualified to NVQ Level 2 The new manager should register with the Commission for Social Care Inspection. 3. OP31 Rivington Park Nursing Home DS0000043352.V351737.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway 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. Extracts may not be used or reproduced without the express permission of CSCI Rivington Park Nursing Home DS0000043352.V351737.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. 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