The inspection was carried out on 24 and 25 June 2015. The first day of the inspection was unannounced.
Rivington Park Care Home is situated near to Chorley town centre, close to transport links and a variety of local shops. The home provides personal and nursing care for up to 25 older people. At the time of the inspection there were 24 people accommodated at the service.
The accommodation is provided over two floors, accessed by a passenger lift and stairs. There is a lounge with dining area on both floors. There are three double bedrooms with en-suite facilities and 19 single bedrooms. From the ground floor lounge there is access to an enclosed patio area, with flowers, shrubs and garden furniture. There are a small number of car parking spaces to the side of the premises.
At the previous inspection on 9 May 2013 we found the service provider was meeting the legal requirements.
At the time of the inspection, the registered manager was no longer in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager therefore needed to apply for de-registration, in order to formally relinquish their legal responsibilities. A new manager had been appointed at the service and they had applied for registration with the Commission.
During this inspection we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Some environmental risks had not been identified and assessed. This meant appropriate action had not been taken to reduce the risks to people’s well-being, safety and security. We found staff recruitment practices had not been properly carried out for the well-being and safety of people who used the service. People’s concerns and complaints were not always properly managed and responded to. There was also a lack of effective systems to assess, monitor and improve the quality of the service provided. You can see what action we told the provider to take at the back of the full version of the report.
We found the providers had not consistently reviewed and updated their publicity information and operational policies and procedures. We have therefore made a recommendation about reviewing and updating the service’s written material.
There were some processes in place to manage and store medicines safely. However further safeguards were needed and the manager had already begun to make improvements. We have made a recommendation about the management of medicines.
People spoken with made positive comments about the staff team at Rivington Park, they said “I think the staff are kind and caring,” “We have some fantastic staff here, they give me a hug and are proper nice and kind” and “They are like my family.”
People had mixed views on the availability and numbers of staff on duty; however the manager took action to increase staffing levels during the course of the inspection. There was no formal process in place to asses staffing arrangements, to make sure there was always enough staff; the manager agreed to address this matter.
We found the care planning process was lacking in providing a person centred approach to care and treatment delivery. However there were clear plans in place to introduce a person centred approach within the service.
Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns. Staff confirmed they had received training on safeguarding and protection.
The MCA 2005 (Mental Capacity Act 2005) and the DoLS (Deprivation of Liberty Safeguards) sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. We found appropriate action had been taken to apply for DoLS and authorisation by local authorities, in accordance with the MCA code of practice and people’s best interests.
Healthcare needs were monitored and responded to. We observed people being supported and cared for by staff with kindness and compassion. We saw people were treated with dignity and respect and people told us consideration was given to their privacy.
We found bedrooms did not have an appropriate door lock in place. Door locks are necessary to help ensure people's privacy and dignity is protected. We discussed this with the manager and were given assurances this matter would be resolved.
During the inspection we observed staff involving people in routine decisions and consulting with them on their individual needs and preferences. Discussion meetings were held and people had opportunity to complete satisfaction surveys. People spoken with had an awareness of the service’s complaints procedure and processes.
People made positive comments about the meals provided at the service and further improvements were being introduced. People’s individual dietary needs, likes and dislikes were catered for. Various drinks were readily available and regularly offered.
We observed examples where staff involved people in routine decisions and consulted with them on their individual needs and preferences. Staff spoken with described how they involved people with making decisions and choices.
Systems were in place to ensure all staff received regular training, supervision and support. Health care workers spoken with understood their role in providing people with effective care and support.
People were keeping in contact with families and friends. Visiting arrangements were flexible. Arrangements in place to provide activities and entertainment; however we found the programme of activities was being further researched and developed.