Inspection on 20/02/06 for Nightingale

This inspection was carried out on 20th February 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Nightingale 26/03/08

Nightingale 20/02/07

Nightingale 20/09/05

Nightingale 09/03/05

Nightingale 21/09/04

Nightingale 26/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Nightingale Nether Lane Ecclesfield Sheffield South Yorkshire S35 9ZX Lead Inspector Michael O’Neil Unannounced Inspection 20th February 2006 08:55 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 Nightingale DS0000002990.V279382.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. Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Nightingale Address Nether Lane Ecclesfield Sheffield South Yorkshire S35 9ZX 0114 257 1281 0114 257 1279 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) None Paxfield Associates (Sheffield) Limited Ms Janice Maw Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (40) Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Under 65`s can only be accommodated with the consent of the Registering Authority. 20th September 2005 Date of last inspection Brief Description of the Service: Nightingale care home is a purpose built two storey building overlooking fields to one aspect and situated in Ecclesfield.The home caters for a client group aged 65 years and over who require personal care because of their diagnosis of Dementia (DE) or Mental Disorder (MD). The home is sited on a bus route and is close to a supermarket, chemist, bank and other shops. Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mike O’Neil carried out this unannounced inspection from 08:55 to 12:25.Janice Maw ,registered manager, was present for the inspection. Opportunity was taken to make a partial tour of the premises, inspect a sample of records and policies and talk to 5 staff, a visiting health professional, a visiting relative and 8 residents. The inspector wishes to thank the staff, relatives and residents for their time, friendliness and co-operation throughout the inspection process. What the service does well: What has improved since the last inspection? Flammable materials had been cleared from the vicinity of the building. New chairs have been provided in the lounges and dining rooms, which has improved the aesthetics of these rooms. More than fifty per cent of care staff had now achieved their level 2/3 NVQ qualification. The staff and management of the home should be commended for achieving this number of staff with an NVQ qualification. Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 6 What they could do better: 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. Nightingale DS0000002990.V279382.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 Nightingale DS0000002990.V279382.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): None of these standards were checked as the key standards were checked and met at the last inspection. EVIDENCE: Nightingale DS0000002990.V279382.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): Standards 8,9 and 10. Residents themselves said that the care they were receiving was good and that the staff were friendly. Relatives said that the care delivered by staff was very good. Medication procedures provided protection to residents. Residents’ privacy and dignity was maintained. EVIDENCE: A visiting health care professional said that staff at the home communicated well with them and felt that the standard of care delivered at the home was good. Medication procedures provided protection to residents. Medicines were securely stored in the home in locked cupboards. Medicine Administration Records (MAR) checked were completed with staffs’ signatures. Staff interviewed said they had received training on the safe administration of medicines. The inspector saw documentation to support this training having taken place. Residents said that they were happy and that the staff were nice. Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 10 Relatives said that they thought the staff of the home were friendly and that the care delivered by them was “very good”. Residents were well dressed in clean clothes and had received a good standard of personal care. Staff were observed to be assisting residents in a positive and friendly manner Nightingale DS0000002990.V279382.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): Standards 12,13,14 and 15. Residents had a choice of lifestyle within the home and they were able to maintain contact with family and friends. Residents said that meals served at the home were of a good quality and offered choice. EVIDENCE: A friendly, lively and welcoming feel was evident in Nightingale. Residents spoke positively about their life in the home. Staff were interacting positively with the residents. Residents said that they were able to maintain contact with their family and friends. Relatives said they were always made to feel welcome when they visited. It was pleasing and positive to hear that staff were assisting one resident to keep a day-to-day diary to help the resident maintain some orientation to the time and place in which they lived. Residents said they chose when they got up and went to bed and had a choice of food at mealtimes. Residents said the quality of food served was good. Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 12 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): None of these standards were checked as the key standards were checked and met at the last inspection. EVIDENCE: Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 13 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): Standards 19,21,24,25 and 26. The environment within the home was on the whole well maintained and clean providing a comfortable, safe environment for residents. EVIDENCE: Since the last inspection further refurbishment of the home has taken place. New chairs have been provided in the lounges and dining rooms, which has improved the aesthetics of these rooms. The ground floor corridor carpet was marked and needs either thorough cleaning or replacing. The manager said that the carpet was being professionally cleaned on a regular basis and it was due for cleaning again. Three bedrooms were checked in detail and many others seen, all were comfortable and homely. Residents said their beds were comfortable. Bed linen checked was clean and in a good condition. The home was generally clean, with no unpleasant odours noticeable. Residents and relatives said that the home was always kept clean. The bathrooms and toilets looked tired, clinical and stark. The rooms need redecorating and refurbishing. Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 14 The home was warm in all areas. Window restrictors were fitted to all windows checked. This will assist in maintaining resident safety. Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 15 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): Standards 27,28,29 and 30. Staff were employed in sufficient numbers. In the main recruitment procedures promoted the protection of residents. Staff are trained and competent to do their jobs. EVIDENCE: The manager stated that agreed staffing levels were being maintained. The staff rota identified agreed staffing levels had been met. This will assist in making sure that residents’ needs are met. Staff said staffing levels were adequate. The manager said that fifty per cent of care staff had now achieved their level 2/3 NVQ qualification. Documentation provided to the inspector identified that over 50 of staff had achieved their NVQ qualification. The staff and management of the home should be commended for achieving this number of staff with an NVQ qualification. The recruitment information obtained for new staff was in the main sufficient to adequately protect the welfare of residents who lived at the home. The staff files contained references from the staffs last employer, information to verify identity and Criminal Records Bureau enhanced checks. Records were held at the home of all CRB checks that had been carried out. However, the records did not identify whether the checks included a Protection of Vulnerable Adults (POVA) check. Staff said that there were good training opportunities available to them, and new staff said they had undertaken a detailed and informative induction programme, which enabled them to feel competent to do their job. Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 16 The inspector checked training files, which identified that staff had undertaken this training. The inspector would, however recommend that staff do undertake additional training on issues specific to the residents assessed needs. The inspector and manager discussed ways that staff may undertake this training. Nightingale DS0000002990.V279382.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): Standards 31,32,33,35,37 and 38. There was a positive style of management in the home. The homes policies and procedures promoted the health, safety and welfare of residents and staff. EVIDENCE: The CSCI have not received notification to confirm that the manager has completed her level 4 NVQ management qualification. The manager said that she had nearly completed the qualification. Relatives said that the manager was approachable and helpful and that they were regularly asked for their views about the home. Staff said that they enjoyed working at the home. No records were available to indicate that recorded visits by the registered provider had been carried out. The manager said that the registered provider did, however, visit the home very frequently. Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 18 Records were securely stored around the home, which protected the residents’ best interests and confidentiality. At the time of inspection fire exits were clear and window restraints were in situ at first floor windows checked to prevent falls. Hazardous products were safely stored in the home. The hot water temperature in one bathroom measured a safe temperature of 42 degrees centigrade. Fire records were up to date and stated that weekly testing of the fire alarm system and fire drills had occurred. A sample of records showed that staff were receiving fire safety and other statutory training. Staff interviewed said they were receiving this training. This will promote the safety and welfare of the service users. Nightingale DS0000002990.V279382.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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 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 X 17 X 18 X 2 X 2 X X 3 3 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 3 X 3 3 Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23 Requirement All areas of the home used by residents must be well maintained. (Corridor carpet) Timescale for action 01/05/06 2. 3. 4. OP21 OP29 OP33 23 19 26 All areas of the home used by 01/08/06 residents (toilets and bathrooms) must be well maintained. CRB records held must identify 01/05/06 whether the checks included a POVA check. The registered provider must 01/05/06 visit the home and produce a report. The report must contain the information as highlighted in regulation 26. 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 OP30 Good Practice Recommendations Staff should receive increased training on issues that are specific to the assessed needs of the residents in the home. DS0000002990.V279382.R01.S.doc Version 5.1 Page 21 Nightingale 2. OP31 Preparations should be made to ensure that the registered manager has a level 4 NVQ qualification in management or equivalent by 2005. Nightingale DS0000002990.V279382.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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