Inspection on 25/11/05 for Whitehaven (Gold Care Limited)

This inspection was carried out on 25th November 2005.

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.

Other inspections for this house

Whitehaven (Gold Care Limited) 26/05/09

Whitehaven (Gold Care Limited) 07/01/09

Whitehaven (Gold Care Limited) 24/01/07

Whitehaven (Gold Care Limited) 07/07/05

Whitehaven (Gold Care Limited) 05/11/04

Whitehaven (Gold Care Limited) 03/08/04

Whitehaven (Gold Care Limited) 31/03/04

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

CARE HOMES FOR OLDER PEOPLE Nightingale (Gold Care Limited) 218 - 220 Kettering Road Northampton Northants NN1 4BN Lead Inspector Mrs Moira Mosley Unannounced Inspection 25th November 2005 10:00 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 (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 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 (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Nightingale (Gold Care Limited) Address 218 - 220 Kettering Road Northampton Northants NN1 4BN 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) 01604 626272 01604 626272 Gold Care Limited Mrs Sharon Sooriah Care Home 19 Category(ies) of Dementia (19), Dementia - over 65 years of age registration, with number (19) of places Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No person under 50 years of age who falls within the category DE may be accommodated in the home. The home may continue to accommodate two named service users whose needs fall within the category Mental Disorder over the age of 60 who were accommodated in the home prior to re-registration with CSCI. 7th July 2005 Date of last inspection Brief Description of the Service: Nightingale is a care home providing twenty-four hour care for up to 19 older people. The home is situated close to the centre of Northampton overlooking a large area of parkland. The home comprises a three-storey building, with off road parking to the rear of the house, and an enclosed garden area. The garden has been landscaped and provides a very pleasant, safe area for service users use. An awning has been fitted over a paved area just outside the back of the house to create a covered area for smokers. The original frontage of the house has been retained so that the home blends in with others in the road. There are two lounges a dining room and a sun lounge. Bedroom accommodation is in single and shared rooms, some of which have en-suite washbasins and toilets. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a statutory unannounced inspection; 1.5 hours were spent gathering information and planning for the inspection and 3.25 hours were spent in the home. The care of three service users was reviewed to include their care plans, risk assessments, medication and other records. Due to their level of need most of the service users were unable to comment on their care however a period of observation and general interactions with three of the service users was undertaken along with discussions with three staff members to ascertain how care is provided. What the service does well: What has improved since the last inspection? What they could do better: Care plans for dealing with service users in relation to pressure ulcer assessments need to demonstrate action taken when a risk is identified. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 6 Medication needs to have a clear audit to ensure medication is being administered as prescribed. Activities in relation to the specific needs for people with dementia need to be further explored to ensure the service users are appropriately stimulated. Resident’s monies should be regularly checked by two people to ensure it is appropriately managed and any discrepancies quickly acted upon. 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 (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 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 (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 There is an effective system in place to ensure that resident needs are fully assessed prior to admission. EVIDENCE: There is a comprehensive pre admission assessment and the views of the resident, their families and any care professionals are sought prior to the offering of a place with residents and families encouraged to visit the home prior to an admission. Intermediate care (standard 6) is not provided at this home. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Care plans and risk assessments ensure that resident needs are met, however action taken in response to identified risks of pressure ulcers are not being recorded. Further development of medication records is needed to provide a clear audit trail of medication in the home. EVIDENCE: Care plans seen were written to a generally high standard with regular reviews and updates and provided clear directions for staff to ensure consistent care. Healthcare assessments included pressure ulcer and nutritional assessments along with falls risk assessments and there is evidence of involvement of the multi disciplinary team as required, for example the GP and Community Psychiatric Nurse (CPN). The three service users whose care was tracked all had an identified risk of developing pressure ulcers and although equipment was in evidence, there was no documentation or care plans to identify what action is being taken and to ensure pressure areas are being monitored. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 10 The medication was cross-referenced to the Medication Administration Records (MAR) and there were procedures in place to ensure the safe storage, administration and disposal of medication. The total amount of medication in the home was not clearly identified and this prevents an audit to ensure medication is being administered as prescribed. The requirement made at the last inspection for variable doses to be recorded when medication is administered was mainly met, however there were two service users prescribed senna on an ‘as required’ (PRN) basis, whose dosage was nor recorded. Observations showed positive interactions between staff and service users and the staff spoken to showed a good understanding of individual needs. Interventions were managed with sensitivity and the privacy and dignity of the service users was maintained. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Further development of activities for service users with dementia is needed to provide meaningful occupation for the residents. EVIDENCE: There is an activity plan and records of activities maintained, however it was evident on reviewing the records and discussions with staff that activity provision is limited. There is no activity co coordinator to oversee the programme, to train staff and provide inspiration for suitable activities, especially within dementia care. Staff spoken to were keen to interact with service users but are unsure of how to motivate those with dementia, as most are unable to partake in traditional activity programmes. Staff and records confirmed regular visitors to the home and there is an open visiting policy. Staff stated that they try to access local facilities as often as possible and do use the local park and shops for outings with the service users. Observations showed staff interacting positively and encouraging service users to communicate their needs. The service users were supported to move freely round the home and choices were offered where possible, for example meals and drinks. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 12 The menus are regularly reviewed and the cook confirmed that they provide alternatives to cater for likes and dislikes as well as providing specialised diets for a range of needs. There is a proactive approach to the dietary needs for older people with dementia and dietetic advice has been sought to try and prevent weight loss, this has included the provision of high-energy foods, supplementing meals and close monitoring of individual needs. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 There is an effective complaint system in place to ensure service user needs are addressed. EVIDENCE: The complaints procedure has been updated since the last inspection and a complaints file has been compiled. There has been one complaint since the last inspection, via the CSCI and this was appropriately investigated with records maintained. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The home provides a safe and comfortable environment for the residents. EVIDENCE: The communal lounges and dining areas were clean and tidy with no hazards evident. Records demonstrated compliance with fire and EHO (environmental health officer) requirements. The weekly fire alarm test and monthly emergency light test was just overdue and this may be due to the manager being on annual leave – with no plans in place for its ongoing testing in her absence. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 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): 29 and 30 Suitably qualified and experienced staff are employed to meet service user needs. EVIDENCE: Staff spoken to confirmed comprehensive recruitment practices prior to being offered employment. A recently appointed member of staff spoke about providing references and undertaking a CRB clearance, he then had a period of induction and felt supported in learning about the role of care worker. A training programme is in place and the staff spoke about the range of training available including all statutory training and a number of staff are currently attending a dementia course. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 16 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): 35 and 38. Resident monies are not being regularly audited to ensure appropriate management. EVIDENCE: The service users monies are appropriately stored and records are available of all income and expenditure. However the money is not being regularly checked, of the two service users reviewed one had not had the balance checked since September and the other October and this was not countersigned to protect the service user and the staff member accessing the monies. There were systems in place to monitor and maintain the health and safety of residents and staff. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 17 Staff confirmed they have received all statutory training and there is a programme of regular updates. Manual handling assessments and training were all up to date. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 18 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 2 X X 3 Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 19 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 OP8 Regulation 12(1)(a)( b) 13(2)17(1 )(a) Requirement Records must be maintained to evidence action taken as a result of identified risk of pressure ulcers. A clear audit trail of all medication in the home must be available. Timescale for action 01/01/06 2. OP9 01/01/06 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 2 Refer to Standard OP12 OP35 Good Practice Recommendations The provision of activities and staff training to provide these should be explored specifically in relation to suitability for service users with dementia. There should be a regular audit of service users money with countersignature to protect staff. Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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. Extracts may not be used or reproduced without the express permission of CSCI Nightingale (Gold Care Limited) DS0000060368.V268496.R01.S.doc Version 5.0 Page 21 - 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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