Inspection on 07/01/09 for Whitehaven (Gold Care Limited)

This inspection was carried out on 7th January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Whitehaven (Gold Care Limited) 26/05/09

Whitehaven (Gold Care Limited) 24/01/07

Whitehaven (Gold Care Limited) 25/11/05

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Nightingale (Gold Care Limited) 218 - 220 Kettering Road Northampton Northants NN1 4BN     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Catherine Perrins     Date: 0 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Nightingale (Gold Care Limited) 218 - 220 Kettering Road Northampton Northants NN1 4BN 01604626272 01604626272 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Gold Care Limited care home 19 Number of places (if applicable): Under 65 Over 65 19 dementia Additional conditions: 19 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. Date of last inspection Brief description of the care home Nightingale is a care home providing personal and nursing care for up to 19 older people. The home can accomodate people from 50 years of age. The home is situated close to the centre of Northampton overlooking the racecourse park. The home comprises of a three-storey building, with off road parking to the rear of the house, and an enclosed garden area. 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 conservatory. The majority of bedrooms are single with one double. Some rooms have en-suite washbasins and toilets. Owing to the complex needs of residents in the home, fees are charged on an individual assessed basis. Further information about current fees can be obtained from the manager. Care Homes for Older People Page 4 of 26 Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This was an unannounced key inspection which means that we focused on the key national standards. The key standards are those considered by the Commission to have the most impact on outcomes for residents. As part of the preparation for this inspection a period of four hours was spent reviewing previous inspection reports the other information that CSCI has received about this service. Care Homes for Older People Page 6 of 26 The inspection visit lasted five and a half hours during the morning and afternoon of a weekday. During the inspection three people were case tracked. This involves looking in detail at all aspects of their care and experiences at Nightingale,including looking as their individual plans of care and other records, talking to them and talking to their care staff. Because people with dementia are not always able to tell us about their experiences we also used observations of peoples state of well being and how they interacted with staff members and others. A sample of staff files were also viewed as part of the inspection, we also spoke to some of the staff on duty at the time of inspection. The Manager and the Area Manager were present during this visit and one of the directors was present for a short period. What the care home does well: What has improved since the last inspection? What they could do better: The current manager needs to apply for registration with The Commission for Social Care Inspection. Care plans need to accurately reflect peoples current needs to ensure that they receive Care Homes for Older People Page 8 of 26 the appropriate care. When peoples needs change their care plan should be updated. The home needs to ensure that it is meeting the requirements of the Freedom of Information Act and be able to make the records of one person available without compromising confidentiality of another. Creams should be dated when opened to ensure that they are used within three months of opening. The systems for internal auditing need to be reinstated to make sure that the home is running as it should be and that the people who live there and their relatives and representatives are happy with the service they are receiving. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information and assessment and a flexible admissions procedure mean that when people decide to move in to Nightingale they can be confident that their needs will be met. Evidence: The admissions process appears to be well managed. Records show that people have an initial assessment before they move into the home to make sure that the home can meet their needs. The area manager explained that admissions procedure is flexible to accommodate peoples individual circumstances. People or their families are able to visit the home before they decide whether to move in. The home has a comprehensive brochure, statement of purpose and service user guide which give people good information about the home and the services offered. The information does, however, need updating to include details of the current manager Care Homes for Older People Page 11 of 26 Evidence: and the correct address of the Commission for Social Care Inspection. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is some good information about peoples needs and preferences within their individual plans of care but this is not consistent which means that staff do not always have the information they need to care for people in the right way. Evidence: Each person who lives at Nightingale has an individual plan of care. These tell staff how people want and need to be cared for. Individual plans of care viewed contained some details of peoples preferences such as food likes and dislikes, what time people liked to get up in the morning and go to bed at night, how many pillows they liked at night, whether they liked to have a light on at night or their bedroom door open and how they liked to be helped with personal care. This information is important as it helps staff give people individual care in the way that they wish to be cared for. People have assessments and care plans covering areas such as their mental health, dementia, personal care needs, any specific health needs such as diabetes, personal care, and nutrition. People are also assessed for pressure area care and where Care Homes for Older People Page 13 of 26 Evidence: required they have specialist equipment, such as pressure relieving mattresses, and a specific care plan outlining the care that they need to help them avoid getting pressure sores. One persons file had some inconsistencies with regard to their cultural needs which could result in their cultural needs not being fully met. One care plan stated that a pureed diet was required but the manager and staff confirmed that a soft, not pureed, diet was being given to the person concerned. It is important that peoples care plans accurately reflect their needs to ensure that they receive the care that they need. When peoples needs change their care plan should be updated. Where necessary appropriate health and social care professionals should be involved in reassessing the persons needs, for example a speech and language therapist may be involved in assessing whether someone needs a pureed diet. Records show that peoples have regular health appointments such as general practitioner, podiatry and opthalmic visits. Details of some health appointments and checks are kept in general files rather than in peoples personal files. The home needs to ensure that they are meeting the requirements of the Freedom of Information Act and that they are able to make the records of one person available without compromising confidentiality of another person. The administration of medication appears to be well managed. Each person who lives at Nightingale has a medication profile with their photograph on. Medication administration records seen were signed to show that medication was being given as prescribed. The manager stated that it was not current practice to date creams when opened. This is important to ensure that they are used within their use by time. The manager explained that the home had a good relationship with the local pharmacy who would dispense and deliver tablets on the day they received a prescription. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to a range of activities available and their visitors are welcomed into the home. Evidence: One person told us that she was very happy living at Nightingale and that she had Nothing to grumble about. She told us that she enjoys playing cards or bingo and watching the television. She said that she also has friends who visit he on a regular basis. The manager explained that an activity therapist, employed by the provider, visits the home to offer advice and training to staff about appropriate activities for the people who live at Nightingale. The home have an activity programme which includes group activities, singing and dancing, ball throw, sensory activities, looking at family pictures or magazines and massage. Staff explained that this had to be kept flexible to meet peoples needs and preferences. Care Homes for Older People Page 15 of 26 Evidence: Staff were observed doing activities with residents during the inspection, one person in particular was really enjoying this. Staff explained that when the weather is better people can go into the garden, or to the shops or park which is opposite the home. Lunch on the day of inspection was sausages, spaghetti and mashed potato followed by chocolate pudding. There were alternatives available for people on special diets. The home employs a cook to prepare breakfast and lunch seven days a week. The cook explained that lunch is always a cooked meal and that they also have a cooked tea three times a week. On the other evening people have sandwiches for tea. Staff were seen assisting people who needed help with their lunch in a sensitive and unhurried manner. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that any concerns that they have will be acted upon. Evidence: The complaints procedure was viewed. The home has received one complaint in the last twelve months. A relative raised concerns about someones health needs. The home have worked with the relative and the persons social worker to resolve this issue. Staff spoken to were aware of how to raise concerns. There have been no safeguarding allegations made in the last twelve months. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can enjoy a well maintained, spacious and homely place to live. Evidence: The home has two lounges, a dining room and a conservatory. The standard of decor is good and the home is generally clean with no unpleasant odours. Pictures, vases of flowers, ornaments and some period features make the property feel homely. The carpet in the front lounge was showing signs of heavy usage. The area manager explained that it did suffer from a lot of spills and wear and tear and was due to be replaced shortly, despite only being fitted twelve months ago. All of the communal reception rooms are of a domestic size. There are two bedrooms and two bathrooms downstairs with the other bedrooms on the first and second floors. There are three double bedrooms with all of the rest being single. Some have an ensuite WC. People are able to personalise rooms with own possessions. Further communal bathrooms are available on the first and second floors. There is a laundry room in the basement and a small garden at the rear of the property. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive sensitive and individual care from a competent, well trained staff team. Evidence: One person told us that the Staff are very good - day and night. The recruitment of staff appears to be well managed with staff having all the required pre recruitment checks to make sure that they are suitable to work with older people. Records show that staff have a thorough induction when they first start working at the home. This includes including health and safety, food hygiene, pressure care, moving and handling and safeguarding of vulnerable adults. Staff were observed talking to people in a sensitive way appropriate to the communication needs of the person involved. The area manager explained that staff were very good at caring for people who could be quite challenging. Staff told us that they received the training they needed to help them do their jobs in the right way. One person said that she was in the process of doing training on dementia care. Care Homes for Older People Page 19 of 26 Evidence: Staff explained that each staff member was given allocated tasks this ensures that everyone knows what they are doing. Staff spoken to said that there were always enough staff on duty to meet the needs of the residents. During the day there is three or four carers and a nurse on each shift. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The current management arrangements have been effective in the short term but the home needs a registered manager to ensure people have good quality care. Evidence: The home does not currently have a manager who is registered with The Commission for Social Care Inspection. The current manager explained that he had been working in the home as a deputy manager and was appointed as the manager at the end of November. He stated that he will be applying to register with The Commission. The manager is a qualified mental health nurse and is undertaking his registered manager award. Staff told us that they get good support from the manager and that he does deal with any issues they raise. The home employs a handyman to ensure that the property is well maintained. Care Homes for Older People Page 21 of 26 Evidence: Records show that fire checks and other safety checks have been completed. Other safety measures such as radiator covers, stair gates and hot water temperature restrictors were being used to make sure that people who live at the home are safe. The home has a system for carrying out internal audits against all of the national standards. Records showed that some areas such as laundry and housekeeping had been audited in June 2008. Records were not available to show any recent audits for other areas such as care plans and risk assessments. The area manager explained that she would be going through the internal audit with the manager as part of his ongoing induction. A file was viewed that contained numerous compliments received from relatives in the last twelve months. Many referred to the staff as being kind, caring and sensitive. The home has a comprehensive brochure, statement of purpose and service user guide which give people good information about the home and the services offered. The information does, however, need updating to include details of the current manager and the correct address of the Commission for Social Care Inspection. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 Where it has been identified that someone is at risk of falling their individual plan of care must identify what needs to be done to minimise that risk. To make sure that all staff know what to do to reduce the risk of people falling. 14/04/2009 2 7 15 Individual plans of care must 14/04/2009 detail peoples current care needs and be updated as peoples needs change. To make sure that staff have the information that they need to care for people in the right way. 3 31 8 The current manager must apply for registration with the Commission for Social Care Inspection. To ensure accountability for complying with national standards of care. 14/04/2009 Care Homes for Older People Page 24 of 26 4 33 24 The home must audit and evaluate the quality of care and services being provided and act on any areas for improvement identified. To make sure that the home is providing a high quality of care and service that meets the needs and aspirations of the people who live there. 14/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The homes Statement of Purpose and Service User Guide should be updated to give details of the current manager and the correct address for the Commission for Social Care Inspection. Where people are prescribed creams these should be dated when opened to ensure that they are used within the recommended three months. Records should comply with the requirements of the Freedom of Information Act 2000 and allow one person to see there care records without compromising the confidentiality of other people. 2 9 3 37 Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!