Inspection on 26/05/06 for Nightingale House

This inspection was carried out on 26th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 House 30/04/09

Nightingale House 02/04/08

Nightingale House 24/04/07

Nightingale House 02/12/05

Nightingale House 08/02/05

Nightingale House 12/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Nightingale House 69-71 Crowstone Road Westcliff On Sea Essex SS0 8BG Lead Inspector Diane Roberts Unannounced Inspection 26th May 2006 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 House DS0000015550.V293085.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 House DS0000015550.V293085.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Nightingale House Address 69-71 Crowstone Road Westcliff On Sea Essex SS0 8BG 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) 01702 338552 01702 331788 xassist@aol.com Mr Abi Oduyelu Mrs Anita Mary Veronica Martin Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (30) of places Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The number of service users for whom personal care is to be provided should not exceed 30 (total number not to exceed 30). Personal care may be provided for up to 30 people over the age of 65. Personal care may be provided for up to 30 service users with dementia over the age of 65. One named person known to the CSCI who is under 65 years of age. Date of last inspection 2nd December 2005 Brief Description of the Service: Nightingale House is registered to care for both older people over the age of 65 and those over 65 who may have dementia. At the current time the home is primarily caring for people with dementia. The home is situated near Southend seafront. It is close to the shops and local bus routes. The home has a small car park to the front and a garden at the rear. As of the 26/5/06 the fees were £343.49 to £400.00 for a single room and £326.43 - £400.00 for a double depending on dependency level of resident. Additional charges would be made for hairdressing, chiropody etc. The home has information available for prospective residents. A copy of the latest inspection report is readily available in the reception area. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key Inspection took place over six hours and was carried out as part of the annual inspection programme for this home. The registered manager was present at the inspection. There was a very limited response to the last agenda for action, which is disappointing. The home needs to address this in order to stop further action being taken by the CSCI. The Inspection focused upon all of the key standards and the home’s response to the last agenda for action. A partial tour of the premises was undertaken. Evidence was also taken from the Pre Inspection Questionnaire completed by the home and submitted to the CSCI. Five relatives, two residents and three staff were spoken to during the inspection. Seventeen comment cards were received from residents or relatives on behalf of residents. A District Nurse was also spoken to as part of the inspection. Due to the care needs of the residents at the home it was not possible to fully obtain their views but residents’ appeared happy, relaxed and willing to chat to the inspecting officer. What the service does well: What has improved since the last inspection? There has been a limited response to the last agenda for action. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 6 The manager has undertaken some more safe working practice risk assessments in line with its health and safety policy. 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 House DS0000015550.V293085.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 House DS0000015550.V293085.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): 1,2 and 3. Standard 6 is not applicable to this service. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and their families have the information they need to make an informed choice about the home, but documents require updating. Each resident has a contract of admission. Prospective residents are assessed prior to admission to the home, which ensures the home can meet their current needs. EVIDENCE: The home has both a Statement of Purpose and Service Users Guide in place. Relatives, who commented, found these documents helpful and informative. The home needs to review both these documents, which contain out of date and misleading information. This was an agenda item at the last inspection and it is disappointing to note that these documents have still not been reviewed. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 9 Relatives confirm that they have had a copy of the resident’s contract of admission. The content of the contract was seen to be satisfactory and outlines clear terms and conditions. The manager currently undertakes all pre-admission assessments. The forms used meet all the requirements under this standard and completed documentation was inspected at random. These were completed well, giving detailed and individualised information. Records show that the home obtains, where possible, copies of Com 5 – Social Service assessments. This gives the home a good overall assessment. From discussion with the manager, thought is obviously given as to whether the home can meets the needs of residents and action is taken when it is shown that they are unable to, if circumstances have changed. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 10 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. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. The home has a basic care planning system in place that requires further development. Resident’s health care needs are met but records need to improve, to evidence this further. The home generally has satisfactory systems in place for the safe handling of medicines. Residents are treated with respect and their privacy is upheld. EVIDENCE: The home has a care plan in place for each resident and a system for reviewing the care plans. Information from monthly reviews, which are of a good standard, is not being transferred into the care plan and many are therefore not up to date, despite the reviews being done. Those care plans in place are, although basic, Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 11 informative and personalised to the resident. The care plans do not always have identified objectives. Daily notes are of a variable quality with some giving limited information and others being slightly better. The daily notes do not link to the care plan. The care plans are primarily written by the manager who has limited time to do this. A review of this system may be of value. Some risk assessments are in place but these are basic and need development. The home does not have a formal manual handling or nutritional risk assessment in place. Falls risk assessments are mentioned in care plans but again no formal risk assessment is in place. Social records and backgounds/social histories of residents in the home are limited and could be better, especially for this resident group with predominantly dementia related care needs. Relatives who visit the home feel that the residents are well cared for and that staff listen to them regarding any queries they may have over the care provided or needed. From discussion with staff, they know the residents well but some care is intuitive rather than knowledge based, with some aspects of the care provided not being fully understood or reflected in the care plans. Discussion with relatives showed that they were unaware of the care plans and records that the home holds on their relatives. Relatives are happy with the GP services at the home and state that the home are good at letting them know if there are any changes to medication or care. District nurses visiting the home are happy with the standards of care at the home and feel that the staff know the residents well. They feel that the manager drives a lot of the good care practices in the home but staff are always aware of their visits and prepared. Records of residents’ weight monitoring were inspected. These were good records and evidenced that two residents with weight loss were being appropriately seen, by the dietitician etc. and given supplements and high calorie foods. Medical records seen for residents show that flu vaccine are given and that the practice nurse comes to do patient reviews/checks. Records also show that the home calls the GP proactively and in a timely manner for any concerns they have regrding residents’ health. Residents are seen by the psychiatric team as appropriate and overall the medical records are good and evidence that residents are receivng a good standard of healthcare. The home also has positive links with the local Macmillan service for one resident at the home. The home has up to date policies and procedures in place for the safe handling of medicines. They also have copies of local and national guidance. Records show that all staff that handle medications are either trained or about to undertake a refresher course. The record sheets and medication stock was inspected and seen to be in good order, with clear records and reasonably good stock control. One resident was noted to have excessive stock of one medication and dates of opening were Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 12 not being recorded on liquid medications, giving a limited audit trail. This needs to be addressed. Records contained pictures of residents and any allergies were noted. The home was not managing any controlled medications at this inspection but the cupboard, which is situated high up, contained old standard medications. A new cupboard has been purchased and is due to be placed where staff can see all the shelves clearly. Records show that generally a satisfactory returns system is in place. Records show that both General Practitioners and Nurse Practitioners undertake medication reviews at the home. From observation and discussion with relatives, the residents are treated with dignity and their privacy is respected. Staff address residents correctly and knock when entering rooms. The laundry system at the home is satisfactory, with carers undertaking the laundry tasks. From observation staff interact with residents appropriately and with sensitivity. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 13 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a basic activities programme in place that needs to be developed further and records fully maintained. Residents are able to maintain contact with family and friends as they wish. As far as possible, residents are helped to exercise choice and control over their lives. The home provides a satisfactory meal service, but needs to ensure a current menu is in place. EVIDENCE: The majority of relatives who commented were either unsure about the activities programme or stated that activities did no occur in the home. Residents spoken to were unable to comment or stated that they just liked to sit and watch the activity within the home. Records of activities undertaken by residents are held in their care plans. These were inspected and found to be very limited and basic. It may well be that the poor records reflect badly on the home as even the basic activities Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 14 provided are not recorded. From discussion with staff there are some activities taking place, including visits out of the home for some residents, but again records do not reflect this. One relative confirmed attendance of one resident to a local stroke club and others do go out shopping with the manager on occasions. There is evidence of reminiscence around the home with new photos displayed of film stars and social history which staff confirm are used when talking to residents. The home needs to address this shortfall and evidence that they are providing a meaningful programme for the residents at the home. The home has an open visiting policy and during the inspection many relatives visited residents at the home. Were possible the home encourages relatives to take residents out. The home has some links with the local community, which benefit some residents such as the local church and stroke clubs. Relatives spoken to were happy with the visiting arrangements. The home has information available on local advocacy services and in the past has used these services. At the current time no one in the home is using an advocate. Residents at the home have their family or guardian looking after their financial affairs for them. Residents are encouraged to bring personal items/possessions with them on admission to the home. The limit on this would be discussed at the time of admission and this was evident around the home. Relatives who commented felt that the meals at the home were on the whole, good, appetising and tasty. Residents observed over the lunchtime period appeared to be enjoying their meal and commented positively. Records show that residents are having choice and that special diets are caterered for. This was confirmed by residents. Good records are in place which show how much people ate, using a code system. No nutritional risk assessment is in place and these records could link to a full assessment. The kitchen was seen to be much cleaner than at the last inspection. Since the departure of the last chef, new menus are being planned and implemented and these were seen to be more resident orientated. Residents are able to choose where they eat but are encouraged to use the dining room. Tables were seen to be layed appropriately and condiments were available. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 15 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure in place, which helps to ensure that complaints will be listened to and acted upon. The home has systems and staff training in place, which helps to ensure that residents are protected from abuse. EVIDENCE: The home has a satisfactory complaints policy in place, which is on display in the reception area and can be found in the Service Users Guide. Residents spoken to were sure who they would raise any concerns with and relatives who commented knew about the complaints procedures and who they would go to. The manager is very accessible to residents and relatives at this home. The home has not received any complaints since the last inspection, but does have a system in place for logging complaints and concerns should they arise. The home has an adult protection policy in place, which was updated in May 2005. This was seen to be comprehensive and up to date. The home also has copies of the blue book, which gives guidance from Essex County Council. Training records show that the current staff group are nearly all up to date with adult protection training. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 16 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 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The premises and facilities are steadily improving but there is still work to do. The home is clean and but décor and facilities affect this. EVIDENCE: A partial tour of the home was undertaken. The proprietor is gradually replacing beds and bedroom furniture around the home. Sixteen beds and ten wardrobes have been replaced since the last inspection. Some bedrooms have been decorated since the last inspection and in some rooms carpets have also been replaced. It is a shame that where work has been undertaken the finishing off is very poor and make do, which spoils the effort and effect. For example, mismatched tiles or no tiles or a new sink has been put in and stood on an old bit of cracked melamine and carpet no longer fits. This gives an uncaring look overall. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 17 Many of the ensuites require work and refurbishment. Some have odour problems and this could possibly be linked to old flooring which also needs replacing. Many of the vanity units in the home are in a poor condition and require attention. It was noted that there is still a vanity unit in the upsatirs lounge, which has been recently decorated. This could have been removed as it does not fit in with the décor and nature of the room. The home still has a damp problem in the back downstairs corridor, despite work already being done and the corridor being redecorated. There is obvious damp on the walls in the downstairs corridor and on carpets in the local area. There is no musty odour at the current time. Further work is planned on this problem by another builder and the proprietor already has new carpets in the garage ready to go down when this is complete. At the last inspection a tripping hazard was noted in the upstairs bathroom where the floor is in a poor condition. This has yet to be attended to. One bedroom was noted to have no lampshade and odd bedroom carpets around the home are poor The state of the home also reflects the limited quality assurance programmes the home has in place. The home has a lawn and hardstanding area to the rear where residents can sit out. There is good wheelchair access from the conservatory. The home’s records evidence that the fire safety equipment, including the alarm and emergency lighting system are maintained up to date and that regular fire drills are carried out. The manager attended training to become a fire marshall in November 2005. No records were submitted to evidence that the staff have up to date fire safety training. This needs to be addressed. Whilst the home is generally clean, the state of some ensuites and bathroom floors etc. adversley affect this work and there are odour issues in some specific areas. Overall residents and relatives are happy with the standards of cleanliness in the home. The home have up to date policies and procedures in place for Infection Control but there is not evidence submitted by the home that infection control training has taken place for staff. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 18 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): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ needs may not be met by the current staffing levels and skill mix at times in the home. The home needs to develop its NVQ training programme further. The home has sound recruitment systems in place. The home needs to plan and develop its staff-training programme more formally and maintain clear records. EVIDENCE: The staff rota for a four week period was inspected. The home aims to provide 4 care staff in the morning, 4 in the afternoon and three at night, to care for 30 residents. The home’s records show that at times they are unable to keep to this level, if staff go off sick etc. The manager does a lot of hands on shifts as well as managing the home. At times this takes her out of the home and the home is left without a Senior in Charge. The proprietor and manager need to reassure the CSCI that the home is adequately staffed and that when the manager leaves the home the home is left with some one competent in charge. Records show that the Manager has limited supernumerary days to attend to management responsibilities. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 19 Relatives who commented felt that staff were always available to speak to them and were helpful. Ancillary staff, such as domestic and kitchen staff, are employed in reasonable numbers for the size of the home. There is no domestic cover at weekends or laundry staff. The home encourages its staff to undertake NVQ training. Three care staff have achived level 2 in care and three more are commencing this course in the near future. One member of staff is undertaking level 3 in care. The home hope to send more staff on the course as more funding is availble for over 25s. At the current time less than 25 of care staff are trained to NVQ level 2 and above. The home needs to continue to address this. The home has up to date recruitment policies and procedures in place, which include equal opportunities. Staff files were checked at random and found to contain all the required documentation and checks. A checklist system to make things easier for administration is recommended. Whilst the home provides staff with training, at the current time there is no formal staff training and development programme in place. Training at the home could be better organised, with clearer records maintained. The majority of staff have attended the in house dementia course run by the manager – this is fine but limited. Staff need to have a more in depth knowledge base and a more formalised training structure, as the home tends to specialise in Dementia care. Because this training is limited much of the care is intuitive rather than knowledge based and often not put into practice as shown with the activities programme. This training needs to have a higher profile in the home. Records provided by the home show that training has been provide for staff in Moving and Handling, Basic Food Hygiene, Nutritional Needs, Protection of Vulnerable Adults, Dementia and First Aid. Records do not show that training has been provided in Health and Safety, Fire Safety, COSHH or Infection Control. This needs to be addressed. The home has quite a comprehensive in house induction. The manager has also been sending staff on external induction courses run by TOPSS/Skills for Care. The manager needs to plan and organise how she is going to continue with her staff induction programme so there is some consistency and that the required standards are met. From discussion with staff they confirm that they have had an induction to the home. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 20 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): 31,33,35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is qualified and experienced to run the home but needs the time to do this properly. The quality assurance programme in the home is basic and needs developing. Residents’ financial interests are safeguarded. Residents’ health and safety is generally protected but there are some areas for improvement. EVIDENCE: The manager is qualified and experienced to run the home. Both staff and relatives feel that the home is well managed. Staff find the manager Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 21 approachable and they are aware of her standards and says that she always explains things clearly and listens to staff. Staff say that there is an open atmosphere in the home. Whilst this is a relatively small care home, the manager is pulled in many directions with the rota relying heavily on her input in providing day to day hands on care. This is reflected in many of the business and recording systems in the home, the organisation of staff training and services for residents, such as activities. The proprietor and manager need to seriously review this if they want the home to continue to develop in a positive manner. The manager also has no admin support working in the home. The quality assurance programme in the home is limited. Satisfaction questionaires are sent out to families but at the current time there is no formal analysis of these and subsequent action plan. This was discussed with the manager. The home needs to develop their quality assurance programme further, including a internal audit. The home does not manage any monies on behalf of residents and does not act as appointee. They will hold small amounts of money on behalf of residents and satisfactory records and recepits are maintained. Two signitories are recorded where transaction occur and residents sign if they are able. The home has a health and safety policy in place. Since the last inspection the manager has developed the safe working practice risk assessments further and reports that the Fire Officer has checked the home’s fire safety risk assessment. Some of the working practice risk assessments are due for review. Accident records were inspected and found to be recorded correctly. It was noted that there are some residents who fall regularly and this was discussed with the home’s manager, as there is no falls risk assessment at the current time. The manager reports that she has just linked in with the local falls prevention team and is going to start using their documentation. Records provided by the home show that all the facilities and equipment in the home have up to date safety or maintenance certificates. Those sampled for inspection were found to be in order. The home reports that they have thermostaic valves on all taps and temperatures are checked regularly. Window restrictors are in place throughout the home. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 22 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 2 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 23 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 OP1 Regulation 4 Requirement Timescale for action 31/07/06 2. OP7 3. OP8 4. OP12 5. OP15 6. OP19 The registered person must review and update the Service Users Guide and Statement of Purpose to ensure that they contain the correct information. This is a repeat requirement. 15 The registered person must provide a plan of care that is kept up to date and where possible involves the resident or their relative/representative. This is a repeat requirement. 13 The registered person must ensure that all health related risk assessments are in place and are under review. With particular reference to manual handling, falls and nutrition. 16 (m and The registered person must n). provide a meaningful programme of activities for residents in the home and maintain records of such. 17(2) The registered person must Schedule provide a record of food provided 3 for service users in sufficient detail - with regard to menus. This is a repeat requirement. 23 (2) The registered person must DS0000015550.V293085.R01.S.doc 31/07/06 31/07/06 31/07/06 30/06/06 30/06/06 Page 24 Nightingale House Version 5.1 7 OP19 23 8 OP19 23 9 OP26 16 10 OP27 18 11 OP30 18 12 OP31 18 13. OP33 24 10. OP38 12/13 ensure that the home is maintained to a satisfactory standard with regard to flooring in bathrooms. This is a repeat requirement. The registered person must make good the damp problem in the downstairs corridor and address any décor needs following that work. The registered person must submit a plan for the refurbishment of vanity units and en-suite toilets in the home and removal of the bathroom sink in the upstairs lounge. The registered person must address the issue of unpleasant chronic odours in some of the en-suite toilets in the home. The registered person must ensure that the home employs enough staff to maintain the staffing levels at the home and that there is always a competent person left in charge of the home at all times. The registered person must ensure that staff are trained appropriately for the work they are to do. This refers to staff induction, dementia training, health and safety training, fire safety training, infection control etc. Full records must be maintained. The registered person must review the manager’s job description to ensure that she has the time and resources to manage the home efficiently. The registered person must ensure that there is a system for monitoring the quality of care provided by the home. This is a repeat requirement. The registered person must ensure safe working practice risk DS0000015550.V293085.R01.S.doc 31/07/06 31/07/06 31/07/06 30/06/06 13/08/06 31/07/06 01/09/06 31/07/06 Page 25 Nightingale House Version 5.1 assessments are kept under review and the prevention of falls is addressed in the home. This is a partial repeat requirement. 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 3. 4. 5. Refer to Standard OP9 OP19 OP28 OP29 OP19 Good Practice Recommendations The registered person should ensure that dates of opening are recorded on liquid medications and that excess stocks of medication are returned to pharmacy. The registered person should review the standard of building work carried out in the home and home this affects the quality of the home and life of residents. The registered person should continue to develop the NVQ training in the home in order to achieve the 50 trained staff standard. The registered person should give consideration to developing a checklist for staff recruitment. The registered person should develop a formal staff training and development plan for the home. Nightingale House DS0000015550.V293085.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 House DS0000015550.V293085.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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