Inspection on 27/06/06 for Nightingale House Care Centre

This inspection was carried out on 27th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Nightingale House Care Centre 04/09/07

Nightingale House Care Centre 20/02/06

Nightingale House Care Centre 29/03/05

Nightingale House Care Centre 15/12/04

Nightingale House Care Centre 11/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Nightingale House Care Centre Clovermead Farm Main Road Bucknall Lincs LN10 5DT Lead Inspector Kima Sutherland-Dee Key Unannounced Inspection 27th June 2006 09:45 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 Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 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 Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nightingale House Care Centre Address Clovermead Farm Main Road Bucknall Lincs LN10 5DT 01526 388261 01526 388487 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) Knightingale Care Limited Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th February 2006 Brief Description of the Service: Nightingale House is a single story building, which has been extended and adapted to provide accommodation for up to 45 Older People who require personal or nursing care. The home is a detached property, which is accessed from a main road through the village of Bucknall. There is car parking available and the home is set within grounds, which can be easily accessed by service users. The home has had a new extension built in 2000. The home is located in a village, which is approximately 12 miles from Lincoln and 7 from Horncastle. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was undertaken using a review of all the information available to the Inspector regarding Nightingale House, and through undertaking a visit to the home, with the inspector using a method of inspection called “case tracking”. This involved identifying three residents who currently live at the home and tracking the experience of the care and support they have received. This inspection was achieved by the inspector talking to the manager and deputy matron, looking at information on care plans and files, talking to residents and care staff, and observing day-to-day care practice within the home. The Fess for the home varies between £400.00 and £600.00 per week depending on each residents needs. What the service does well: What has improved since the last inspection? The manager has ensured that the information in the pre admission assessments and the care plans has improved, so the staff have a better understanding of the care that the residents need. The storage of unwanted medication is now more secure. The manager has consulted the fire officer and the staff no longer use door wedges. New door closers have been fitted. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 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 Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 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): 3,4 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Prospective residents are assessed and the provider assures them that the home can meet their needs. EVIDENCE: The records for one new admission showed that a pre admission assessment had been completed and the resident had been written to, to confirm that the home could meet their needs. A copy of quality report from May 2006 stated that all the residents and the relatives were happy with the admission information, even though some had forgotten they had received a welcome pack. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 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): 7,8,9,10 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service.’ The manager has complied with the previous requirement to improve the care plans, and the resident’s health care needs are being met. The medicine administration procedures on admission could place residents at risk. EVIDENCE: The manager stated that the staff have worked hard to improve the care plans, and this is an ongoing process. The care plans now have more information about the way the staff need to care for each individual resident. The manager has made arrangements for more secure storage of unwanted medication and controlled drugs that are not being used are destroyed. Pressure relieving equipment was being provided, and the pre inspection questionnaire states that this is reviewed monthly. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 Page 10 Those residents identified as being nutritionally at risk had fluid balance charts in their rooms, and their weights are being monitored. The quality report states that the residents are happy with the care they receive and that they have access to the G.P, and they can be involved in their care if they wish. It was found that the medicine records for a resident admitted 2 weeks ago did not state the allergies even though these were on the care plan. This did place that resident at risk. The manager added these to the record during the inspection. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 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): Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service.’ The residents are enabled to have control but they do not have sufficient food choices. The resident’s families are made welcome. EVIDENCE: The notice board in reception shows a programme of activities. The residents complete a social activities form and then their participation is recorded. One record shows that opportunities have been made available for a resident to participate in activities that they enjoy. The residents said they were happy with the activities. One resident said that they like gardening so the activities co-ordinator does take them into the garden and help them to plant seeds. An Activities co-ordinator is employed 15-20 hours per week. The staff said they do get time to talk to the residents and their preferences were identified in the care plans. The quality report states that all the residents can choose when they get up and what they wear. It says that the resident are encouraged to be involved in the care plans. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 Page 12 Some residents said they would like to go out more. The managers comment is that there are trips out arranged but they are dependent on the booking of the age concern bus. The residents and 1 member of staff said that the food was good but there should be more choice at lunch times. 1 resident said that ‘there could be more variety of vegetables as it was always carrot and cabbage’ The quality review states that a review of menu choices would be carried out but this had not happened by June 2006. Two visitors said that they are made welcome and that they are kept informed. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 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): 16,18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service.’ The manager is ensuring that the staff are competent to deal with complaints. The residents are being protected form abuse. EVIDENCE: The deputy matron demonstrated that they were aware of how to deal with complaints, and that all the information would be recorded. The complaints procedure is kept in admin office. One new complaint had been received from a resident, but the manager is dealing with the complaint appropriately. Previous inspections have identified that the staff have received abuse awareness training, and that they are aware of how to respond to suspicions of abuse. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 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): 19,26 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service.’ The home suits the needs of the current residents, although there was a slight odour of urine in one part of the home. EVIDENCE: The pre inspection questionnaire states that the providers have re decorated 3 bedrooms, a bathroom, and a shower room has been re fitted. There was a slight urine odour detected in the corridor from the office to the nurse’s room. This was discussed with a housekeeper and the manager who said that although they couldn’t smell it they would clean the carpets. The home is generally well maintained. The quality review states that the residents think the home is clean and comfortable, and that the garden needs more colour. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 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): 27,28,29,30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service.’ The residents benefit from a staff group, which are trained, supervised and recruited in an appropriate manner. EVIDENCE: Three staff recruitment files were checked and found to contain all the required checks, which help protect the residents from possible abuse or harm. This has been confirmed during previous inspections. The duty rota was seen and confirmed that there were enough staff on duty. The deputy manager said there were enough staff, and they could meet the needs of each resident, although they are rushed at times. The residents said that they were happy with the staff, apart form one case that was discussed with the manager and deputy matron. The inspector tested the response time of the staff by ringing a call bell and the staff attended quickly. The staff files had up to date supervision records and the pre inspection questionnaire states that training is ongoing through N.V.Q courses and home study. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 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): 31,33,35,38 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service.’ The acting manager is managing the staff team. They are also ensuring the continuing health and safety of the residents. EVIDENCE: The Deputy Manager said she did work well with the manager but obviously it takes time to settle into a new system. The acting manager assured the inspector during the site visit that they are about to submit an application to register with the commission. The manager and the deputy matron have had to support a minority of the staff with some difficult relationships with a minority of the residents. The Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 Page 17 manager has ensured that the residents continue to receive the care they need. A Quality review took place in May 2006 and the results have been analysed into a report with actions. The review states that the residents are happy with the response of the manager if they raise any concerns, and how often they see the manager. The pre inspection questionnaire states that the equipment in the home is being serviced and checked regularly. The manager states in the pre inspection questionnaire that they do not have responsibility for managing any of the resident’s finances. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 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 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 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 OP15 Regulation 16(2)(i) Requirement The registered person must ensure that they provide food that meets the expectations and needs of all of the residents. Timescale for action 30/08/06 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 Refer to Standard OP9 Good Practice Recommendations The registered person should ensure that any allergies are noted on the medicine administration sheets on admission. Nightingale House Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Care Centre DS0000002546.V290359.R01.S.doc Version 5.2 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. 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!