Inspection on 11/05/05 for Nightingale Lodge

This inspection was carried out on 11th May 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Nightingale Lodge 17/09/07

Nightingale Lodge 12/07/06

Nightingale Lodge 11/10/05

Nightingale Lodge 23/11/04

Nightingale Lodge 23/06/04

Nightingale Lodge 30/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Nightingale Lodge Great Well Drive Romsey Hampshire SO51 7QN Lead Inspector Roy Bega Unannounced 11/05/05 09:30am and 12/05/05 2.00pm 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 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 Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Nightingale Lodge Address Great Well Drive, Romsey, Hampshire, SO51 7QN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01794 512138 Hampshire County Council Ms Lynne Green CRH 44 Category(ies) of DE (E) Dementia-over the age of 65 years registration, with number OP Old Age of places Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 23/11/2004 Brief Description of the Service: Nightingale Lodge is a large purpose built, two storey building situated in a quiet area of Romsey. There are a small number of local shops within walking distance. The home is registered to provide accommodation for 44 older persons but only accommodates 43 at any one time. Nightingale Lodge is divided into 5 living units all with their own kitchen, lounge/diner and bathing/toilet facilities. The home provides 41 single bedrooms and one double bedroom. None of the rooms have en-suite facilities· The home also offers facilities for service users requiring respite care. Other facilities comprise of a range of offices/staff room, main kitchen, large entrance hall, laundry and separate activity rooms. To the front of the home is a small garden and car parking area and to the rear is a large enclosed designed garden and patio area. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The manager was not available on the day of inspection. Therefore, due to the inspector wanting to discuss staffing issues there was the necessity to revisit the home on 12 May. In all the inspection took a total of 7.5 hours. Four requirements raised as a result of the previous inspection were assessed as having been met. Two requirements were raised as a result of this inspection. This report reflects the situation with regards to standards inspected at the time of the visit. Standards not inspected on this occasion will be assessed during future visits. What the service does well: What has improved since the last inspection? Senior staff vacancies have been appointed to form a permanent management team. Care staff vacancies have been filled. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 6 Both of the above will assist to enhance the stability of management and continuity of care due to not requiring the use agency staff to fulfil these posts. A stair lift has been installed to compliment the shaft lift. Staff training in respect of – Managing challenging behaviour and Care giving in dementia have been arranged. At the time of the visit, external redecoration of the home was in progress. 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 Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 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 standard(s) 3, 4 and 5. The admission process is well managed with residents and their representatives being provided with clear information regarding the home and ability to make pre admission visits. EVIDENCE: Care managers and management staff from the home are involved with prospective residents pre admission assessments. Further information is obtained when the potential resident visits the home. This includes, for example, communication, mobility, dietary requirements and medication. A sample of 2 comprehensive pre admission assessments were seen. There was evidence to confirm that residents and/or relatives are involved in the assessment process. Residents spoken with stated staff were so kind and helpful before and after they had moved in. They and their family had opportunities to visit the home before making a decision. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 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 standard(s) 7, 8, 9, 10 and 11. The health and personal care needs (including medication) of residents is provided in a manner which ensures respect, dignity and rights. EVIDENCE: A sample of 2 care plans which covered all aspects of residents assessed needs were seen. Observations, discussions and available training records indicated that staff have the skills and experience to deliver care effectively. Staff were observed to inform residents aspects of care before carrying it out. Staff were also observed to be courteous, respectful, ensuring residents dignity and privacy at all times. Residents and visitors echoed this in discussions. Medication records seen were up to date. Medication was stored appropriately. Staff were observed to distribute medication in a respectful manner. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 10 During the visit two residents were escorted to hospital appointments. The inspector had the opportunity to speak with two visiting general practitioners who commented on the home’s appropriate use of their service. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 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 standard(s) 12, 13, 14 and 15 Residents experience a stimulating and varied life at the home with visitors encouraged and various informal activities made available. Residents receive a balanced, appealing and wholesome diet which was praised by residents. EVIDENCE: Discussions with several residents indicated that they have been consulted about the activities that occur in the home and are satisfied with the programme. An activities programme was “posted” in all 5 units. During the afternoon of the inspection, an arts and craft activity took place. Residents were observed to enjoy themselves. Residents readily discussed the musical attributes of a member of staff who provides stimulating sing-a-longs. “He knows everything and if he doesn’t he’ll learn it for you”, were comments made by residents. Residents spoken with confirmed that they are able to see family and friends in private which was echoed by visitors present during the inspection. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 12 Discussions and observations indicated that residents are encouraged to maintain contacts within the community. For example one resident attends the local multiple sclerosis society. Majority of residents spoken with expressed their satisfaction with the meals provided by the home and stated that they are asked about their likes and dislikes. All residents spoken with were aware of the choice of meals for the day. Menus were available in all 5 units. The inspector was afforded the opportunity to join a group of residents for lunch which was taken at their pace. Food was well presented and enjoyed by the majority. A four week menu plan was seen which indicated that a well balanced and nutritious diet is provided. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 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 standard(s) 16 and 17. Residents and their relatives are confident that their complaints will be listened to, taken seriously and acted upon. EVIDENCE: The home has Hampshire County Council’s a policy and procedure document with regards to the protection of vulnerable adults. It was noted that the protection of vulnerable adults forms part of staff training. Discussions with staff indicated a good awareness in respect of the protection of vulnerable adults. Residents and visitors comments indicated that people feel comfortable in discussing any concerns with management. Discussions and available records indicated that no complaints have been received by the home subsequent to the previous inspection. The Commission for Social Care Inspectorate have not received any concerns either. Residents informed the inspector that they were able to conduct their legal right to vote in the recent general election. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 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 standard(s) 19 and 22. On this occasion, Standard 19 was inspected in part. In general a comfortable and safe standard of accommodation is provided for residents. EVIDENCE: As a result of the previous inspection a requirement was made in respect of the exterior of the home to be redecorated. At the time of this inspection contractors were on site in the process of completing said work. Lounge chairs in Chilworth wing were noted to be stained therefore, are in need of cleaning/replacing. The wallpaper behind one of the radiators in Chilworth lounge has lost its adhesion ability. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 15 The home provides a variety of adaptations and equipment to enable residents to maximise their independence. The home and gardens are easily accessible to all residents. Subsequent to the previous inspection a stair lift has been installed to compliment the passenger lift. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Residents needs are met by the number and skill mix of staff. EVIDENCE: The inspector was informed that the need to use agency staff has been minimised due to the appointment of 2 assistant unit managers and 3 care staff. Interviews are taking place on 20 May for a further three permanent care staff. On the day of the inspection, 2 assistant unit managers, 5 care staff, 3 housekeeping and 2 kitchen staff were on duty. This level of staffing was reflected in the available rota. Discussion and available rota also indicated that night levels comprise of 1 assistant manager sleeping and 3 awake care staff. Discussion and information seen indicated that staffing levels are assessed weekly to meet residents’ needs using the “Residential Forum” calculation format. The inspector was assured that when necessary, additional staff are provided by using an agency. Evidence was seen that the following staff training has been arranged – Managing challenging behaviour and Caring for those have dementia. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 17 The inspector was informed that from June 2005, staff performance and training portfolios are being introduced to replace the current method of assessing development and training needs. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 and 37. Residents live in a home which is well run and managed with an ethos of being open and honest. EVIDENCE: The registered manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. Ms Green has the following qualifications – A Masters degree in Business Administration. A MPhil in Psychology. National Vocation Qualification care, levels 2,3 and 4. National Vocation Qualification (NVQ) level 4 in management. NVQ assessor for care. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 19 Observation and discussions indicated that management approach of the home creates an open, positive and inclusive atmosphere. Minutes of staff meetings were available. Good relationships between staff on duty and staff and residents was evident. Staff portrayed a strong loyalty towards their work and management. Residents spoken with had nothing but positive comments to say about staff which included – “They really care”, “They don’t rush you” and “Staff like a laugh”. Visitors spoken with had nothing but positive remarks with regards to the manner in which the home is run. Comments made included – “They are so helpful here”, “Folk are so friendly” and “Nothing is too much trouble”. It was noted that the requirement raised from the previous inspection for night staff to become more interactive in attending formal meetings for the purpose of them being Made aware of management planning and practices, Able to maintain an awareness of the home’s policies and procedures, Able to participate in development of the home, Able to promote and maintain an awareness of residents needs, has been implemented. Minutes of meetings were made available to the inspector. For the purpose of this inspection, records seen during this inspection were well kept and up to date. It was noted that all records are kept secure to maintain confidentiality. Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 3 3 x x x x 3 x Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 21 No Are there any outstanding requirements from the last inspection? 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 19 Regulation 16 (2c) & 23 (2d) Requirement The wallpaper behind one of the radiators in Chilworth lounge has lost its adhesion ability and requires re pasting. Lounge chairs in Chilworth wing were are stained therefore, require cleaning/replacing. Timescale for action 30/06/05 2. 20 16 (2c) 30/06/05 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 Good Practice Recommendations Nightingale Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 22 Commission for Social Care Inspection 4th Floor- Overline House Blechynden Terrace Overline House Southampton 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 Lodge H54 S37414 Nightingale Lodge V226510 110505.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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