Inspection on 11/10/05 for Nightingale Lodge

This inspection was carried out on 11th October 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 11/05/05

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 Mr Roy Bega Unannounced Inspection 11th October 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Nightingale Lodge Address Great Well Drive Romsey Hampshire SO51 7QN 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) 01794 512138 Hampshire County Council Ms Lynne Green Care Home 44 Category(ies) of Dementia - over 65 years of age (44), Old age, registration, with number not falling within any other category (44) of places Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th May 2005 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 DS0000037414.V257228.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There has been a change in manager subsequent to the previous inspection. Mrs Muir became acting manager of Nightingale Lodge on 11 September 2005 (one calendar month prior to this inspection). This report summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People were being met at the time of the inspection. This inspection took place over one day; a total of six and a half hours between 10 a.m. and 4-30 p.m. Opportunity was taken to look around the home, view records and talk with, residents, relatives and staff. Standards not inspected on this occasion will be assessed as part of future inspections. Both requirements raised resulting from the previous inspection were assessed to have been met What the service does well: What has improved since the last inspection? “Chilworth” lounge has been redecorated and furniture replaced. Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 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 Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Residents are provided with a clear written contract/statement of terms and conditions that outlines services provided. EVIDENCE: A sample of two residents statement of terms and conditions for living in the home were seen. They contained the required information as detailed within the National Minimum Standards. Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11. Residents are assured that at the time of their death they and their family will be treated with care, sensitivity and respect. EVIDENCE: The home has an appropriate policy and procedure to assure residents at the time of their death, that they and their family will be treated with care, sensitivity and respect. Residents’ cultural/requirements/ wishes upon death are recorded in care plans. Training in managing death and bereavement has not been provided for staff. See also Standard 28 of this report (Qualifications). Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 10 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): EVIDENCE: None of the standards in this section wee assessed on this occasion. Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 11 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): 17 and 18. Management ensures residents are safeguarded from any form of abuse. EVIDENCE: The home has an appropriate policy and procedure document with regards to the protection of residents from all areas of abuse. Adult protection forms an integral part of staff training. Discussions with staff on duty indicated that they have a good understanding with regards to the protection of vulnerable adults. Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 12 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, 20, 21, 23, 24, 25, and 26. The location and layout of the home is suitable for its stated purpose. It is accessible, safe, clean and well maintained. It meets residents’ individual and collective needs in a comfortable and homely way. EVIDENCE: Both requirements resulting from the previous inspection with regards to the redecoration of “Chillworth” lounge and replacement of lounge furniture has been met. External redecoration was completed in spring of this year. It was noted that the decoration in communal areas is starting to look “tired” and will need to be considered as part of the home’s maintenance programme. The home is divided into five units, which contain a lounge, dining room, kitchen, bathrooms, toilets and residents bedrooms. Additional to this the home has a large reception area and several smaller activity rooms. Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 13 Majority of services users are offered single accommodation. There is one double bedroom. All single bedrooms except five are below 10 sq. meters. Local authorities were not subject to regulation before April 2000 and Nightingale Lodge was operational prior to this date. The Commission for Social Care Inspection therefore, agreed the current amount of usable bedroom floor space permissible. It is the responsibility of the registered persons however to ensure prospective residents and their representatives are made aware of this as part of the pre admission process. It is also the responsibility of the registered persons to ensure that prospective residents needs and wishes can be met. For example, if the resident needs the assistance of two staff to with their mobility, access to both sides of the bed is required. A sample of ten bedrooms were inspected. It was noted that the decoration in is starting to look “tired” and will need to be considered as part of the home’s maintenance programme. Rooms are furnished and equipped to assure comfort and privacy. It was noted that residents’ have personalised rooms with their own possessions. Bedrooms are individually and naturally ventilated with windows conforming to recognised standards. They are centrally heated with residents having the ability to control the temperature. Radiators and pipe work are guarded to prevent possible burns from hot surface temperatures. At the time of the visit the premises were clean, hygienic and free from offensive odours throughout. Systems are in place to control the spread of infection. Laundry facilities are sited so that soiled articles, clothing and infected linen are not carried through areas where food is stored or prepared. Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 14 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 and 28. There is concern that the staffing levels and skill mix does not reflect the needs of residents, which potentially places them at risk. EVIDENCE: The number of minimum care hours required calculated by using the Residential Forum, equate to 876.24 per week. The current two-week rota indicated permanent staff are covering the following hours – • • Week 1 Week 2 = 547 hrs. A shortfall of 328.9 hours. = 749 hrs. A shortfall of 127 24 hours. Agency staff are being employed to make up the shortfall. Mrs Muir has been in post for a month and is aware that staffing levels and use of agency staff need to be assessed. The inspector was informed by Mrs Muir that consultations are taking place with the registered individual for Hampshire county Council to increase the hours accordingly. At the time of this inspection the home were in the process of recruiting two care staff to cover a total of 65 hours. Interviews were held on the day of the inspection. Mrs Muir also informed the inspector that recruiting was also in progress for domiciliary staff covering house keeping, a cook and a kitchen assistant. Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 15 A minimum ratio of 50 members of staff trained to the National Vocational Qualification level 2 in care has not been achieved. Out of a current total of 25 permanent care staff, six have completed the course and 3 are starting in December. The home’s staff training calendar was seen which indicated the following courses have been completed or booked – • • • • • • • • • Dementia care. Adult protection. Equalities and diversity. Care governance. Fire safety. Food hygiene. Social care generic induction. Moving and handling. Basic first aid. Mrs Muir acknowledged the need to include palliative care as part of the training schedule. Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38. Residents live in a home, which is well run and managed with an ethos of being open and honest. Effective quality assurance systems based on seeking the views of residents and relatives are in place. Residents benefit from an effectively and efficiently run home. EVIDENCE: Mrs Muir became acting manager of Nightingale Lodge on 11 September 2005. Mrs Muir has held senior positions within Hampshire County council for 10 years and has completed the National Vocational Qualification (NVQ) level 4 in care and is currently attending the NVQ level 4 in management. Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 17 Staff spoken with readily informed the inspector that the working environment is open with management being readily available. This was evident during the inspection. Positive working relationships were evident between residents and staff on duty. A random sample of the transaction of residents’ personal monies were seen and assessed to be maintained as required. The home has an annual development plan and internal audit system in place. Views of residents and their relatives/representatives were available. The home also maintains positive contact with visiting professionals as part of the audit system. Hampshire County Council have recently developed a new quality control audit system that is soon to be put in place. Hampshire County Council manages accounting and financial procedures centrally. The manager and unit’s administrator maintain records of all financial transactions within the home. A current employers liability insurance certificate was displayed. Staff induction and further training records were seen. The home’s policies and procedures are gone through with staff as part of the induction process. Copies are available at all times within the home for reference. The home’s health and safety file was available. Staff are provided with a copy and advised of it’s content as part of the induction process. No unsafe practices were observed during the inspection. Certificates were available for required checks of systems and equipment. Risk assessments where necessary have been completed. Staff have received training in first aid and moving and handling. Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 2 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 X X 3 Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 19 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 2 Standard OP19 OP28 Regulation 23 (2b & d) 18(1a&c) Requirement Plan for the redecoration programme of the home’s interior. A minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent) is achieved by 2005. Plan of action required by the stipulated timescale. Timescale for action 21/11/05 21/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Nightingale Lodge DS0000037414.V257228.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 DS0000037414.V257228.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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