Inspection on 17/09/07 for Nightingale Lodge

This inspection was carried out on 17th September 2007.

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 12/07/06

Nightingale Lodge 11/10/05

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 Marilyn Lewis Unannounced Inspection 17th September 2007 09:00 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.V348432.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 Lodge DS0000037414.V348432.R01.S.doc Version 5.2 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 Mrs Maxine Dyer 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.V348432.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th July 2006 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 42 at any one time. Some of the residents have dementia. 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 used as a single room. None of the rooms have en-suite facilities but are provided with hand wash basins· 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. The registered manager said that current fees range from £403 to £446 depending on the level of care needs. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information obtained since the last inspection including the Annual Quality Assurance Assessment (AQAA), completed by the registered manager of the home, survey questionnaires and an unannounced visit to the home, was taken into account when completing this report. The unannounced visit to the home took place on the 17th September 2007, when the inspector met with residents, relatives and staff and sampled documents including care plans and medication records. The registered manager, Mrs Dyer, was on annual leave at the time of the visit and the inspector was assisted by one of the assistant unit managers. The inspector discussed the visit with the registered manager on her return to the home. What the service does well: Residents said that they liked living at the home and ‘the staff were lovely’. The residents felt they were treated with respect and staff were observed talking to the residents in a friendly and caring manner. Relatives spoken with said that the home was ‘absolutely marvellous’ and ‘I can’t fault them’. Residents said that they enjoyed the food provided and were offered a choice of meals. The meals seen were well presented and staff supported residents who needed assistance in a sensitive and friendly manner. The home employs an activities co-ordinator who has responsibility for the activities programme. Residents said that they enjoyed the activities provided which included trips to local places of interest, quizzes and musical events. Care staff support residents with activities over the weekends when the coordinator is not on duty. The home looked clean and homely. Residents said that they liked their rooms and those seen had been personalised with items such as a television, photographs and ornaments. Meetings are held to give residents and their relatives an opportunity to discuss the quality of care provided and residents said that they feel their opinions are taken into account in the day to day running of the home. The home has recently obtained the views of residents through a questionnaire survey and residents were also asked to complete a survey for the Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 6 commission. Information gained from the surveys indicated that residents were, on the whole, very satisfied with the quality of care provided at the home. What has improved since the last inspection? What they could do better: Some staff were not adhering to the home’s procedures when recording the administration of medicines. Although the majority of records seen had been completed appropriately, records for the day prior to the visit had a few gaps where signatures of staff should have been to confirm they had given the prescribed medication. This could pose a risk of error in administration of medication. The registered manager assured the inspector on her return to work that the issue had been discussed with the staff member concerned and she was closely monitoring the recording and administration of medication to ensure the correct procedures were followed. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 8 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.V348432.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care needs assessments are completed for all new residents to ensure the home can meet their care needs. The home does not provide intermediate care. EVIDENCE: The assistant unit manager said that prospective residents are asked to visit the home for the day so that an assessment of their care needs can be undertaken. If it is not possible for the prospective residents to visit then the registered manager goes to their home or place of residence at the time such as another care home or hospital. Pre admission assessments seen covered all aspects of care needs including personal, emotional and social needs. Information from care managers and health professionals was included in the assessment records. A visiting relative Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 10 spoken with said that they had been involved in the assessment process, particularly regarding life history details. The visitor said that they had visited the home with their relative before making a decision about taking a place there. A resident was being admitted for respite care later in the day of the visit. Information from care managers and health professionals had been obtained but the home had not completed its’ own assessment as the person lived a long distance away. The assistant unit manager said that an assessment of care needs would be undertaken over the first twenty-four hours to ensure the current care needs were met. A review of the care assessments takes place four to six weeks after admission or sooner if needed and then on a regular basis to ensure the changing needs of the residents can be met. The home admits residents for respite care but does not provide intermediate care. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are involved in their care planning and their health care needs are being met. The registered manager is addressing the issue of some staff not adhering to the home’s procedures for the recording of medication to minimise the risk of error. EVIDENCE: At the last inspection some care plans seen had not been reviewed for a number of months and the information they contained needed to be more detailed to ensure staff were aware of the actions to take to fully support the residents. Five care plans sampled on this visit showed that there had been an improvement in care planning. The plans provided clear information for staff and they had been reviewed to reflect the changing needs of the residents. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 12 Two residents said that they knew what was in their care plans and felt they recorded their wishes. Three staff members said that the care plans contained all the information they required and were easy to understand. Health records seen indicated that the health care needs of the residents were met, with visits by GPs, district nurses, opticians, dentist, community psychiatric nurses and psychiatrists all documented. Residents said that they were able to receive a visit from their GP on request and one said that staff were quick to arrange a GP visit when it was needed. The assistant unit manager said that relatives were kept informed of changes to the health of the residents unless the resident requested for the information to be kept confidential. A visiting relative confirmed that there was very good communication with staff and they were always kept up to date with changes. The home provides residential care and there was evidence that advice and support was sought from health professionals as needed and that arrangements were made for residents to move to a nursing home, more able to meet their health care needs when necessary. During the visit staff were observed knocking on doors and waiting before entering rooms and spoke to the residents in a friendly, caring manner. Residents are provided with a locked drawer so that they can store personal items safely and they are able to lock the door to their room if they wish. All residents spoken with said that they were treated with respect at all times. The home had systems in place to record medicines brought into the home and for the disposal of unwanted medication. Medication was supplied from the pharmacy in blister pack format, with a separate sheet for each different type of tablet. Medication records seen for one resident had Paracetamol written on it but did not have the dosage documented. The home has procedures for recording the administration of Temazepan as a controlled drug. Records seen contained gaps where signatures of staff should be for the administration of medication on the two days prior to the visit. The assistant unit manager said that this had been due to staff being very busy and unable to sign the records as required. Some medication such as eye drops were stored in the medication fridge. The temperature of the fridge was not being monitored and recorded to ensure the medication was stored at the correct temperature. The assistant unit manager said that no information was available on the medication administered in the home. However some information was contained in the home’s medication procedures file. The assistant unit manager immediately made arrangements to discuss the issues raised with the staff concerned. Medication issues were discussed with the registered manager on her return from annual leave. Mrs Dyer has assured the inspector that the staff involved have been instructed in the correct procedures for dealing with medicines and are being closely monitored when recording and administering medication to Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 13 ensure they follow the home’s procedures and minimise the risk to the health of residents. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14,and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to exercise choice and control over their lives, participate in the activities programme as they wish and they enjoy the choice of well presented meals provided. EVIDENCE: The assistant unit manager said that ministers from churches of different denominations visited the home to provide services for residents on three Sundays in the month and the ministers also called on request. At the time of the visit there were no residents of a different ethnic background resident at the home. The assistant unit manager said that if someone with differing faith or religious needs came to live at the home, information would be obtained on their particular needs to ensure they were met. Photographs of residents participating in social activities were on display in the reception area of the home. Activities included a garden party, visits to local gardens, bingo, skittles in the garden and a musical event. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 15 The home employs an activities co-ordinator who works for four days a week and the care staff arrange activities for the days the co-ordinator is not available. Residents said that the previous weekend staff had arranged bowls and skittles in the garden on one day and bingo the following day. The residents said that they were also involved in quizzes, crosswords, art- work and exercise sessions. Entertainers visited the home and staff and residents said that a recent Music around the World session had been very enjoyable. Arrangements were being made for some of the residents to go on a boat trip later that week and residents said that they had been on trips to the coast and places of local interest in the area. The activity co-ordinator records whether the resident has participated fully, partially or not at all on activities arranged as part of the activities programme. Very little was recorded on participation in daily activities such as one to one chats although one carer had good records of activities such as with a resident who had helped lay the tables for lunch. The staff member has started to develop life history books for the residents living on the unit where she usually worked. One of the books seen contained photographs and information of the residents’ life including schooling, family and work life and gave a very good picture of the resident’s life. The staff member said that the information would be used during reminiscence chats and when arranging activities for the activity programme. The staff member said that staff on the other units were due to start developing life histories for their residents. The assistant unit manager said that the recording of daily activities would be discussed during supervision meetings with staff. Residents said that they could receive visitors as they wished and visitors said that they were always made to feel welcome at the home. During the visit staff were observed encouraging and supporting residents to make decisions and care plans also recorded the need to allow residents to make decisions and maintain their independence. A resident said that staff always let them know what activities were to take place that day and they could join in as they wished. One resident said that they liked to spend time in their room and staff respected their wishes. Residents spoken with said that the food provided at the home was good. The choice for lunch on the day of the visit was chicken casserole or bacon rolypoly with mashed potatoes, swede and cabbage followed by spotted dick and custard. Other options were available for those who did not wish either of the two main dishes and some residents had requested the vegetarian choice of cheese and onion pasty or omelettes. The cook said that additional options such as salads and fish were always available. The food was taken to the units in heated trolleys and staff served the meals for the residents. The meals were well presented and staff supported residents who needed assistance in a friendly, sensitive manner. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 16 Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 17 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. 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. Residents feel that any complaints will be taken seriously and acted upon quickly and they are protected by staff awareness for the prevention of abuse. EVIDENCE: The home has complaints procedures in place that indicate the process for investigating complaints including time scales. Complaints procedures seen contained in residents’ records stated that the commission could be contacted if the matter was not resolved by the home but procedures in the complaints file gave the correct information regarding contacting the commission at anytime. The assistant unit manager said that she would make sure that all residents were given the correct version of the procedures. The complaints records seen indicated that all complaints were taken seriously and acted upon promptly. Three residents said that they would speak to the registered manager or one of the assistant unit managers if they had any complaints and the issue would be dealt with quickly. Relatives met at the visit commented that ‘they had no complaints whatsoever’. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 18 Staff were aware of the procedures to follow should abuse be suspected and procedures for the Protection of Vulnerable Adults were available. Arrangements had been made for staff who have not yet received training in the prevention of abuse to attend training sessions. A staff member said that she had not yet received formal training but the protection of vulnerable adults had been discussed during supervision and staff meetings. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean, safe and homely environment for all who live and visit there. EVIDENCE: The home has accommodation for forty-two residents. The structure of the home provides five small units, each with a lounge/dining room with kitchenette, bedrooms and bathroom and toilet facilities. If a large room is required for use for a large social event furniture is removed from one of the larger lounge/dining rooms or the reception area is used. There are also small seating areas provided around the home and a smoking room for residents who wish to smoke. Two rooms are available for use for activities. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 20 Although residents tend to stay in their own unit they are free to walk around the home and gardens as they wish. Staff admit visitors to the home and the doors are alarmed to alert staff if a resident leaves the home unaccompanied. Residents each have a single room with hand washbasin. The rooms seen had been personalised with items such as a television, pictures and ornaments. Residents spoken with said that they liked their rooms and had everything they needed. One of the residents has a budgerigar, which is kept in the lounge area that the resident likes to use. The other residents using the lounge at the time of the visit said that they liked having the bird in the room. Two of the five bathrooms have baths, which are low and staff said that residents do not like using them. Staff said that this sometimes results in residents having to wait until one of the newer, more appropriate baths were available to have a bath. The registered manager said that arrangements were in place for two new baths, suitable for residents, to be fitted later in the year. Sufficient toilet facilities are provided. Call alarms were fitted throughout the home and were seen to be available to residents. Staff said that they had the equipment they required to fully support the residents. A passenger lift and a stair lift plus stairways provide access to each of the two floors. All areas of the home seen looked clean. The home employs separate staff for domestic duties. Pleasant gardens are provided to the rear of the property and residents said that they liked to sit out in the good weather. Staff said that the garden was also used for activities such as bowls and skittles. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff receive the training they require to support the residents and meet their care needs. The registered manager is addressing the occasionally low staffing levels by actively recruiting more staff and providing agency cover as needed. EVIDENCE: Survey information seen while at the home stated that eight out of nineteen people asked felt that there were not enough staff on duty. Two residents spoken with said that sometimes they had to wait for assistance, mainly on weekends and two staff members also said that sometimes staffing levels were low again particularly at weekends. At times only four staff members have been on duty in the morning on a weekend instead of the six or seven for a weekday. The assistant unit manager said that new staff are being recruited but one weekend in the month is difficult to cover. Staff did say that the situation had improved recently and the registered manager has stated in the AQAA information that more staff are being recruited. Following the visit the registered manager also said that some of the issues regarding staffing levels had arisen from the agency responsible for providing agency staff as needed, not being able to meet the demand and this caused Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 22 staffing levels to be low during times such as staff sickness. This is being addressed by the staff recruitment agency and the availability of agency staff has improved. Staff said that training opportunities at the home were good. AQAA information stated that nineteen of the care staff either hold or are in the process of obtaining NVQ level 2 or above. This is an improvement since the last inspection when a requirement was made for the number of staff with NVQ to be increased. Recruitment records were seen for two staff members employed since the last inspection. All the information required was available for one of the staff members including two written references and Protection of Vulnerable Adult (POVA) and Criminal Records Bureau (CRB) checks. However the records for the second person only contained one written reference and a POVA check but no CRB. Notes were in the file indicating that the registered manager had tried to get the information from the Human Resource department of Hampshire County Council, but had not yet obtained it. The assistant unit manager confirmed during the visit that HR had the information required and they would be forwarding it to the home as a priority. Staff said that training opportunities at the home were good and records seen indicated that staff were receiving mandatory training such as moving and handling, infection control, first aid and food hygiene. New staff completed an induction programme that covered all aspects of care provision. Some staff had received training relevant to the service group such as dementia awareness and challenging behaviour and the assistant unit manager said that the training programme was ongoing so that more staff would be attending sessions. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run in the best interests of the residents. EVIDENCE: The registered manager, Mrs Maxine Dyer, has experience of managing care homes and holds NVQ level 4 in care, the Registered Managers Award and a Certificate in Management. Since the last inspection Mrs Dyer has registered with the commission. The registered manager is pro active in addressing issues such as staffing levels as they arise. Residents said that they felt at ease talking with the registered manager and visitors said that communication with the registered manager and staff at the home was very good. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 24 Mrs Dyer has overall responsibility for the day- to- day running of the home and she is assisted by four assistant unit managers. Staff said that they received good support from the management team. Records seen indicated that regular meetings were held for residents to discuss life at the home. The assistant unit manager said that relatives were welcome to attend these meetings. A resident said that she had ‘chance to talk about the home’ during the meetings. Meetings were also held for staff with minutes of the meetings made available to staff who had not been able to attend the meeting. The home had recently obtained the views of relatives and residents through a questionnaire survey on the quality of care provided. A summary of the views obtained was seen which indicated that 100 of people who had responded were very satisfied with the care provided, with the welcome they received and with the bedrooms. However as previously stated in standard 27, only 53 were satisfied with the staffing levels. AQAA information indicates that the registered manager is aware of the need for improved staffing levels and is actively recruiting staff. The home holds small amounts of money for residents. The monies are held in individual containers that are stored securely. Records are kept of all transactions. Records seen for two residents matched the amount of money held. Staff said that they received regular supervision. Records seen confirmed this. Supervision sessions covered the care needs of residents plus personal development and performance. During the visit to the home hazardous substances such as cleaning fluids were stored safely. Staff were observed following safe working practices and they had received training in health and safety issues such as moving and handling and infection control. Health and safety information was displayed around the home. The laundry and kitchen looked clean and in good order. Fire records seen indicated that regular checks were made on fire safety equipment including fire extinguishers and emergency lighting. Recording of drills only documented the date and number of staff who had taken place and this meant that it was not possible to confirm that all staff had attended drills to ensure they were aware of the appropriate procedures to follow should an incident occur. Following the visit the registered manager said the recording of fire drills had been changed immediately after the visit to include the names of staff attending. Since the visit an evacuation of the home exercise had also taken place. Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 25 Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 26 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 x 3 N/A 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 3 Nightingale Lodge DS0000037414.V348432.R01.S.doc Version 5.2 Page 27 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 OP9 Regulation 13(2) Requirement Staff should adhere to the home’s procedures for recording the administration of medicines to minimise the risk of error. Timescale for action 18/09/07 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.V348432.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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.V348432.R01.S.doc Version 5.2 Page 29 - 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!