Inspection on 04/10/05 for Nightingale Lodge

This inspection was carried out on 4th 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 19/03/06

Nightingale Lodge 29/06/05

Nightingale Lodge 28/02/05

Nightingale Lodge 14/12/04

Nightingale Lodge 25/11/03

Similar services:

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

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

CARE HOMES FOR OLDER PEOPLE Nightingale Lodge 6-8 Austin Street Hunstanton Norfolk PE36 6AL Lead Inspector Mr Christopher Handley Unannounced Inspection 4th October 2005 09:30 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 DS0000027482.V255386.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 DS0000027482.V255386.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Nightingale Lodge Address 6-8 Austin Street Hunstanton Norfolk PE36 6AL 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) 01485 533590 01485 533590 Black Swan International Limited Mrs Sandra Rowe Care Home 22 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (21) of places Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to twenty-one (21) Older People may be accommodated. One (1) person with dementia over 65 years of age may be accommodated. The total number of persons accommodated shall not exceed twentytwo (22). 29th June 2005 Date of last inspection Brief Description of the Service: Nightingale Lodge is a registered home for 22 older people situated in the seaside resort of Hunstanton. It offers personal care, but not nursing care. It sits in a quiet road with access to the main shops within walking distance. There is a Methodist church next door and the sea front is at the end of the road. The house was originally two homes which have been converted into one. The majority of bedrooms are on the first floor with access by a shaft lift. There are three double rooms and 16 single rooms all with toilets and hand wash basin facilities. On the ground floor there are two lounge areas and a dining room. The home has had a new roof in 2004 and further upgrading of the windows is planned for the front of the house in 2005. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which began at 9.30 and was completed at 3.30. There were 21 residents in the home at the time of the inspection. There were 9 staff on duty. Five residents were interviewed, and others briefly spoken to and four members of staff were also interviewed. Ms Kinniard, Senior Carer was in charge of the home at the time of the inspection. This was the first time she had undertaken this task and the Inspector is pleased to say that she handled it very well. What the service does well: What has improved since the last inspection? 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 DS0000027482.V255386.R01.S.doc Version 5.0 Page 6 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 DS0000027482.V255386.R01.S.doc Version 5.0 Page 7 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): The home provided prospective residents with a full range of information about the home which is available in a large print size. EVIDENCE: The Inspector was shown a Statement of Purpose and a Service Users guide. These documents are comprehensive and are well set out. In the last inspection a recommendation was made that the print in this documents should be available in a larger size for people who may have poor sight. The documents now clearly states, in large print, on the front, that if a larger print size is preferred this will be provided, and this fulfils the recommendation made. There are copies of the service users guide in all residents rooms, and this practice is commended for it allows residents time to go through the document in their own time. Staff and residents were aware of these documents, one resident said “They tell you about the home”. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 Page 8 The Inspector was shown a copy of the contract/statement of terms and conditions. This document is well set out, it is detailed and comprehensive. The practice of this home is that the Manager goes through the document with the residents/relative to ensure that they have an understanding of the content. The document is signed by the resident and a copy is kept safe in the office. Staff interviewed were aware that residents had contracts and that they were important documents. Some residents interviewed, informed the inspector that their relatives held their contract. Should a resident be subject to Power of Attorney then a copy would be sent to the solicitor. In the last inspection a recommendation was made that the print size of the document be increased. One of the documents was seen and it now clearly states on the front that if required the document will be provided in a larger size print. This fulfils a recommendation made at the last Inspection The home undertakes comprehensive preadmission assessments to ensure that the home can meet the needs of the prospective resident. In the last inspection a recommendation was made that these documents be clearly headed “Confidential” because of the information which they may contain when completed. This has since been done and one such document was seen. This fulfils the recommendation made. A recommendation was made that the Manager carry identification with her when undertaking these assessments, this is now done and this fulfils the recommendation made. Pre-admission visits to the home are carried out, the purpose of them being to provide the prospective residents with the opportunity to view what may be their new home. They are taken on a tour of the home, and provided with information about the routines of the home. They may meet other residents and staff, and refreshments are provided, and if possible visit their prospective room.. Staff interviewed were aware of the purpose of these visits, one said, that if she went into a home she would want to see it first. Some residents interviewed, told the Inspector that they had visited the home prior to coming in and one said she had seen her room which was one of the main reasons why she came into the home. Nightingale Lodge DS0000027482.V255386.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): All residents have an individual care plan. The home’s medicine system sound. Care and comfort are provided to dying residents their relatives. EVIDENCE: All residents have an individual care plan, which is kept in a folder which are now clearly marked “Confidential Information” this fulfils a recommendation made at the last inspection. The documents are kept safe in the office which is locked when not in use. The storage of these documents has improved since the last inspection and this fulfils the recommendation made at the last inspection. The documents are of good quality and the entries are neat and legible. There is clearly written Assessment of needs, Agreed action , Objectives and Reviews. Residents are involved with their reviews. The home may wish to continue to improve its assessment documentation and this was briefly discussed. In the last inspection a recommendation was made that Depression, a common feature in old age, be included in the assessment. In the documents seen this has not been included and the Inspector repeats the recommendation. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 Page 10 There then follows a wide range of assessment documentation. The documentation is neatly completed. The management of the documentation has been improved since the last inspection as the folder now have dividers in place which enables documents to be found much more easily. The Home’s medicine system was inspected. The medicines are kept in a locked metal cupboard, and Miss Kinniard held the key. Deliveries of medicines are locked away until they can be checked in properly, they are not left in the corridor. The home has an MDS system and the records are neatly completed. There is one resident who is fully self medicating and one who is partially self medicating, and this is discreetly monitored, and the home has written guidelines for this. The home has a medicines policy. The home has a sound working relationship with the supplying pharmacist. If staff had any concerns about medicines they would contact the prescribing doctor. Medicines are reviewed on a regular basis. The medicines were seen they were neat and tidy. There were no lose or unaccounted for medicines. There were no Controlled Drugs in use on the day of the inspection. Only staff who have had training administer medicines. Miss Kinniard said that when residents are dying they are provided with all the care and support they need, as are their relatives. Pain relief is provided by the G.P or district Nurse. The wishes of the dying resident are known and are carried out. Privacy and dignity are provided at all times in the home but especially when residents are dying. Representatives of religious denominations would be called, if that was the resident’s choice. Relatives may stay over night and refreshments are provided for them, and they are supported by staff. Staff support each other at such times. The home has a policy and procedure for care of the dying , which was seen by the Inspector, this is detailed and well set out, and provides clear advice to staff. Staff interviewed said that care of the dying resident was carried out to a high standard in the home and based on what was seen and what the Inspector was told, it was obvious that this was the case, and that staff are fully aware of need for sensitivity at such times. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 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): The residents have a wide range of choice, and are assisted by staff to make choices. Residents receive a wholesome, nutritious and varied menu, which meets the residents’ likes and needs. EVIDENCE: Residents have a wide range of choice in this home, What time they get up, what time they retire, what they have to eat, what they wear, and what they do, the Inspector was told. This was confirmed by the staff interviewed, who take the view that “This is the residents’ home and they should be able to do as they choose. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 Page 12 The residents interviewed strongly confirmed this and named a few of the choices which they make. “I can see my visitors when I choose, I can have a bath when I choose”, “I wear what I choose”. They can handle their own money if they choose to do so, but some told the Inspector that members of their family help them in this matter. The Inspector was told by Miss Kinniard, that help would be provided in this matter if needed. Both residents and staff are aware that they have access to their own records, but few have chosen to view them. The Menus were seen and carefully read by the Inspector, they were nutritious, varied and interesting. At present there are no residents who require a special diet. The cook informed the Inspector that the home always used fresh food, especially meat and vegetables. The cooks knows the likes and dislikes of residents and choice is ascertained on the day. The staff informed the Inspector that they thought that the meals were good and this was confirmed by the residents interviewed, who spoke highly of the meals, confirming what the cook had said that they were always fresh. The Inspector discreetly observed residents taking their midday meal with obvious delight. The cook has undertaken nutritional training, and she and the company are commended for this, as it shows an awareness of the importance of understanding of nutrition, when caring for the elderly. The cook has also had First Aid training. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 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): The home has an effective complaints procedure. Residents’ legal rights are protected. EVIDENCE: The home’s complaint procedure is displayed adjacent to the front door. Since the last inspection the print size has been increased and this fulfils the recommendation. Miss Kinniard said that there had not been any complaints made. Residents interviewed knew what action to take in the event of a complaint and outlined this to the Inspector, another said that they would “just tell the first member of staff or the Manager”. Staff interviewed also told the Inspector what action would be taken in the event of a complaint being made, and gave the Inspector the very strong impression that they would not hesitate to make a complaint on behalf of a resident, if it were needed. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 Page 14 Residents have their legal rights protected, and if needed Advocacy would be obtained on behalf of a resident Miss Kinniard said. In the last election several residents used their postal vote, the Inspector was informed. Some of the residents interviewed, told the Inspector they had their own solicitor who came to visit them from time to time. The home has an Adult Abuse Protection Policy and all staff have received training. It was clear that Miss Kinniard is pro-active with regard to this. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 Page 15 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): The communal facilities are of a high standard. EVIDENCE: There are two large lounges at the front of the home and a large dining room at the rear of the home. The lounges are very comfortably furnished and give an impression of warmth and comfort. There are pictures in these rooms. The standard of decoration and furniture is good. The lighting is domestic in nature. The decoration and furniture give the two front rooms “character”. A variety of activities take place in these rooms. The dining room, which is at the rear of the home, is very comfortably furnished with dining tables, each of which has four chairs. This is a large and pleasant room. The lighting is domestic in nature. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 Page 16 At the rear of the home there is a pleasant patio area which is level and suitable for wheel chair users. On the morning of the inspection there was a residents sitting in his wheelchair, who was warmly wrapped up, who told the Inspector that he liked to sit outside and could quietly think about things. Other residents spoken to also confirmed that they thought the lounges were very comfortable. One member of staff said she that there was as always a pleasant atmosphere in the front lounges. Based on what was said it was obvious to the Inspector that these four areas, are well used and much appreciated by residents. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 Page 17 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): The residents are protected by the home’s recruitment policy and procedure. EVIDENCE: Miss Kinniard outlined the Company’s detailed recruitment procedure. Posts are advertised, application forms are provided, short listing takes place, and references are obtained. Interviews are prepared for. There are always two people involved in the interview. Police and POVA checks are carried out. The first POVA check is carried out prior to any employment. The successful candidate is provided with a contract and a job description. Miss Kinniard is aware of the importance of having a sound process for the recruitment of staff, as it is important to ensure that only the “right” staff are employed. Staff interviewed recalled their selection interview and this confirmed what had been said. These staff also confirmed that they had had an induction period of employment. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 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 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): The home’s records are kept safe. EVIDENCE: A wide range of records required by regulation were seen by the Inspector during the process of the inspection. The records are up to date and accurate. Residents have access to their records if they wish. Records are kept secure. They are kept in the office which is locked when not in use. The records are maintained in accordance with the Data Protection Act. Residents interviewed are aware that records concerning them are kept. Staff interviewed said that they write in some of the records and that they are aware of the importance of records. They are also aware that records are not left about but locked away safely. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 Page 19 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 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 x 3 x x x x x x STAFFING Standard No Score 27 x 28 X 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x 3 x Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 Page 20 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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations It is recommended that the mental health assessment part of the care planning be made more comprehensive and include Depression. Nightingale Lodge DS0000027482.V255386.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 DS0000027482.V255386.R01.S.doc Version 5.0 Page 22 - 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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