Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 14/01/09 for Nightingale Nursing Home

Also see our care home review for Nightingale Nursing Home for more information

This inspection was carried out on 14th January 2009.

CSCI found this care home to be providing an Excellent service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

We saw staff at Nightingale being helpful and friendly to people who live there and largely treated them with respect. `This must be the best home I could have come to`, one resident said. People are supported to maintain relationships with family and friends. A resident said, `My daughter is always greeted warmly by staff and offered a cup of tea`. Visitors confirmed that they are always welcomed by staff. The menu is varied, and the food is well presented. People living at Nightingale get freshly made home made food, which they all appreciate. The home is clean and tidy, and good standards of hygiene are maintained. `The home is kept clean and tidy which I like`,one resident said. Members of staff have received training in many different areas of care practice to help them improve their skills. Management are very supportive of staff so that they can produce a high standard of care to residents.

What has improved since the last inspection?

Medication security is fully in place. Health and safety systems have improved so that fire doors were not propped open, therefore fire security for residents had improved and hot water temperatures are regulated to prevent residents scalding themselves. Staff training on residents conditions is in place.

What the care home could do better:

Medication must always be administered safely by signing after the resident has taken it and ensuring that gloves are used in supplying it to residents to ensure best infection control practice. Residents dignity when being assisted to eat needs to be fully in place. Setting up a programme of outings would provide more stimulation to some interested residents. Two written staff references need to be received before staff commence employment to ensure residents are fully protected from unsuitable staff.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Nightingale Nursing Home 35 Aylestone Lane Wigston Magna Leicestershire LE18 1AB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Keith Charlton     Date: 1 4 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Nightingale Nursing Home 35 Aylestone Lane Wigston Magna Leicestershire LE18 1AB 01162883443 01162887715 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Nightingales Nursing Home Limited care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability terminally ill Additional conditions: No person falling within category Older Persons (OP) may be admitted to the home when 37 persons falling within that category are already accommodated within the home. No person falling within category physical disability (PD(E)) may be admitted to the home when 37 persons falling within that category are already acc ommodated within the home. No person falling within category terminal illness (TI(E)) may be admitted to the home when 37 persons falling within that category are already accomm odated within the home. Service User Numbers. No person under 55 years of age falling within category PD may be admitted to the home when 6 persons falling within that category are already accommodated within the home. Date of last inspection Care Homes for Older People Page 4 of 27 Over 65 37 37 37 0 6 0 Brief description of the care home The last key inspection of this service was on the 22nd May 2007. Nightingale Nursing Home is a family run, large, well-adapted, nursing home situated in the pleasant residential area of Wigston and provides nursing care for 37 older persons, older persons with a physical disability (which may include 6 younger adults) and/or terminal illness. The building is a modern family house, set in approximately one acre, which has been extended to the rear of the property. All accommodation is on the ground floor. It is a bright, well-furnished homely home, with a good standard of fixtures and fittings. The home has a strong family ethos within a homely environment. It is well adapted to provide the specific care that the residents require. Residents rooms are spacious, individually decorated and some have en-suite facilities. There are lounges, a dining room and attractive gardens. In addition, the home is fully equipped with showers and assisted bathing facilities with lifting apparatus. All areas of the home are fully accessible for wheelchair users. The city centre can be reached by a journey of approximately twenty minutes by car. Bus services to the city centre are available from outside the home. The main shopping area of Wigston is within five minutes walking distance, and offers a wide range of shops and services. The following fees were provided by the registered manager as being current at the time of this inspection 650 to 750 pounds per week. The fees include personal care, accommodation and meals. Other costs include hairdressing, papers/magazines, and personal telephones. The home provides information to residents and prospective residents in the form of a Statement of Purpose that describes the services it offers, and a copy of the last Inspection Report can be provided to enquirers to give a view as to the quality of life for residents. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection included a visit to the service. We (the CSCI) visited Nightingale on the 14th January 2009. The Registered Manager and staff in the home helped us during the visit. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by, - talking to the people who live in the home, - talking to staff and management, Care Homes for Older People Page 6 of 27 - watching how people are given support, - looking at records. We also looked at the Annual Quality Assurance Assessment (AQAA). This is a document the provider (the person who owns the service) sends to us at the CSCI, and it tells us what the provider thinks about the service they deliver to people who live at Nightingale. As well as this, we looked at information that had come to our attention since the last key inspection in May 2007. We spoke with seven people who live at Nightingale during our visit and with three visitors. People told us that staff were very friendly and caring and did a good job. One person said staff are excellent. None of the people spoken with had any complaints about attitude of staff. We spoke with three members of staff during our visit to the home who told us about working in the home and gave us their views. They all were very positive about working at Nightingale and wanted to provide the best care to people living there. One staff member said: Management support us and help us to do our best. We are fairly dealt with and are encouraged to train. We checked all the standards that the Commission for Social Care Inspection has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 27 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Nightingale have had their needs properly assessed before moving into the home. Evidence: Residents and relatives spoken with said they had enough information at the time of the admission to make up their minds about the home. Yes, I was given something which told me about what to expect, one resident said. We case tracked a person living in the home who had recently moved in to Nightingale.We checked that his family had received information to help with the choice of home, and the relative said she had received enough information. We also checked that this person had her needs properly assessed prior to moving in, to ensure that the staff at the home could meet these needs. Care Homes for Older People Page 11 of 27 Evidence: The AQAA stated that prospective residents are invited to the home, relevant information is provided and assessments are carried out by the management at the point of contact - home/hospital etc. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at Nightingale receive good health and social care practice though some areas need improvement to ensure residents health is fully protected. Evidence: Residents said that staff were excellent in providing personal care to them: staff are so friendly at this home and no one can fault the staff. They are always friendly and will help you with anything, were some of the many very positive comments that residents made. A resident spoken to could recalled having a care plan though was not interested in looking at it to see it reflected her care needs. We checked the care plans of three people living at the home who were case tracked. Plans showed detail regarding the support required by staff to ensure the physical health of people living at the home, and there was information to inform staff of the preferred daily living routines of residents to ensure their social and emotional wellCare Homes for Older People Page 13 of 27 Evidence: being is fully supported. However there were gaps on medical checks insofar as a care plan stated that sight, hearing, teeth and foot care was poor but no information to see how this was dealt with. There was also only minimal information regarding peoples past history to properly inform staff as the individuality of residents though there was information that residents families had been asked to provide personal histories. Accident records were checked and medical services were contacted when a resident had a potentially serious injury. We checked the medication records, and found that mostly there was accurate recording of the administration of the medicines in the home except a small number of gaps. It was found that staff issuing the medication signed the record before giving it to a resident. The Manager said this would be followed up. Staff were seen to issue medication from the bottle with hand contact to medications. This does not follow strict infection control guidelines, though the Manager thought that as staff continuously wash their hands this should not pose any risk to residents health. Controlled medicines were stored in a properly secured cabinet. Controlled drugs were checked against the register were found to be accurately recorded. We spent time watching staff interaction with people living at Nightingale. We saw staff being gentle and caring to people throughout the day doing their best to meet the needs of people living at the home except where two residents were fed alternately at lunch, which did not fully respect their dignity - the Manager said this was not normal practice and should not have occurred. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are opportunities for people to take part in activities and have a relaxed lifestyle. Evidence: Residents said that they were satisfied with the current activities. One resident said There are activities though some of us would like to go on trips. The Manager said that a trip had been organised last year but on the day no one wanted to go. The AQAA stated that there are regular activities. We saw that there is a weekly list of activities and that the home employs an Activities Organiser who comes twice a week. There are also one-to-one activities such as walking around the garden, taking residents to the shops if they want to go, reminiscing with people, and communal activities such as chair exercises and games. Visitors are welcomed at Nightingale and we were informed by residents and visiting relatives that they could come at any reasonable time and they were always warmly greeted by staff. All residents spoken with said the food was excellent. The food here is home cooked Care Homes for Older People Page 15 of 27 Evidence: and very tasty, one resident said. We observed lunch being served. There was a choice of a hot dinner or alternative. Food was well presented and appetising, with good portions being served to each person. There was a displayed menu to provide information to residents. We spoke to the cook who explained how she regularly consults with residents regarding the menu and their preferences, and consults the dietician to ensure that there is a proper food supply to residents with difficulties. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents feel safe and staff are aware of how to progress concerns if abuse was to take place. Evidence: Residents said that they had no complaints but if they did they thought the staff or management would quickly get it sorted out. A resident said, I dont think I would ever need to complain but I am sure Matron would deal with it quickly if I did. The AQAA stated that there that there has only been one complaint in the past year and this was not found to have been proved. We have not been contacted by any complainants since the last key inspection in May 2007. We talked to staff to find out how much they knew about protecting people in the home from abuse. Records showed they had received training about safeguarding adults from abuse, and they knew the in house procedure and Agencies to whistle blow to if the in house procedure failed. We looked at the staff recruitment records to see whether all the proper checks had been made on staff before they started employment at Nightingale. We found records which showed staff had started work with written references and legal checks in place to help Management reach the judgement that people were safe to start employment, Care Homes for Older People Page 17 of 27 Evidence: though there was only one written reference for one staff member, when two are needed to ensure complete protection for residents. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Nightingale live in a safe and well maintained environment. Evidence: All residents spoken with said that they liked their bedrooms: My bedroom is nicely decorated and I can have all my things here, one resident said. We saw people at Nightingale living in a clean and well maintained environment. The furnishings in the communal area are homely, and people are encouraged to bring their personal possessions into their bedrooms. The AQAA stated that there has been the replacement of six profile beds in the past year. The Manager said that when there is a vacancy then the room is redecorated and recarpetted in the style the new resident chooses. Records show that the home is well maintained, and good measures are in place to control infection and keep the home hygienic. The only slight odour detected was from a toilet near the office. There are radiator covers and water valves to protect residents from burn risks. We saw that there is a monthly audit check of the homes facilities to ensure that they Care Homes for Older People Page 19 of 27 Evidence: are properly maintained. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by a well trained and competent staff group. Evidence: Residents and staff said that there were enough staff to meet residents needs regarding personal care. Staff come as quick as they can when I ring for help, one resident said. A number of residents and the staff we spoke to thought staffing levels were good and met residents needs. The AQAA states that all residents needed assistance with their personal care from staff. We spoke with the Manager about the staffing - excluding the Manager there are seven staff (care and nursing staff) on duty until 2.00pm, and then six staff on duty to 8.00pm followed by three waking night staff. This is in addition to kitchen and domestic staff shown in the staff rota, seven days a week. The AQAA stated that staff had training on essential care practice and that over fifty per cent of staff had attained at least NVQ 2. We found that staff have been on a number of training events to help update their practice on areas such as Moving and Handling, Fire Safety, Infection Control and Dementia, residents conditions such as Sight and Hearing Impairment, Stroke, Parkinsons etc. Care Homes for Older People Page 21 of 27 Evidence: Staff records showed that proper checks had been carried out to protect residents from unsuitable staff apart from one reference that was missing from one record we looked at. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management maintain a high quality of life for people at Nightingale. Evidence: Both staff and residents said that Debbie, the Manager was very friendly and ran the home in an efficient way. One resident said, The Matron knows what she is doing and gets the best out of staff. This positive view of the Manager was shared by staff who said that management were very supportive to staff and this created a positive atmosphere in the home which resulted in low staff turnover. This is the best home I have worked in. Residents come first here, one staff member said. The Manager has the relevent nursing qualifications to be in charge at Nightingale and has also attended management training where she was awarded this qualification. She updates staff practice with ongoing training. The Manager said that management use different ways of finding out from people who live at the home what their views are about the care given at Nightingale by asking Care Homes for Older People Page 23 of 27 Evidence: them regularly on a one to one basis and how they can improve, though there was no evidence to support this.We asked that the Manager try having residents meetings to give people the opportunity to voice their views and have this recorded so that they can check that any follow up action is taken. We saw that the Manager had sent out a quality assurnance questionaire last year to ascertain views of the service, which were very positive. We saw a folder that has risk assessments for safe working practices, and were informed by staff that they felt appropriately supervised to do their jobs. We asked that there is in place a risk assessment for window restrictors to ensure that residents security is fully protected. There are regular checks for fire safety and hot water temperatures are monitored to protect residents from scalding risks. We checked the hot water temperature from a bathroom and found it was within the safe standard and would not cause injury to a resident. The Manager said that no monies are kept by the home so we did not need to check records of money transactions. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 All aspects of residents lives should be included in the Care Plan, including medical checks and cultural and religious practice. The provider must ensure that staff follow the correct procedures for the administration of medication. Residents dignity needs to be protected when they need assistance to feed. The Complaints Procedure needs to give complainants the choice to first complain to the Lead Agency if they wish. The Provider must ensure that staff do not commence employment prior to the receipt of two written references. 2 3 4 5 9 10 16 18 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!