Inspection on 19/05/06 for Nightingale Nursing Home

This inspection was carried out on 19th May 2006.

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 Nursing Home 12/06/09

Nightingale Nursing Home 03/05/07

Nightingale Nursing Home 16/11/05

Nightingale Nursing Home 10/05/05

Nightingale Nursing Home 16/09/04

Nightingale Nursing Home 26/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Nightingale Nursing Home 85 New Road Ware Hertfordshire SG12 7BY Lead Inspector Yoke-Lan Jackson Key Unannounced Inspection 19th May 2006 11:00 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 Nursing Home DS0000019483.V296627.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 Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nightingale Nursing Home Address 85 New Road Ware Hertfordshire SG12 7BY 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) 01920 463123 01920 463013 Greenswan Consultants Limited Jayne Maxine Hewett Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34), Terminally ill (3) of places Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. This home may accommodate 34 older people who require nursing care. This home may accommodate 3 older people with terminal illness who require nursing care. This home may accommodate 34 older people who require respite nursing care. 16th November 2005 Date of last inspection Brief Description of the Service: Nightingale Nursing Home, provided by Greenswan Consultants Limited, is registered for 34 older people, who may require nursing or respite nursing care. It also provides nursing care for service users who may be terminally ill. The home is a five-storey period building. It is situated in a residential area, close to Ware town centre. The home has 24 single bedrooms and 5 shared bedrooms, 3 lounges and one dining room. There are 2 bathrooms with over bath hoists and an assisted shower room. All floors are serviced by a lift. There are parking facilities at the front and to the rear of the building. The back garden has a small patio with seating for service users. The home charges £475 - £650 per week. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 19/05/06 following a monitoring visit. The proprietor, the registered manager and the deputy manager were present. There were 32 service users present. The inspection included a tour of the premises and discussion with the management team. Staff performance was observed during lunchtime. Service users and their visitors were interviewed. Documents and care plans were examined. (See below for details of the inspection findings). What the service does well: What has improved since the last inspection? What they could do better: Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 6 The garden has been cleared of debris and hazards to safety since the monitoring visit on 19/04/06. Additional work is being carried out at the far end of the garden to construct a garden shed. There is ongoing maintenance work still to be done in the basement area. The registered manager shall ensure that there is minimal disruption and that the premises are made safe for the service users while building work is being carried out. 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 Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4. (6 is not applicable). A prospective service user will be assessed before admission into the home. The home can only admit those prospective service users whose care needs can be met. Quality in this outcome area is Good. This judgement has been made using available evidence. EVIDENCE: The pre-admission assessment form and relevant information were seen in the care plan files examined. The home will only admit a prospective service user whose needs can be met. One service user is in hospital and will be reassessed before being readmitted to the home, to ensure her needs can still be met. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 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): 7, 8, 9, 10. Service users are treated with respect and dignity. Each service user has a written care plan. Medicines are administered in accordance with legislation. Quality in this outcome area is Good. This judgement has been made using available evidence. EVIDENCE: The written care plans have been reformatted. Some care plans have been revised and the rest will be completed within the next couple of weeks. Where appropriate, risk assessments have been carried out and documented. The relatives of one service user said that they “were well informed” of the service user’s care needs and that the “staff are very helpful”. Service users have access to specialist medical and therapeutic services. Any referral made is via the general practitioner. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 10 Service users are offered drinks at regular interval to maintain hydration. The majority of the service users are in the lounge and dining room during the daytime. For those who wish to remain in their own bedroom, a member of staff is assigned to ensure that they have adequate fluid intake. The Medication Administration Record (MAR) Charts were examined and they were correctly filled in. The medication trolley is attached to the wall in the storage room when it is not in use. The local pharmacist gives regular training sessions to the nurses. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 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): 12, 13, 14, 15. Service users are helped to exercise choice and control over their daily living in the home, including recreational interests. Mealtime is the highlight of the day. The meals provided are nutritious and balanced and choices are given. Service users have good contact with their family and friends. Quality in this outcome area is Good. This judgement has been made using available evidence. EVIDENCE: The home has a planned activity programme that includes a session called ‘Pets for Therapy’ organised for service users who love dogs, and a sing-along session. There is an organised day trip to Southend on 28/07/06. The home is in the process of recruiting an activity co-ordinator. A number of visitors who were present during the unannounced inspection were interviewed. They all said that they were satisfied with the care and service given. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 12 One visitor remarked that he “visits the home 3 times a week” and each time he noticed that “the staff have been good” to the service users. He said, “I am very pleased with the service”. Since the dining room has limited space, there are 2 sittings at mealtimes. Lunchtime was observed to be well organised and unhurried. The first sitting was arranged for those service users who require assistance with their food. It was noted that a member of staff sat between 2 service users and gave them assistance and attention. There were 6 carers assisting in this way. One service user had help from her daughter, who visits to assist with feeding her at lunchtime. The second group of service users normally wait in the nearby lounge, which tends to get crowded during mealtimes. Service users’ feedback about the food served was positive. One service user spoken to said that he “enjoys the food given”. Choices were offered. Some had second helpings. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 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): 16, 17, 18. The home has a robust Complaints’ Policy and Procedure. Service users’ legal rights are protected. Quality in this outcome area is Good. This judgement has been made using available evidence. EVIDENCE: The registered manager investigates complaints or concerns that are raised by relatives and visitors. Immediate action is taken to resolve the issues, which are documented. Staff have had training on ‘Protection of Vulnerable Adults’. They are aware of the Whistle-Blowing Policy. The home follows the POVA Procedures of Hertfordshire Social Services. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 25, 26. The registered manager shall ensure that there is minimal disruption and that the premises are made safe for the service users while building work is being carried out. Service users have the specialist equipment they require to maximise their independence. The equipment has been regularly serviced. Quality in this outcome area is Adequate. This judgement has been made using available evidence. EVIDENCE: Building work is being carried out to the basement area, including the construction of a canopy to prevent the external grounds by the basement becoming waterlogged. The lounge in the basement will be refurbished once the building work is completed in the basement. The laundry area has been extended and plumbing will be completed within the month. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 15 Additional work is being carried out at the far end of the garden to construct a garden shed. Most of the debris and objects that are a hazard to health and safety have been cleared since the monitoring visit dated 19/04/06. The interior of the building has been recently redecorated and re-carpeted. The hot water system is thermostatically controlled and records are kept of the water temperature. The lighting on each floor has improved. The wheelchairs, hoists and other appropriate equipment have been regularly serviced and are maintained in good working order. A small community space, with comfortable seating and a small table, has been created on each floor for those service users whose bedrooms are nearby and who may wish to use the area among themselves for short periods to socialise or to entertain their guests. All the main community facilities are either on the ground floor or in the basement area which can be “quite crowded and noisy at times” as one relative pointed out. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 30. The home has a training and development programme for staff. The staffing level is satisfactory. The skill mix of nurses and carers is adequate for the current group of service users. Quality in this outcome area is Good. This judgement has been made using available evidence. EVIDENCE: On the day of the inspection, the NVQ assessor from the local college was present. She was assessing 3 carers during lunchtime. Two of the carers are taking NVQ2 and one is completing her NVQ3. The assessor confirmed that this is the second batch of NVQ students from the home. The first batch of carers taking NVQ2 was in 2005. All the carers were successful. Two carers had completed their Health and Safety training. They have been given their roles and responsibilities to oversee health and safety issues in the home. On the day of the inspection there were 2 nurses and 5 carers on the morning shift and 2 nurses and 4 carers on the afternoon shift. The home has implemented the key working system so that there is continuity of personalised care for each service user. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37, 38. The administration and management of the home is positive. The health, safety and welfare of the service users are being promoted. The home has implemented a Quality Assurance System. The records required by legislation are maintained, kept up to date and are accurate. Quality in this outcome area is Adequate. This judgement has been made using available evidence. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 18 EVIDENCE: The home is managed in a positive way. The registered manager’s approach creates an open, positive and inclusive atmosphere. Staff interviewed confirmed that this was so. The registered manager has arranged for all staff to be supervised. The personal allowances of a number of service users were checked and they were found to be accurate and all transactions were properly recorded. The home’s Policies and Procedures have been updated, including the QA Procedures and Practices. The home had a Fire Safety Audit from the Hertfordshire Fire and Rescue Service on 05/05/2006. A copy of the audit report has been submitted to CSCI. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 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 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 X X 3 X X 3 2 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 3 3 Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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 OP19 OP26 Good Practice Recommendations The manager should be vigilant to ensure that the building works being undertaken in the basement have a minimal effect on the daily lives of service users. Nightingale Nursing Home DS0000019483.V296627.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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. 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