Inspection on 23/05/07 for Nightingale Nursing Home

This inspection was carried out on 23rd May 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 Nursing Home 14/01/09

Nightingale Nursing Home 23/08/05

Nightingale Nursing Home 06/06/05

Nightingale Nursing Home 01/03/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Nightingale Nursing Home 35 Aylestone Lane Wigston Magna Leicestershire LE18 1AB Lead Inspector Keith Charlton Key Unannounced Inspection 23 May 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Nightingale Nursing Home DS0000001921.V325388.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 DS0000001921.V325388.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nightingale Nursing Home Address 35 Aylestone Lane Wigston Magna Leicestershire LE18 1AB 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) 0116 2883443 0116 2887715 Nightingales Nursing Home Limited Ms Deborah Margaret Pears Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37), Physical disability (6), Physical disability of places over 65 years of age (37), Terminally ill over 65 years of age (37) Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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. No person falling within category terminal illness (TI(E)) 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 accommodated within the home. 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. 23rd August 2005 2. 3. 4. Date of last inspection Brief Description of the Service: 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 per week. The fees include personal care, accommodation and meals. Other costs include Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 5 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. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for residents and their views of the service provided… The primary method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. This was an unannounced Inspection. The Registered Manager was on duty. Planning for the Inspection included checking on the notifications of significant events sent to the Commission for Social Care Inspection, the last Inspection Report and reading Comment Cards returned by residents, relatives and GPs. There have been no complaints made to the Commission for Social Care Inspection since the last inspection. The Inspection took place between 09.30 and 16.00 and included a selected tour of the home, inspection of records and indirect observation of care practices. The Inspector spoke with nine residents, three staff members, and four visitors. The Inspection was concluded the next day with the Registered Manager, What the service does well: Residents said that staff were always very friendly and helpful towards them, that they were encouraged to retain their independence as much as possible, and reported that staff welcome visitors. Staff were observed to be friendly and positive towards residents. The inspector observed a relaxed and friendly atmosphere in the home. Residents said they would feel confident to raise concerns if they ever had any and were satisfied that these would be listened to and acted on by staff and management. Residents liked the food and the cook goes to see new residents to find out what they like to eat and any equipment needed to help with eating. Residents spoke positively about the activities arranged by the Activities Organiser, who visits two days a week and of having an organist coming to play every month. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 7 Staff thought they were valued and supported in the performance of their jobs by the Registered Manager and that training is encouraged in order to equip them to meet residents needs. The Registered Manager has a positive attitude in seeking to improve the care standards in the service and was receptive to ideas as how to improve the service for residents. Twenty nine Comment Cards were returned from residents, their representatives and GPs. They were overwhelmingly positive as to the high standard of care that the home provides. What has improved since the last inspection? What they could do better: The Registered Provider needs to ensure that the welfare of residents is assured by ensuring that all the social and cultural needs of residents are contained in the pre admission assessment and Care Plan so that staff can follow this information, that a record of daily living choices is part of residents Care Plans so that individual wishes are always followed, that residents confidentiality of information is always preserved, that all medications are secured if the trolley is left for any reason in the corridor, and that fire doors are never propped open, so as to ensure full fire safety. As the home accommodates residents differing conditions – dementia, diabetes, sight impairment etc, staff need be trained in these conditions in order to provide a service that meets residents needs. The Registered Manager recognised that the systems of record keeping were disorganised which meant that information was hard to quickly find. It was recommended that an administrator be recruited to assist with these important tasks. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 8 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 Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 9 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 DS0000001921.V325388.R01.S.doc Version 5.2 Page 10 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): 3,6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The admission process is satisfactory and the pre-admission process ensures that the residents’ health and welfare needs are met. EVIDENCE: The inspector observed that residents are provided with a service users guide to the services the home offers and this is left in their bedrooms for them when they arrive. It was recommended that the Statement of Purpose and copy of the last Inspection Report be displayed to be easily noticed and accessible to current residents and their representatives. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 11 There were no contracts on file to inspect. The Registered Manager said these would be put in place and residents/relatives supplied with them as necessary, as this was mentioned in some Comment Cards returned by relatives. Residents said that they could visit the home if possible prior to their admission usually by way of a trial period, to give them a good idea of what services the home offers. There was evidence of assessments undertaken by the Registered Manager available on the residents files examined by the inspector, which covered their needs, medical conditions etc. The Registered Manager was recommended to use the list of issues contained in the National Minimum Standards to ensure that all relevant issues were included in the assessment. The home does not offer intermediate care facilities. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 12 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): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans describe identified care needs to ensure proper care is supplied by staff though they need to be better organised to ensure staff quickly can get all relevant information. Medication systems are good though one aspect needs to be strengthened to always protect the safety and welfare of residents. EVIDENCE: Residents said they knew they had a Care Plan. The Registered Manager said that residents and their representatives could participate in setting them up. Residents needs are detailed in their Care Plans and all residents case tracked had a plan of care in place. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 13 Care plans and risk assessments continue to be satisfactory but are difficult to track because information relating to the health and welfare needs of the residents appears to be kept in a number of places and plans does not reflect the very high standard of care provided. For example, the Registered Manager could not find information regarding a residents cultural needs though she had very helpfully organised to have a radio playing culturally appropriate music for this resident. Another staff member was not aware of the religious needs of a resident. The registered manager stated that care plans are reviewed monthly and this was seen as recorded in the Plans. It was recommended that there is a record of residents normal routines, capabilities/requirements, getting up and going to bed routines etc., and that all residents personal histories are compiled so that they can be seen as individuals with a valued history. Risk assessments also form part of Plans to reduce the risk of harm from identified risks. A staff member said that she had not read all the residents Care Plans. The Registered Manager said that she would remind staff to do so. It was noted that some residents personal information was available outside the treatment room and that the telephone was also located in this corridor, which can compromise confidentiality. The Registered Manager said this issue would be reviewed and followed up. Both the residents and their relatives again said that staff were very kind and caring and that the standard of care was ‘excellent’; that the Registered Manager and the staff were very approachable and always treated the residents with respect and dignity. The inspector noted that staff knocked on doors before entering and always addressed residents in a friendly manner. Relatives said that they were always made very welcome and the home had a family atmosphere and that the Registered Manager and staff cared for them as well as their relatives and that the atmosphere of the home was relaxed and friendly. The inspector viewed accident records. There was a discussion with the Registered Manager as to when medical services should be called if there had been a potentially serious injury, e.g. a head injury, and the Registered Manager said this policy would be reviewed to ensure that residents needs were paramount in this procedure, though the system was generally sound as there were always trained nursing staff on duty and a second trained opinion could be quickly sought. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 14 The medication system was inspected. The Registered Manager and staff confirmed that only trained nursing staff issue medication. Medication recording was fully complete with no gaps observed on the record of medication issued to residents. Controlled drugs records were viewed and appeared to be satisfactory. Medication is securely kept locked away. Some ‘low level’ medications were observed to be left on top of the trolley when there was a medication round. The Registered Manager said this would be followed up. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 15 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): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have the opportunity to lead full lifestyle and can exercise choice. Menu planning is thorough and residents are appreciative of the food though choice of main meal needs to be reviewed. EVIDENCE: Residents said that there were a range of activities at a good level and frequency, and that there was a choice as to whether they wanted to attend them. An Activities person is employed two afternoons a week to provide this stimulation. They said they like the musical input they get every month. There were some comments about having regular outings. The Registered Manager said this issue has already been thought of and would be put in place for the minority of residents who wanted to go. There were also some views on the Comment Cards that staff do not have time to sit and chart to residents. The Registered Manager said that staff are given every opportunity to do this Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 16 though she would consider the recruitment of volunteers so that this issue could be progressed. The Registered Manager said residents were frequently asked what they would like to do and tailor the activities to individual needs. On Tuesdays and Thursdays a lady provides hand massage and nail care and the hairdresser visits regularly. TV, books, videos, audiotapes and games are available. Visitors came and went throughout the day and the home has friendly atmosphere. The Registered Manager was recommended to consider the provision of ‘memory boxes’, containing valued items, to be set up for residents, particularly for residents with dementia, so as to provide valuable reminiscence material for staff to talk to residents about. Residents said that there were no rules that they knew of, e.g. no one reported that there were set going to bed and rising times, and all thought the atmosphere of the home was friendly and relaxed. Some residents spoken with were glad staff gave them medication so they didn’t need to worry about keeping it themselves. Staff said that residents could keep their own medication if they were safe to do so. Residents also spoke of being able to maintain their independence in other ways – personal care etc. The Registered Manager said that residents religious needs are respected; and that they are asked if they wish to attend places of worship, and religious people can visit if this was wanted. Information as to the Requirements of a resident who was case tracked could not be located though the Registered Manager described how this information was obtained from family. Inspection of residents accommodation demonstrated that they were able to bring in to the home their personal possessions. Residents confirmed this. Both residents and the relative stated that visitors are always welcomed to the home and no one reported any restrictions. The visitors spoken to thought that staff were very friendly and welcoming. There were unanimous positive views regarding the food. There is an excellent system in place whereby the cook meets the resident/representative and records likes and dislikes and any equipment needed. Residents said that they are able to choose whether they wish to eat their meals in the dining room or in their rooms and if they did not want the food offered they could ask for an alternative and this would be provided. The inspector discussed the issue with the Registered Manager and recommended that there are always two set choices each day, as per the National Minimum Standard, to extend the range of choice. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 17 The food was tasted by the inspector, was found to be well cooked and had good flavour with two vegetables followed by a choice of three desserts. Residents said that staff came to see them to ask what they wanted for tea. The Registered Manager was also recommended to increase the frequency of residents/elatives meetings so that any relevant issues regarding the running of the home can be regularly raised with residents. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 18 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): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident in the system of managing complaints and staff have a good level of understanding regarding the prevention of abuse. EVIDENCE: Residents said that they thought that if there was a problem then they thought that the Manager or other staff would sort it out. The Complaints Procedure is generally satisfactory but does not give the complainant the opportunity to go to a relevant Agency at the initial stage, e.g. the local Social Service Department, as per the National Minimum Standard. The Registered Manager said this would be altered to reflect this standard. Staff members spoken with were generally aware of the procedure regarding most of the Agencies to contact if the in house arrangement failed. The Registered Manager said this issue would be followed up by drawing up a short procedural statement as to the contact details of all statutory agencies that staff need to be aware of. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 19 The homes records were inspected and there were a small number of complaints recorded in the file, which were appropriately recorded with relevant action taken to deal with complaints. The Commission for Social Care Inspection have received no complaints about the service since the last inspection. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 20 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): 19,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Facilities are seen as homely, clean and well maintained by residents. Odour control is of a very good standard. EVIDENCE: The residents spoken to were all content with their bedrooms and happy they could bring in their own furniture. The inspector spent time in the communal lounges and dining rooms and met with a number of residents in their bedrooms. All areas of the home seen were decorated, furnished and maintained to a high standard. Furnishings are comfortable and of a generally good quality. Residents said that they liked the Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 21 home’s gardens where they could sit out in warm weather if they choose and enjoy the flowers that had been planted. There were also flowers in the conservatory that they appreciated. The inspector found that the home was very clean and there were no unpleasant odours. Residents said this was always the case though there were a small number of views in Comment Cards that there were sometimes odours outside toilet areas. The Registered Manager doubted this was the case for more than a short period of time but said this would be monitored. There was a maintenance book available, which indicated that facilities were assessed on a monthly basis and action taken as needed to maintain facilities to a good standard. This is a good system. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 22 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): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels meet residents needs. Recruitment processes are generally thorough to ensure the protection of residents from unsuitable staff. A staff training system is in place though needs to be bolstered to meet the needs of all residents conditions. EVIDENCE: There were a no adverse comments regarding staffing numbers and the ability of staff to always respond to residents needs. The rota and the Registered Manager confirmed that there were seven care/trained nursing staff on duty during the morning and six on duty for the afternoon/evening period, with three staff on duty during the night. In addition there are catering and domestic staff on seven days a week. Residents were again very happy with the staff team and said they are very helpful at all times. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 23 Three staff files were inspected and contained Protection of Vulnerable Adults checks prior to staff commencing employment, with other information, references etc. in place. This protects residents from unsuitable staff. The Registered Manager said that upon checking there was no standard Criminal Records Bureau check for one staff member and this was an isolated oversight and would be immediately attended to. Training files contained evidence of training though not all staff had received training on training on residents health conditions – stroke, diabetes, hearing and sight impairment etc. The Registered Manager and staff said that there was a system of monthly training and records were seen to support this. The Registered Manager said she would ensure that all staff were trained on residents health conditions. The Registered Manager and staff stated that there is encouragement to undertake National Vocational Qualification level 2 training and that the home was easily meeting the National Minimum Standard of 50 of staff with National Vocational Qualification level 2 training, as there were only two care staff without this training. Discussion with the Registered Manager indicated that the induction programme used for new staff is the National Training Organisation (Skills for Care) Standards, as per the National Minimum Standard, and there was a completed manual in place to evidence this. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 24 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): 31,33,35,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to protect the health and safety of residents. EVIDENCE: Residents, relatives and staff said that they thought the Registered Manager was very organised as to the running of the home and that she carried this out in a positive and friendly manner. The Registered Manager has completed a Registered Managers Award in care management and is also a Registered General Nurse. Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 25 There was evidence on staff records that staff have one to one supervision and staff confirmed this occurred on a regular basis. Staff Meetings have been held and there was evidence of one being recorded in 2007. It was recommended to the Registered Manager that meetings are held more regularly and staff asked if they would like to add items to the agenda. Residents meetings are held, and minutes of the last meeting were available at the time of inspection. It was recommended to the Registered Manager that meetings be held more frequently and to invite relatives so that they all have more opportunity to express their views. There were comments in the relatives Comment Cards that they would appreciate this opportunity. There is a Health and Safety folder with Risk Assessments for safe working practices. There are radiators with covers to protect residents from burning. A Quality Assurance system was in place for 2006. Questionnaires had been supplied to residents to gauge their views as to the care, food, cleaning and laundry. The Registered Manager said that she did not keep any residents monies, as either residents or their families did this and it helped to preserve residents independence. Fire Precautions: The inspector noted that most fire doors were on approved closures so that they could be held open, as they would shut and preserve fire safety when fire bells sounded. There was a fire door propped open by an extinguisher to the corridor by the conservatory. The Registered Manager, who said this was not the normal practice of the home, quickly dealt this with. Fire training is regularly carried out though a fire drill had not been recorded for four months between 2006/07 – the Registered Manager said fire drills were held on a weekly basis when bells were tested and this would be recorded in future. System testing was on required schedules for fire bell testing and emergency lighting. There was a fire risk assessment on file. A staff member was asked about the fire procedure and was aware of the procedure. The hot water temperature was checked in a bathroom and found to be 42.5c; close to the National Minimum Standard of 43c, which was fully satisfactory though it measured 46c from a sink in a bedroom. The Registered Manager said the water would be tested and adjusted accordingly to ensure residents are protected from scalding. Nightingale Nursing Home DS0000001921.V325388.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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X X X X 2 Nightingale Nursing Home DS0000001921.V325388.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. 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 OP3 Good Practice Recommendations The Registered Provider is recommended to ensure that there are full details of all residents needs in the pre assessment form so that all relevant care can be supplied. The Registered Provider is recommended to provide training on all residents health conditions to ensure staff have detailed knowledge to deliver all relevant care. The Registered Provider is recommended to ensure that all health and safety systems are fully robust, e.g. fire and hot water temperatures to fully protect residents. 2. OP30 3. OP38 Nightingale Nursing Home DS0000001921.V325388.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Nursing Home DS0000001921.V325388.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. 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