Inspection on 03/05/07 for Nightingale Nursing Home

This inspection was carried out on 3rd 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 12/06/09

Nightingale Nursing Home 19/05/06

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 Unannounced Inspection 3rd 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 DS0000019483.V339068.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.V339068.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.V339068.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. 19th May 2006 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 people 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. It is accessible to residents and wheelchair users. The home charges £533 - £650 per week. Further information can be obtained from the home’s Statement of Purpose and the Service User Guide. A copy of the CSCI Inspection Report is available in the home. Nightingale Nursing Home DS0000019483.V339068.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection included a site visit on 3 May 2007. The registered manager and the deputy manager were present. The home has 31 residents. The inspection included a tour of the premises and discussion with the management team. Staff practice was observed during lunchtime. Service users and staff were interviewed. There were no visitors at the time but written responses were received from some relatives. 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? Nightingale Nursing Home DS0000019483.V339068.R01.S.doc Version 5.2 Page 6 The surrounding grounds and back garden have been cleared of all hazards. The garden is safely accessible to all residents including wheelchair users. All building work and internal redecoration have been completed. Carpets have been replaced with new ones. All communal spaces are now accessible to residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Nightingale Nursing Home DS0000019483.V339068.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.V339068.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective clients have the information they need to make an informed choice of care home. A prospective client will be assessed before admission to the home to ensure that their care needs can be met. EVIDENCE: The pre-admission assessment documents were seen in the care plan files examined. There was a trial period of stay for each new resident before the contract was agreed. The registered manager or the deputy manager carries out the pre-admission assessment of a prospective client. Nightingale Nursing Home DS0000019483.V339068.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident has a written care plan that sets out their personal, healthcare and social care needs and these care needs are being met in the home. The home’s medication policy, procedures and practice protect the residents from any medication error. EVIDENCE: The revised written care plans are now more structured and the information provided is more detailed. Where appropriate, risk assessments have been carried out and documented. The care plans have been kept up to date. The residents have access to their own doctor and other healthcare specialists when required. Since the last inspection, there have been no incidents of falls or pressure sores among the residents. All members of staff, including the nurses and carers have contributed to this excellent result. Nightingale Nursing Home DS0000019483.V339068.R01.S.doc Version 5.2 Page 10 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 to the nurses. Nightingale Nursing Home DS0000019483.V339068.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. 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 are assisted to exercise choice and control over their daily living in the home, including recreational interests. They receive a wholesome, appealing and balanced diet, which is beneficial to their general health and wellbeing. Residents have close links with their family and friends. EVIDENCE: Members of staff have specific roles and responsibilities and recreational activities are considered part of the care to be delivered by all the care staff. The home, therefore, does not employ an activity co-ordinator. There are planned group activities that include a session called ‘Pets for Therapy’ organised for residents who love dogs, and a sing-along session. Group outings are planned throughout the year. During the Christmas period, a Christmas dinner was held at a local hotel for all the residents. In the summer, coastal trips are organised. Nightingale Nursing Home DS0000019483.V339068.R01.S.doc Version 5.2 Page 12 Residents present in the dining room gave positive feedback about the food served. Several said that they enjoyed the food given and that choices were offered. Nightingale Nursing Home DS0000019483.V339068.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a robust Complaints’ Policy and Procedure that ensures that service users and their supporters have a clear ‘voice’ in the home. Service users’ legal rights are protected. 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. All members of staff have had training on ‘Protection of Vulnerable Adults’. They are aware of the Whistle-Blowing Policy. The home follows the Adult Protection Procedure of Hertfordshire Social Services. Nightingale Nursing Home DS0000019483.V339068.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, comfortable and well-maintained environment. They have the specialist equipment they require to maximise their independence. EVIDENCE: The external grounds have being kept neat and tidy. More communal space has been created in the back garden following restructuring of the storage facilities. Residents can safely access the garden daily. All building work and internal redecoration have been completed. The interior appears homely and comfortable. All communal spaces are now accessible to residents. A small communal space, with comfortable seating and a small table, has been created on each floor for residents whose bedrooms are nearby Nightingale Nursing Home DS0000019483.V339068.R01.S.doc Version 5.2 Page 15 and who wish to spend reading quietly or who want some private time with their relatives away from the lounge. The lift and equipment such as hoists and wheelchairs have been regularly serviced and are maintained in good working order. Nightingale Nursing Home DS0000019483.V339068.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. 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. The home has an effective staff team and the quality of care provided benefits the residents. The staffing level is maintained consistently to a high level. There is a training and development programme for staff. EVIDENCE: The staffing level has been consistently maintained. On the day of the unannounced inspection, in addition to the registered manager, there were two nurses (one of whom is the deputy) and five carers to care for thirty residents. The home operates a key working system so that there is continuity of personalised care for each resident. There is a staff training and development programme, in line with the Skills for Care guidelines. Nurses have refresher courses and further training has been arranged on topics such as ‘Liverpool Care Pathways’ and ‘End of Life Care’ given by Isobel Hospice. Some carers are working towards NVQ 2 and NVQ 3. Two carers who completed their Health and Safety training are allocated roles and responsibilities to oversee health and safety issues in the home. Nightingale Nursing Home DS0000019483.V339068.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32,33, 34, 35, 36, 37, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standards of administration and management of the home are well maintained. Residents’ health, safety and welfare are being promoted and protected. The residents benefit from the ethos, leadership and management approach of the home. EVIDENCE: The registered manager, a trained nurse, has recently completed her Registered Managers Award. Her management approach creates an open, positive and inclusive atmosphere. The home has greatly improved since the Nightingale Nursing Home DS0000019483.V339068.R01.S.doc Version 5.2 Page 18 current manager took over. The residents seem more content, more active and more involved in the daily routine of the home. There is an effective quality assurance and monitoring system. Feedback is actively sought from residents, their relatives and other visitors. All members of staff have regular supervision and a yearly appraisal. The home is not involved in the financial affairs of the residents. However the managers oversee their personal allowances. Proper accounting records are kept. Random checks were made and all transactions were found to be accounted for. The home’s Policies and Procedures have been updated. All necessary annual servicing has been carried out, including the test for legionnaires bacteria in the water system. The home had a Fire Safety Audit from Hertfordshire Fire and Rescue Service on 05/05/2006. The CSCI Registration Certificate and the Liability Insurance Certificate are on display in the office. Nightingale Nursing Home DS0000019483.V339068.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 3 3 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 3 3 3 3 3 Nightingale Nursing Home DS0000019483.V339068.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Nightingale Nursing Home DS0000019483.V339068.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 DS0000019483.V339068.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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