Inspection on 31/01/06 for Nightingale Nursing Home

This inspection was carried out on 31st January 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 23/02/09

Nightingale Nursing Home 30/11/06

Nightingale Nursing Home 28/07/05

Nightingale Nursing Home 09/11/04

Nightingale Nursing Home 11/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings 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 43 Beach Road Littlehampton West Sussex BN17 5JG Lead Inspector Miss Helen Tomlinson Unannounced Inspection 11am 31 January 2006 st 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 DS0000024181.V277937.R01.S.doc Version 5.1 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 DS0000024181.V277937.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Nightingale Nursing Home Address 43 Beach Road Littlehampton West Sussex BN17 5JG 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) 01903 717376 01903 732933 Cadogan Care Limited Mrs Tracey Elizabeth Searle Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th July 2005 Brief Description of the Service: Nightingale Nursing Home is registered to accommodate up to thirty five residents in the category of Older People. The property is a detached three storey Edwardian house located in the town of Littlehampton. The house overlooks a park and is a few minutes walk from the shops, public transport, local amenities and the sea front. The accommodation is provided on two floors with a lift providing access between the ground and first floor. There are 31 single rooms with three rooms offering en-suite facilities and two rooms offering shared facilities. One single room is accessible via a short flight of stairs. A lounge with dining space is available on each floor. There is outdoor space available with seating for the residents. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The inspector arrived at 11am and left the home at 4pm. The registered manager was not on duty at the time of the inspection. The deputy manager was in charge of the home on this day. At the time of this inspection twenty nine residents were accommodated in the home. During the course of the inspection fourteen residents, five members of staff and two visitors were spoken with. Staff were observed giving support and assistance to residents, care plans were examined and other documents seen as was necessary. Two staff files were examined. A tour of the premises took place. Following the last inspection five requirements and two recommendations were made. At this inspection three of the requirements and both recommendations had been met. Two requirements remain outstanding and one new one was made and three recommendations were made following this inspection. What the service does well: What has improved since the last inspection? The carpet on the corridor of the ground floor had been repaired, with tape placed over it to prevent trips. Since the last inspection a lot of training had been made available for the staff. They said this was helpful for their work. This included moving and handling, food hygiene, infection control, protection of vulnerable adults and first aid. This met two of the requirements made at the last inspection. More training Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 6 was planned and this was now on-going in the home to make sure all staff were kept up to date. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 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 DS0000024181.V277937.R01.S.doc Version 5.1 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): None of these standards were assessed. Standard 3 was assessed and met at the last inspection. Standard 6 does not apply to this home as they do not provide intermediate care. EVIDENCE: Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 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 and 9 All residents had an up to date plan of care. The health care needs of the residents were met. The recommendation made at the last inspection, regarding medical equipment, had been met. Standard 10 was assessed and met at the last inspection. EVIDENCE: Three residents files were examined. These had a plan of care which was comprehensive, clear, detailed and up to date. All necessary information to assist staff to care for the resident was included. Risks were identified and management plans were in place. At the last inspection a recommendation was made that only current information was kept in these files, to avoid confusion. This had been done and the files seen contained up to date information with older information securely stored elsewhere. The health care needs of the residents were assessed and reviewed. These were met either by the qualified nurses working in the home or, where necessary, other health professionals. Equipment necessary to meet the health care needs of the residents, such as pressure relieving equipment, was in place. The nursing staff kept themselves updated with training and sharing of information. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 10 Standard nine regarding medication was assessed by the pharmacy inspector at the last inspection. A recommendation was made that all medical equipment, such as nebulisers, must be maintained in line with the manufacturers instructions. At this inspection this recommendation made had been met. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 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): 13,14 and 15 Standard 12 was assessed and met at the last inspection. Residents were supported and assisted to maintain contact with their friends and family. Residents were able to make choices about their daily lives within the home. The residents said the meals served were varied and enjoyable. EVIDENCE: Visitors spoken with said they could visit their relative whenever they liked. They said the staff were always welcoming and friendly with “smiley faces.” They could see their relative in the privacy of their own bedroom or the lounges, whichever they chose. Where residents wished to maintain contact with community services, such as the local church, this was facilitated by the staff. Local community services did visit the home such as children from the school to do plays, church ministers and individual societies of which residents were members. The care plans contained information about how the resident wished to be cared for. This included their preferences around rising and retiring times, food likes and dislikes and any other specific choices. Residents said they could choose where to sit during the day, either in their bedrooms or the lounges, how to pass their time, to go out of the home, so long as they were safe to do so and where to eat their meals. They said the staff asked their preferences and respected their wishes. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 12 The food seen during the inspection was nutritious and appealingly served. Residents could eat their meals in their bedrooms or the dining room. Two residents on the first floor said sometimes the food was not hot enough when served. The procedure for serving food should make sure all meals are hot. Residents were given assistance on a one to one basis, should they need this. Equipment to assist independence was used e.g. plate guards. There was a menu on display in the dining room and set choices were available each meal time. Residents said they had a good choice of meals. Hot and cold drinks were served throughout the day. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 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): 18 Standard 16 was assessed and met at the last inspection. Residents were protected from abuse. EVIDENCE: At the last inspection staff had not received training in the protection of vulnerable adults. A requirement was made that this be carried out. At this inspection all staff had completed this training. They reported it to have been useful in giving them the understanding of their responsibilities in protecting the adults in their care. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 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): 19,20,21,22,24 and 26 At this inspection the home was clean, tidy, well maintained and free from odour. One aspect of fire safety could present a risk to residents. Residents have access to communal space, have personalised bedrooms of varied sizes and are close to sufficient toilets and bathrooms. Any specialised equipment necessary to meet their needs was provided. EVIDENCE: At the time of this inspection the home was well maintained. Decoration was ongoing as bedrooms were vacated and required this. Since the last inspection the deputy manager said the fire doors were maintained by the in house handyman. He had records to show this had been done. Not all fire doors were kept closed, with some being held open by a wedge. These included fire doors on corridors, particularly on the first floor. This must not be done as any fire would not be contained, putting residents at risk. A requirement to cease this practice was made at the last inspection and remains unmet. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 15 The home was generally clean and tidy, with domestic staff working on each floor to maintain the cleanliness. Residents said they thought the home was kept clean. Two issues were brought to the attention of the person in charge and should be addressed. Some armchairs had food debris around the seat and arms, particularly where the resident did not go to the dining room for meals. In one bathroom the non-slip bath mat was stained and should be replaced. All areas of the home were free from offensive odour. The bedrooms in the home varied in size and layout. It was discussed that some would present a hazard for moving and handling purposes, should the resident require much equipment. Risk assessments for each room had been carried out and these were assessed prior to any new resident being accommodated in the home. Residents said they could bring in their personal belongings and bedrooms were personalised with pictures, photographs and furniture. There were toilets and bathrooms close to the bedrooms and communal areas. These contained equipment necessary for the resident. In one toilet, closest to the lounge used by residents, there was no seat on the toilet. This should be made safe for the residents use. Specific equipment to meet the needs of the residents was provided. This included hoists, bath seats, raised toilet seats, grab rails and hand rails. The issue of some bedrooms having a few steps leading to them was raised, in relation to the mobility of the residents accommodated in these bedrooms. Staff said they had a portable ramp which was used for those residents who needed to use a wheelchair. This had not been assessed by an occupational therapist, or any other person qualified to do this. It was recommended that this be done to make sure it was safe for use. The communal space in the home consisted of a combined lounge and dining room on both the ground and first floors. Residents used the lounge on the ground floor and many ate their meals in the dining room there. The communal area on the first floor was not well used, but was available to residents at any time. These areas were pleasant and comfortable. The area on the ground floor provided a sociable environment for residents, with staff passing through frequently. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 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): 28,29 and 30 Standard 27 was assessed and met at the last inspection. Since the last inspection an increased amount of training had been provided for staff in the home. This had been relevant for the work they were doing. Not all records required to assess the safe recruitment of staff were present in the home. EVIDENCE: Since the last inspection staff had received a lot of training which was relevant to their daily work. This included moving and handling, food hygiene, infection control, first aid, health and safety and the management of challenging behaviour. All staff had received up to date fire safety training. The induction training had been changed and met the current guidance. Staff said they had enjoyed this training and more was planned for the future. The requirement made at the last inspection for staff to be adequately trained had been met. The current number of care staff with NVQ level two does not meet the standard of fifty per cent. The person in charge said there was a plan for more staff to carry this out in the future. At the last inspection not all information which should be obtained for all persons working in the care home, was present in the staff files. This remained the same, although some additional information was present. There was no evidence that satisfactory CRB and POVA checks had been obtained prior to the person starting work. There was not a full employment history and there was no verification of the information obtained from another source. The responsible individual was required to confirm to the Commission, in writing, Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 17 that all necessary checks had been completed, for all staff members, prior to them starting work. The requirement made at the last inspection was not met. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, 36 and 38 The residents benefit from a home which is managed by an experienced and appropriately qualified person. Reviews of the quality of care provided should be carried out. Staff at the home do not assist residents to manage their personal finances. Staff receive supervision from a more experienced staff member. Two health and safety requirements from the last inspection had been met. One issue of fire safety remains unmet. EVIDENCE: The registered manager of the home is a qualified general nurse. She has worked at the home for eleven years and has knowledge of the needs of older people. She has completed her Registered Managers award and keeps herself up to date by attending training courses relevant to her role. Staff said she was supportive, organised and approachable. They described working in the home as part of a team. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 19 There was no formal or recorded system of reviewing the quality of care and service provided at the home. Informal discussions take place with residents during the working day and some questionnaires had been used in the past for example about the meals provided. Relatives had been offered the chance to hold meetings, but had declined. Staff meetings were held every six weeks. Some of the information from the above activities was used to review the quality of the service, but a more formalised and recorded system should be developed. The person in charge said that staff at the home did not assist any residents to manage their personal finances. This was either done by themselves, a family member or other representative. Staff said they received one to one supervision by a more senior and experienced member of staff. This was carried out on a regular basis and recorded. Staff said it was becoming more useful as they got used to it, and they used the time to discuss all aspects of work in the home. At the last inspection two requirements regarding health and safety issues were made. These had been met at this inspection with staff having received health and safety and other statutory training, and the carpet on the first floor corridor having been made safe. As discussed in Standard thirty a lot of statutory training which impacts on the health and safety of the residents, had been carried out since the last inspection. Staff said they had more awareness now and felt they had benefited from this training. Risk assessments were present in the home. One issue of fire safety remains unmet. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 20 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 3 2 3 X 3 X 2 STAFFING Standard No Score 27 X 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? 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. 1. Standard OP19 Regulation 23(4c )(i) Requirement All fire doors must be closed unless held open by a device which is approved of by the fire service. All fire doors must be in good working order. This part of a requirement remains unmet since the inspection of 28/07/05. The timescale given of 31/08/05 has expired. All staff must be recruited so as to be sure they are fit to work with vulnerable adults. The recruitment records must be kept in the care home. This part of a requirement remains unmet since the inspection of 28/07/05. The timescale given of 31/08/05 has expired. A system for reviewing and improving the quality of care must be in place Timescale for action 31/08/05 2. OP29 19 & Sch 2 31/08/05 3 OP33 24 31/05/06 Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 22 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 2 3 Refer to Standard OP21 OP22 OP26 Good Practice Recommendations The toilet close to the lounge should be made safe for the residents use. The portable ramp used at the steps on the first floor should be assessed by an appropriately qualified person. All armchairs should be cleaned on a regular basis and kept free from food debris. The stained non slip bath mats should be replaced. Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Nightingale Nursing Home DS0000024181.V277937.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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