Inspection on 06/06/05 for Nightingale Nursing Home

This inspection was carried out on 6th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 23/05/07

Nightingale Nursing Home 23/08/05

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 Mrs Carole Burgess Unannounced 6 June 2005 09:30am th 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 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 C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Nightingale Nursing Home Address 35 Aylestone Lane Wigston Magna Leicestershire LE18 1AB 0116 2883443 0116 2599179 None Nightingales Nursing Home Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ms Deborah Margaret Pears Care Home (CRH) 37 Category(ies) of (OP) Old age (37), (PD) Physical Disability (6), registration, with number (PD(E)) Physical disability - over 65 (37), of places (TI(E)) Terminally ill (37) Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 1st March 2005 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 offered on the ground floor. It is a bright, well-furnished homely home, with good quality 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. Wigston offers a wide range of shops and services. Service users spoken to during the inspection said that they were very happy and satisfied with quality of care that Nightingale Nursing Home provides. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day. The primary method of inspection used was ‘case tracking’ which involved selecting four residents and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. An opportunity was taken to look around the home, view records, policies and care plans and to talk to staff and residents and relatives. Many of the residents were seen during the inspection, and six residents, five residents’ relatives and a district nurse gave the inspector their impressions of the home. What the service does well: Nightingale Nursing Home provides an excellent standard of nursing care within a homely and family style environment. High levels of staffing ensure that the residents’ health and welfare needs are met. Residents receive individualised care and staff are knowledgeable regarding residents’ needs and preferences and are respectful and kind to the residents. Food is nutritious and well-presented, individual diets and preferences are catered for and the cook and staff are very flexible to ensure that residents’ requests are accommodated. Relatives are invited to eat free of charge when visiting their relatives. Matron and the staff are supportive of families and ensure that they feel welcome at all times i.e. a buffet meal is provided on Sundays which visitors are welcome to share. The home maintains a high standard of décor and cleanliness throughout. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 6 What has improved since the last inspection? 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 C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 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 standard(s) 1, 2, 3, 4, 5 & 6. The admission process is satisfactory and residents and their relatives/representatives are given clear information regarding the service; thereby ensuring that the residents’ health and welfare needs are being met. EVIDENCE: There is a comprehensive Statement of Purpose & Service Users’ Guide and a signed copy of the residents Terms and Conditions is retrained. The Statement of Purpose & Service Users’ Guide reflects the care provided. The pre-assessment process is satisfactory and reflective of the health and welfare needs of the residents. Residents’ assessments could be more detailed; however, Matron has recently reviewed the admission process and produced updated documentation to ensure that this addressed. This, when implemented will provide a detailed assessment to ensure that residents’ health and welfare needs can be fully met. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 9 Residents and/or their relatives are able to visit the home prior to taking up residency to assess the suitability of the home. Intermediate care is not provided. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 10 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 standard(s) 7, 8, 9 & 10. Residents are very well looked after in respect of their individual health and personal care needs. There are good informal arrangements with residents and relatives in reviewing care plans, although participation in formal evaluation is not as well supported. Residents, their relatives or representative could be encouraged to take a more participative and pro-active role in drawing up and reviewing the resident’s care plan, which in some cases lacked detail. EVIDENCE: Care plans, although accurate, tend to be, in some cases, basic, unsophisticated and lacking in detail. Information relating to the health and welfare needs of the residents appears to be kept in a number of assorted places. The Inspectors acknowledge that the outcome for the residents is paramount. The professionalism of the staff whose knowledge of the individual resident’s (and their relative’s) requirements is evident, but the care plans do not reflect the very high standard of care provided. There were a small number of gaps in the monthly reviews. Most, but not all, of the care plans reviewed, had a signed form stating if residents/relatives wished to be involved in the care planning process. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 11 The Registered Nurses, within the home’s medication policy, manage medication administration effectively to ensure the safe and timely delivery of residents’ prescribed medicines. Residents are able to self-medicate, following a recorded risk assessment. The assessments could be more detailed to demonstrate that an individual risk assessment had been completed and that the resident was able to selfmedicate effectively, and safely store their medication. Both the residents and their relatives said that staff were very kind and caring and that the standard of care was ‘excellent’; that staff ‘genuinely cared’ and always treated the residents with respect and dignity. Relatives said that they were always made to feel very welcome and that the home had a family atmosphere and that Matron and the staff cared for the whole family not just the residents. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 12 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 standard(s) 12, 13, 14, & 15. The staff work hard to ensure that residents experience a safe, homely life style, but expansion of and attention to detail within the care plans would demonstrate that all care needs are met. EVIDENCE: The home does not have set daily activities but tends to ask residents on a day-to-day basis what they would like to do and tailor the activities to individual needs. On the day of inspection the local vicar was due to call in the afternoon to sing songs of praise. 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 a lively, family and friendly atmosphere. Residents are supported in maintaining their autonomy and independence as much as possible. Individuality and choice is supported at all levels enabling residents to retain control over their lives. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 13 Menus are balanced, freshly prepared, are of a good standard and are served in an attractive dining room. The staff and cooks are aware of the specific needs, likes and dislikes of all of the residents and special diets can be catered for. Residents can have a cooked breakfast every day, served in their room, if they wish. Residents and relatives said that the food was very good and relatives said that they were invited to have a meal, at no extra cost, when visiting. A buffet lunch is provided on Sundays for residents and their visitors. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 14 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 standard(s) 16, 17 & 18. Arrangements for receiving and responding to complaints are satisfactory but the complaints policy and procedure needs updating to ensure that residents and their relatives are provided with current information. EVIDENCE: The home has a complaints policy and procedure, which is available to residents and their relatives. The policy, when next reviewed, requires updating to reflect the new details of the CSCI and to include time frames for the response to complaints. Matron said that she had not received any complaints and minor concerns are dealt with as they occur. The home’s guidelines require updating to reflect the most recent advice provided by the Department of Health (which Matron has in hand and is awaiting the new documentation). Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 15 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 standard(s) 19, 20, 21, 22, 23, 24, 25 & 26. A comfortable, homely, clean and safe standard of accommodation, within a family style environment, is provided for the residents. EVIDENCE: The home is safe and well maintained with many adaptations to suit residents’ specific needs. It is decorated and furnished to a high standard that creates a comfortable and homely environment, and there is a system of maintenance and refurbishment. Residents have access to attractive safe gardens and all areas of the home are fully accessible for wheelchair users. Good use is made of specialist equipment to maximise the independence of residents. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 16 Residents’ rooms are clean and well decorated, and residents are able to bring items of their own furniture and possessions with them to personalise their rooms. There are sufficient toilet, bathing and assisted bathing facilities. Hot water temperatures are checked to ensure they comply with Health and Safety legislation and were satisfactory when checked during the inspection. All areas of the home were cleaned and maintain to a high standard and residents and their relatives said that they were very satisfied with the general care and maintenance of the home. Both residents and their relatives praised the staff for the high standards of cleanliness and décor in the home. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 Staff at the home are well trained and supported and employed in sufficient numbers to meet the needs of the residents. EVIDENCE: Staffing levels, at the point of inspection, were above the minimum standard, as advised in Department of Health Residential Forum Guidelines. There are Registered Nurses on duty day and night with additional domestic, maintenance and kitchen staff. Residents and their relatives said that they felt staff were capable and very caring, and that there were always sufficient staff on duty to meet the needs of the residents. Training is planned and supported to ensure that the varied needs of the residents are met. Eleven of the care staff hold National Vocational Qualification (NVQ) in Care, Level 2 or above. The recruitment process is satisfactory and Registered Nurses Personal Identification Numbers (PIN’s) are checked to ensure that they are registered to practice. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37 & 38. The Matron, who is a Registered Nurse and has Registered Manager status, manages the home effectively and ensures that the residents’ rights are protected. Staff are well organised to ensure that a high quality of care is maintained. EVIDENCE: Matron is an experienced nurse who is currently undertaking NVQ Level 4 – Registered Managers Award. Excellent interaction between staff and residents ensures that there is a culture of openness and friendliness in the home. There is also a strong family feel to the home. A relative said that she can ‘relax’ knowing that the staff are very caring and will inform her day or night if her mother was unwell or needs her. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 19 Staff support the residents to make decisions in their everyday life, which promotes thier independence. Residents’ monies are not managed by the home: whatever residents require is bought by the home, receipts kept and presented to the residents’ relatives/representative. Records demonstrate that staff receive supervision and appraisals to ensure that staff maintain the standards of care expected at Nightingale Nursing Home. Health and Safety Policy and Procedures, such as regular recorded fire drills and fire alarm tests are completed, to ensure the health and safety of the residents and staff. Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION 4 3 3 3 3 3 3 4 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 4 4 3 3 3 3 3 Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 21 NONE 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 Regulation NONE 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. 2. 3. Refer to Standard 7.2 7.4 7.6 Good Practice Recommendations The Registered Provider is recommended to ensure that all the details of residents care is recorded in their individual care plan. The Registered Provider is recommended to ensure that all care plans are reviewed at least once a month. The Registered Provider is recommended to, where possible, involve residents and/or their relatives/representatives in the care planning process or demonstrate that they do not wish to participate in the process. The Registered Provider is recommended to ensure that updated risk assessments and nutritional screening is recorded in the residents care plan. The Registered Provider is recommended to update their Complaints Policy incorporating all of information detailed in Regulation 22. 4. 5. 8.8 & 8.9 16.1 Nightingale Nursing Home C51 S1921 Nightingale Nursing Home V218973 060605.doc Version 1.30 Page 22 Commission for Social Care Inspection The Pavilions 5 Smith Way, Grove Park Enderby, Leicestershire LE19 1SX 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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