Inspection on 21/05/05 for Nightingales

This inspection was carried out on 21st May 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Nightingales 08/11/05

Nightingales 05/09/05

Nightingales 06/03/05

Nightingales 17/08/04

Nightingales 17/06/02

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 Nightingales 38 Western Road Newick East Sussex BN8 4LF Lead Inspector Andy Denness Unannounced 21 May 2005 13:00 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. Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Nightingales Address 38 Western Road Newick East Sussex BN8 4LF 01825 721120 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) Mrs Anne Lewis Mrs Anne Lewis Care Home (CRH) 17 Category(ies) of Old age, not falling within any other category registration, with number (OP) 17 of places Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is seventeen (17). Date of last inspection 6 March 2005 Brief Description of the Service: Nightingales is an older extended property situated in the village of Newick. The village centre with its facilites and shops is a short level walk away and local bus services run past the home. Accommodation is on two floors, a stair lift is fitted to assist access to the first floor. Bedroom accommodation consists of fifteen single and one double room. The home has large gardens to the side and rear and ample off road parking at the front of the building. The home is registered to accommodate seventeen older people and the registered provider is Mrs Anne Lewis. Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a Saturday afternoon in May and lasted 4 ½ hours. To help gather evidence on how the home is performing the Inspector met with staff and the home’s manager/owner, examined a range of records and written information and undertook a short tour of the premises. In depth discussions took place with eight service users. What the service does well: 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 6 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 Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 7 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, & 5. Satisfactory pre admission arrangements are in place to ensure that service users move into a home which is appropriate to meet their needs. EVIDENCE: The home has a service user guide and a statement of purpose in place, these documents describe the service and how it is performing and are to help service users in their decision in whether to move to the home. Both documents were of a good standard and were on display in the home for easy access by service users and others interested in their care. Detailed assessments are undertaken of service users’ need prior to admission to ensure that the home is suitable for them and that staff can support them appropriately, a selection of these were examined, they were of a good standard. Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 8 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, The policies, procedures and practices in the home regarding health, personal and social care needs are good and help ensure that identified service user needs in these areas are appropriately met. EVIDENCE: Using the initial assessment of need as a starting point individual plans of care are compiled for each service user; these identify amongst other things what support they require from staff to meet their day to day needs in relation to health, personal and social care needs. A selection of the individual plans was examined they were of a good quality and clearly identified needs and support required. From records examined and discussions with service users it was evident that needs identified in the plans were being appropriately met. Service users also confirmed that medical and other professional help is obtained for them when and if they need it. In most instances staff manage service user’s medication for them; a monitored dosage medication system is used, storage and records were examined and found to be in order. Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 9 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) 12,1 3, 14 & 15. Arrangements in the home regarding social and recreational needs, visitors and community participation are good and ensure service users choice and variety in all areas of daily living. A varied and wholesome menu is provided. EVIDENCE: Service users care plans include details of their preferences regarding social and recreational activities. Records examined confirmed that activities included bingo, musical events and outings out. The home’s comments book contained several requests from service users for specific additional activities, all of which had since been provided. The home has small library/lounge; this room contains a range of books, talking books and a computer terminal with internet access for service users to use if they so wish. Service users confirmed that their friends and relatives can visit at any time and are made to feel welcome. They also said that they have control over all areas of their daily lives, including what time to get up or go to bed, choices with meals and what to do with their time, one service user said that she can “please myself what I do”. Menus examined confirmed that a varied and wholesome diet is provided. Without exception all service users spoken to were complimentary of the quality of meals and choice that they offered. Staff were observed asking service users their choices for the evening meal, they were able to have anything that they wanted within reason. Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 10 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 & 18. Arrangements regarding complaints were satisfactory resulting in service users being confident that their complaints will be listened to and acted upon. EVIDENCE: A written complaints procedure is in place for service users or their representatives to follow should they be unhappy with any aspect of the service provided at Nightingales, this was of a good standard. Service users spoken to said they felt able to approach staff and the manager with their concerns if they need to and that action would be taken to address their concerns. At the last inspection it was required that the home’s adult protection procedure was revised, this has still not happened although the home is still within the timescale for the completion of this piece of work. Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 11 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, 23, 24, 25 & 26. Physical standards in the home were good resulting in service users living a comfortable, safe, family type environment which is suitable to meet their needs. EVIDENCE: Most areas of the home were inspected during the inspection. The building was well maintained and clean and hygienic throughout. Bedroom accommodation is provided in 15 single and one double room, which is usually used as a single. The rooms were decorated and furnished in a comfortable and homely style. Service users said that they appreciated the opportunity to bring their own furniture and belongings with them. Several rooms have ensuite facilities and sufficient additional bathrooms and WCs are available for those who do not have ensuites. Two bathrooms have facilities to assist those who may have mobility problems. A dining room and two lounge areas are available for service users use; these were furnished and decorated to a good standard. Emergency call points are fitted in areas for service users to call for help in an emergency. Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 12 All radiators are fitted with guards and hot water outlets are controlled to ensure service users safety. The home has large rear and side garden with ramped access and seating facilities; service users said that they much appreciated the garden in the warmer weather. Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 13 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, 29 & 30. Staffing arrangements are satisfactory with the number, qualities and skills of staff ensuring that service users’ needs are met appropriately EVIDENCE: Sufficient staff were on duty to meet the needs of service users, the rota was examined, which indicated that it is the case at all other times. Service users confirmed that there was always enough staff on duty to provide them help when they required it. They spoke very positively of the staff employed saying that “they are very kind here” “very caring” and “very nice”. As yet 50 of staff are not trained to NVQ level as is required although the manager is confident that they will reach this target in the near future. Records examined confirmed that robust recruitment procedures are followed, when new staff are employed, this includes the use of application forms, the following up of two references, ID checks, criminal record checks, Protection of Vulnerable Adult checks and the issuing of contracts of employment. However in one instance it was noted that the manager had accepted an old Criminal Records Bureau Check from one member of staff when she started work in the home, it has been required that a new check is obtained. Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 14 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 35, 37 and 38. The management and administrative arrangements in the home are good and help support the excellent standard of care provided for service users. EVIDENCE: The registered manager presents as experienced and competent, she is a trained nurse, holds the Registered Manager’s Award and is an NVQ assessor; during the inspection she demonstrated a clear understanding of the needs of older people; service users spoke very positively of her. The manager and her staff are not involved in any aspect of service users’ finances. A selection of the records that are required by regulation were examined, these were in order and stored securely. The manager was aware of the importance of ensuring a safe environment for both service users and staff. Records examined confirmed that equipment is regularly serviced and that the risk assessment process is used to help ensure safety. Training records confirmed that staff are trained in moving and handling, food hygiene, fire safety, infection control and fist aid. Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 15 A full fire protection system is fitted, records confirmed that this is tested regularly, staff are regularly trained in fire protection matters and that drills take place at the required intervals. Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 3 x x 3 x 3 3 Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 17 Yes 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 18 Regulation 12(1)(a) Requirement That the service produces an up to date adult protection policy.(this requirment was made following the last inspection of the home and is still with the given timescale for completion) That the home continues to work towards the target of 50 of staff trained to NVQ level 2. (This requirement was made following the last inspection of the home and is still within the given timescale for completion) That a new CRB check is obtained for the member of staff discussed. Timescale for action 1/6/05 2. 28 18(1)(a) 31/12/05 3. 29 18(1)(a) 21/6/05 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 Good Practice Recommendations Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 18 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Nightingales H59-H10 S21172 Nightingales V225675 210505 Stage 4.doc Version 1.20 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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