Inspection on 08/11/05 for Nightingales

This inspection was carried out on 8th November 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 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

Nightingales 05/09/05

Nightingales 21/05/05

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 Elaine Green Announced Inspection 8th November 2005 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 Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 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. Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Nightingales Address 38 Western Road Newick East Sussex BN8 4LF 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) 01825 721120 Mrs Anne Lewis Mrs Anne Lewis Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is Seventeen (17) 21st May 2005 Date of last inspection Brief Description of the Service: Nightingales is an older extended property situated in the village of Newick. The village centre with its facilities and shops is a short level walk away and local bus services run past the home. Accommodation is over 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 DS0000021172.V252111.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 11th November 2005 from 10am to 4pm. Prior to the inspection the Registered Manager completed a pre inspection questionnaire to provide statistical information about the home and service users and their relatives were given the opportunity to complete comment cards and return them to the Inspector. On the day of the inspection the Inspector held discussions with the Registered Manager and Deputy Manager relating to the day-to-day running of the home, joined service users for lunch, visited service users in their own rooms, spoke to a health care professional, had a tour of the building and grounds and examined a range of documents and records. What the service does well: What has improved since the last inspection? What they could do better: Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 6 The procedure for making an adult protection alert needs to be amended in line with the local guidance specified in the Brighton and Hove and East Sussex Multi Agency Guidelines for the Protection of Vulnerable Adults. This home continues to work towards 50 of their care staff obtaining a National Vocational Qualification in Care at Level 2 or above however, as they have not yet met this target a further requirement is made. 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. Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 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 Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 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): 1,2,4,5. Service users are provided with the information required for them to make and informed decision about whether to reside in the home. EVIDENCE: The manager stated that all prospective service users are able to visit the home as part of the process of assessing if the home can meet their needs. Discussions with service users confirmed this. The first month’s stay in the home is a trial period for both the service user and the home to further assess the suitability of the home in meeting the service users needs. This is specified in the Statement of Purpose and the Residents’ Guide. Specialist services are not offered by the home though evidence was seen of multi agency working and of referrals for specialist input made by the home when required. The staff team employed at the home have the required skills to competently deliver the services the home offers. Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 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): 7,8,9,10,11. Care plans are adequate. Service users health care needs are fully met and they are protected by the home’s medication policies and procedures. Service users wishes in death and dying are respected. EVIDENCE: Four care plans were examined and found to be relevant. The information contained provides guidance for staff to follow to support service users in all aspects of their daily living however, this information could be more detailed to specify exactly how the support should be delivered. Service users should be involved in writing their own care plans and sign them when they are completed as well as when there are any major changes. Information relating to service users being treated with dignity and respect are included in the Residents Rights and in the Residents Guide both of which are documents that have been produced by the home. Discussions with service users confirmed that they are treated with dignity and respect and one service user stated “I am very well treated and always with TLC.” A visitor commented that “They treat my friend with care and compassion….she appreciates their care for her.” A relative stated, “Our family are delighted by the care and the dignity given to my mother.” It was noted that staff knocked on service users Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 10 doors before entering and they were observed speaking to service users in a respectful manner. Records examined relating to service users medication and health care confirmed that their health care needs are fully met. Records showed evidence of multi agency working on a regular basis. They give clear instruction were needed and are informative. The homes’ medication policies and procedures are adequate. A visiting health care professional spoke highly of the management and staff. They stated that the home is very well organised and that they always know when they are coming and whom they are going to visit. They spoke highly over the care residents receive and commented that they are kept informed on a need to know basis. Comments received by another health care professional included, “Staff are caring, welcoming and well informed.” The home has a policy regarding death and dying and this subject is covered on the staff induction programme. The manager explained that she consults with service users about their wishes on death and dying and records this on the care plan however, not all service users wish to discuss this and in these cases she consults with of relative. Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 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): 15 The arrangements for the provision of meals are good and the food provided is of good quality. EVIDENCE: The inspector joined service users for midday meal in the dining room. The food served was of good quality. It was homemade from fresh ingredients, hot and well presented. Service users likes and dislikes regarding food were recorded on their care plans and the chef had a copy of this information. The menu for the day was displayed and although an alternative was not specified, service users stated that they can always have an alternative meal if they do not wish to have the main meal for the day. They also explained that they have a choice of light meals for their evening meal. The menus examined confirmed that a varied and wholesome diet is provided. Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 12 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): 17,18 Service users legal rights are protected. The procedure for making an Adult Protection Alert needs to be amended. EVIDENCE: The Resident Guide was examined and provides information relating to the arrangements provided for voting. The manager explained that most service users have a postal vote but they would arrange transport to a polling station should it be required. She also explained that she would make a referral to an advocacy service for a service user if they did not have a friend or relative who could act as their representative. The policy and procedures relating to Adult Protection and making an Adult Protection Alert were examined. Although they had been updated as required at the last inspection, they require further amendment to ensure that the Alerting Procedure is in line with local guidance as specified in the Brighton and Hove and East Sussex Multi Agency Guidelines for the Protection of Vulnerable Adults. Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 13 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): 19,20,22,23,24,25,26. The environment is clean, hygienic, well equipped and homely in character. Service users rooms are personalised, safe and comfortable. EVIDENCE: This home can meet all the needs of the service users who live here. The recreational and dining areas are homely and comfortable. All service users’ rooms meet their needs and they are able to bring their own furniture and belongings. This was confirmed when the Inspector visited three service users in their own rooms. There is level access throughout the ground floor. There is a small flight of stairs on the first floor. The service users whose bedrooms are accessed by these stairs are able to manage them at the current time. The manager assured the Inspector that reassessments would be undertaken should there come a time when service users could not manage the stairs. The garden is accessible to all service users though some service users with mobility difficulties require support to do so. Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 14 The home has been assessed by an Occupational Therapist in 2002 and there are grab rails and banisters around the building. There is an alarm system installed in every bedroom and in all the communal areas of the home. The Manager demonstrated the alarm system to confirm that it is in working order. Those who need them use mobility aids, and referrals are made to the relevant professionals if additional help is required. There are an adequate number of adapted baths to meet the needs of the service users resident in the home. Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 15 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): These standards were not inspected EVIDENCE: Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 16 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): 31,32,33,36,37,38. The management, and administration systems in place, are good. This home is run in the best interest of the service users. EVIDENCE: The manager of this home is qualified and experienced. She has all the qualities required to run this home well. Throughout the inspection she was observed to be interacting appropriately with service users who approached her on a range of issues throughout the day. The information detailed in the care plans demonstrates the fact that this home is run in the best interest of the service users. All stakeholders are offered the opportunity to partake in n annual questionnaire. The manager explained that the results of these are audited and improvements to the service made wherever possible and this was confirmed when past questionnaires and results were examined. The manager explained that she has initiated a service user comment book this was examined and has been Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 17 used by the service users to make comments about the services provided. The home still needs to implement a service user survey and make this available for Inspection. The insurance certificate confirmed that the cover for the home is appropriate. A visiting health care professional confirmed that the home shared information with them on a need to know basis. All the records examined were accurate, legible, complete and stored appropriately. Policies and procedures are reviewed and updated on a regular basis. All staff receive supervision which typically takes place two monthly. The topics covered include, practice issues, NVQ, training as well as issues relating to personal and professional wellbeing and development. Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 18 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 2 X 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 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 2 3 3 X 3 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 3 Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 19 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 OP18 Regulation 12(1)(a) Requirement That the service produces an up to date adult protection policy.(this requirement 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) Timescale for action 01/12/05 2. OP28 18(1)(a) 30/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Nightingales DS0000021172.V252111.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection East Sussex Area Office 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 DS0000021172.V252111.R01.S.doc Version 5.0 Page 21 - 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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