Inspection on 23/01/07 for Nightingales Nursing Home

This inspection was carried out on 23rd January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Nightingales Nursing Home 23/07/09

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Nightingales Nursing Home 355A Norbreck Road Thornton Cleveleys Blackpool Lancashire FY5 1PB Lead Inspector Mrs Christine Marshall Unannounced Inspection 23rd January 2007 12:00 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 Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nightingales Nursing Home Address 355A Norbreck Road Thornton Cleveleys Blackpool Lancashire FY5 1PB 01253 822558 01253 829020 cathy@nightinglaescarehome.com 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) Nightingales Care Ltd Mrs Joan Massey Care Home 55 Category(ies) of Dementia (21), Old age, not falling within any registration, with number other category (34), Physical disability (1) of places Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 55 service users to include up to 21 service users in the category of DE (dementia) up to 33 service users in the category of OP (older people over the age of 65 years) one person in the category of PD (physical disability under the age of 65 years) 25/01/06 Date of last inspection Brief Description of the Service: Nightingales is a Care Home is situated in the residential area of Thornton Cleveleys, offering residential and nursing care for 55 service users, including people with dementia. There is a condition of registration for one service user under the age of 65 years. The home was registered under a new provider in April 2006. The manager and staff have remained with the new provider. The main building is a converted and purpose built extension to a farmhouse and has a ground and first floor facility. There are single and double bedrooms and all have en-suite facilities. There is a passenger lift in place. There is another residential building within the grounds and this is known as The Barn again with ground and first floor facilities. Each bedroom in this building is single with en-suite facility. This also has a passenger lift in place. In both buildings of the home there are bedrooms, dining areas and lounge accommodation. There are adequate bathing and toilet facilities in both buildings. All garden areas around the home are accessible by wheelchair and this includes paved and sitting areas. There is a domiciliary care agency, operated from a small office within the main building. A day care facility is provided to the side of the building. The home is owned by Nightingales Care Ltd and managed by Mrs Joan Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 5 Massey. At the time of this inspection visit (23/1/07) the fees for the home ranged from £353 to £510 with added expenses for hairdressing and chiropody. A daily newspaper is provided for the home, but any extra newspapers or magazines are not included in the fees. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Nightingales included a site visit to the home that was done between lunch time and early evening; the visit was unannounced, which means that the owners, staff and residents did not know it was taking place until the inspector arrived. Time was spent sitting and talking with people who use the service, alongside their relatives, and observing the day-to-day routines of the home and care staff, as they provided support. A tour of the home included looking at bedrooms, lounges and dining areas, toilets and bathrooms. This was to assess whether the home provided a comfortable, homely environment for the enjoyment of everyone, and to ensure the residents’ safety. Relatives completed comment cards, because the majority of the residents were unable to express their views about the home. Those that were returned showed a very good level of satisfaction with the care at the home. Visiting relative’s were spoken with and their comments included – “It’s such a relief to know that my husband is being looked after so well.” “He (relative) gets the best care here, I am always made welcome and everybody knows me” “I visit two or three times a week and I am always more than happy with how things are.” Discussions took place with the registered manager Joan Massey, deputy manager Julie Bingham, and members of the care staff. Administration records were also looked at. Everyone at the home was friendly, welcoming and co-operative throughout the visit. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 7 What the service does well: In line with the home’s policies and procedures, Nightingales made sure that there was equal care given to all residents, considering their individual choices and preferences, and giving equal support to all, irrespective of their race, gender, disability, sexuality, age, religion or beliefs. There was equal consideration given to all employees and there were opportunities for male, female and overseas staff, between the ages of 18 and 65 years to work at the home; training and development programmes were offered to all members of staff. The home also provides placements for student nurses and trainee paramedics. The home has made sure that residents have equal access all parts of the home through a passenger lift to the first floor and wheelchair ramps to the garden area. There was a very relaxed and friendly atmosphere and the furnishings were comfortable. Bedrooms were very personalised and homely. The carers were friendly and understood the personal needs of each resident; there was extremely good interaction between the staff on duty and the people living at the home. A large number of residents were unable to voice their opinions, but through friendly chatting, showed that they were happy and content in their environment and with their carers. Nightingales prides itself in its individualistic approach to every resident’s care. The main ethos of the home is that of providing a lifestyle that suits each resident, with the focus on the value and contribution that each resident has in their life at Nightingales. The staff recruitment, induction, training and development are of a good standard. Policies are in place for the safety and welfare of the people who live at the home. Staff turnover is minimal, and there is an extremely good mix of skills amongst the well-established nurses and carers. All residents looked comfortable and happy. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 8 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. The summary of this inspection report can be made available in other formats on request. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 9 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 Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,3 & 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides enough information about their service, and gathers good information about prospective residents, so that their needs can be met. EVIDENCE: There is a Statement of Purpose and Service Users Guide in place; this is a set of written information that tells you about the care service that is offered, who the owners, manager and staff are and what the resident can expect if he or she decides to live at the home. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 11 The information in these documents had been reviewed and updated, to make sure that current information is available to any prospective resident. The pre-admission assessments were looked at for four residents’ and these were completed extremely well; they were very comprehensive and included all aspects of physical, social and psychological care, making sure that the prospective resident’s strengths and needs were identified, and that the home could provide the care that was needed. These assessments were done by either the manager Joan Massey, or her senior nursing sisters, and were agreed by the resident and/or their family. The residents were unable to say that they had been visited before going into Nightingales, but visiting relatives were able to confirm that there had been an assessment before their relative entered the home. Generally all residents were assessed by the same tool, thus promoting equality of assessment and care provision. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9,10 & 11 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The residents health and social care needs were met and people were treated with dignity and respect at this home. EVIDENCE: Care plans are written records that describe the care that is given to each resident. Four of these were looked at and found to be hand-written, very informative, reflective of the care that was being given, and completely individual to each resident. There is equality of care in that every resident was assessed as an individual, with their differing social backgrounds taken into consideration. All aspects of care had been considered, including a good social history. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 13 Most of the residents were unable to say that they knew about their care plans; visiting relatives confirmed that they knew about these plans and that they were informed of every aspect of the care of their relative. Health care opportunities were offered equally to all residents and there were records of GP, chiropody and physiotherapy visits. The medication system was looked at and found to be satisfactory. Trained nurses administer the medications in the main building of the home and the senior carer, who is trained to National Vocational Qualification (NVQ) level 4, gives the medicines in the “Barn” area of the home. Although the home’s precriptions for medicines are not seen before the chemist dispenses them, the manager and nurses are keenly aware of every prescribed medicine that comes into and goes out of, the home. The residents were seen to be treated with great respect, privacy and dignity, and there were good personal interactions between residents and carers. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The residents benefit by being supported, so as to promote the quality of their daily lives. EVIDENCE: Nightingales provides care for people with varying levels of confusion, and therefore provides and promotes individual and spontaneous activities. There are organised activities such as music, flower arranging and outings in the mini-bus, and residents are encouraged to take part in these; however through the home’s assessment process, each resident’s past interests and hobbies are identified and then every encouragement is given to the resident to continue with these. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 15 Visiting relatives said that they were always welcomed to the home. There is a key worker system at the home. This is when carers have a special responsibility for a small number of named residents, looking after their general care and particular need and choices. Each key worker spends personal time with their key residents, often taking them out for personal shopping, or getting special videos or tapes that their resident might like. Religious ministers visit regularly and there are general trips out to the local shops and community centres. The home offered equal choices for all residents at mealtimes and caters for pureed, diabetic and gluten-free food. Mealtimes and menus are very flexible and if a resident wishes to have a snack or a meal at differing times throughout the day, then they are provided with this. Residents were helped with their meals in a discrete manner. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit by being supported and protected. EVIDENCE: There are policies and procedures in place for complaints, whistle-blowing and adult abuse issues, and the three members of staff on duty staff said that they were aware of these. There have been no complaints either to the home or to the Commission for Social Care Inspection. Residents were unable to say if they were aware of the complaints procedure, however three visiting relatives were asked if they knew about the complaints procedure and who they would speak to if they were unhappy; each of those spoken to said that they knew about the procedure and who to speak to; however they insisted that they had no complaint to make at all. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 17 There is an ongoing programme of formal abuse awareness training and this should be fully completed by March of this year. Three members of staff said that they knew about abuse awareness issues. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents were provided with a comfortable environment and bedrooms were personalised. This means that residents feel at home with their belongings around them. EVIDENCE: Each bedroom was personalised with pictures, photographs and small items of furniture. New wardrobes and drawers had been purchased for each room. There were adequate toilets and bathrooms throughout the home. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 19 All lounges, dining areas and bedrooms were comfortable and furnished to a good standard: There is an ongoing refurbishment programme in place. There were aids and adaptations such as grab rails in toilets and special lifting and bathing hoists for the residents who need help with their mobility. There were also assisted baths for residents that cannot get in and out of the bath without help. The laundry was clean and hygienic and contained all of the equipment needed to prevent cross infection. There are antiseptic gel dispensers at the entrance of the home, to help prevent cross infection and all staff carry small bottles of antiseptic gel, for use each time they attend to a resident. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents care needs were met through adequate staff provisions who were appropriately trained. EVIDENCE: The home’s equal opportunities policy was reflected in that there were male and female staff, between the age of 18 and 65 employed at the home. The list of staff on duty showed that there were adequate levels of carers and domestic staff on duty. The carers and the domestic staff were very helpful and showed that there was a very good mix of people in place. National Vocational Qualifications (NVQ) and staff training programs were in place and over 70 of carers have currently achieved the NVQ award. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 21 The staff who have completed their NVQ training have also done a unit covering Equality and Diversity issues and this means that they will be aware of how they can make sure that the residents were treated equally, and given care according to individual choice and preference. Recruitment files were satisfactory and showed that good pre-employment checks are done so that the residents were protected. The staff training files showed that there are induction and training programmes being given. A training matrix was in place and staff on duty during this visit confirmed that they were up to date with training programmes. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents were supported and there were quality systems in place to make sure that they were protected. EVIDENCE: The registered manager is very experienced and qualified to manage the home and is also accredited to train and support student nurses. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 23 The deputy manager had completed her Registered Managers Award course and this was currently being verified for certification. There was a quality monitoring system in place, which is Investors in People (IIP). Twice yearly quality surveys had been undertaken by the home and the results of these were posted on the notice board. Quarterly newsletters have been produced and there have been regular updates on the home’s activities and events posted on the notice board. The manager had undertaken frequent quality audits on the care plans, risk assessments, fire safety, medications and the general environment. Staff said that they were encouraged to be pro-active in improving the quality of care that was provided at the home. None of the residents were able to give comment about the home and the service, but three visiting relatives said that they were happy with the quality of care. The manager gave assurances that the safety certificates at the home were up-to-date, making sure that the residents were safe and secure. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 24 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 x 3 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations According to the refurbishment plan, the carpets on the first floor corridors that are worn should be replaced as soon as possible. Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Nightingales Nursing Home DS0000067380.V327728.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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