Archived: Nightingales Residential Care Home

Updated 4 March 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 4 January and was unannounced.

The inspection team consisted of an inspector and an Expert-by-Experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, the provider completed and forwarded to us, a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Before our inspection, we reviewed the PIR and other information we held about the home, which included notifications they had sent us. A notification is information about important events which the provider is required to send us by law. We also contacted local authority commissioners of adult social care services and Healthwatch and asked them for their views of the service provided.

We spoke with eight people who used the service, four relatives, four members of the care staff, the cook, deputy manager and registered manager. We also spoke with one healthcare professional who was visiting the home during the inspection.

We looked at all or parts of the care records and other relevant records of ten people who used the service, as well as a range of records relating to the running of the service. We also reviewed staff records.

Updated 4 March 2017

We carried out an unannounced inspection of the service on 4 January 2017. Nightingales Residential Care Home is registered to accommodate up to 22 people who require nursing or personal care. At the time of the inspection there 20 people using the service.

On the day of our inspection there was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People received their medicines safely and their medicines were stored and managed appropriately. However, improvements were needed in relation to the records used to assess the risks for each person in relation to their medicines, along with a more consistent approach to the records used for the administration of ‘as needed’ medicines.

Staff could identify the potential signs of abuse and knew who to report any concerns to. Risks to people’s safety were continually assessed and reviewed. A risk of an unlocked door to the home was identified, but the registered manager had the processes in place to manage that risk whilst not restricting people’s freedom. There were enough staff to keep people safe.

People were supported by staff who completed an induction prior to commencing their role and had the skills, training in place and their performance regularly reviewed to enable them to support people effectively.

The principles of the Mental Capacity Act (2005), including Deprivation of Liberty Safeguards, had, on the whole, been followed when decisions were made about people’s care. People spoke highly of the food provided and were supported to follow a healthy and balanced diet. People’s day to day health needs were met by staff. A visiting healthcare professional spoke highly of the way staff supported people. Referrals to relevant health services were made where needed.

Our observations throughout the inspection found that staff were kind, caring and compassionate. Staff understood people’s needs and listened to and acted upon their views. People’s privacy and dignity were maintained. Staff treated people with respect. People were involved with decisions made about their care and were encouraged to lead as independent a life as possible. People were provided with information about how they could access independent advocates. People’s friends and relatives were able to visit whenever they wanted to.

People were supported to take part in activities if they wished to. Internet based communication systems such as ‘Skype’ were provided to assist people in maintaining contact with friends and family. Other processes were in place to reduce the risk of social isolation. People’s care records were person centred and focused on providing them with care and support in the way in which they wanted. People were provided with the information they needed if they wished to make a complaint.

The registered manager led the service well, was a visible presence throughout the inspection and was respected and well-liked by all the people we spoke with. People were encouraged and supported to maintain links with their local community. The provider’s recruitment processes resulted in low staff turnover and staff understanding and implementing the homes aims and values. People were encouraged to provide feedback about the quality of the service and this information was used to make improvements. Quality assurance processes were in place to ensure people and others were safe in the home.