Background to this inspection
Updated
3 August 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
Two inspectors carried out this inspection. We also had an Expert by Experience who made telephone calls to family members. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Nightingale Holistic Services is a domiciliary care agency which is registered to provide personal care and support to people in their own homes including supported living settings. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.
The service had a manager registered with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours' notice of the inspection. This was because we needed to be sure that the registered manager would be in the office to support the inspection. Inspection activity started on 28 June 2022 and ended on 5 July 2022. We visited the location's office on 28 June 2022.
What we did before inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We reviewed a range of records in the provider’s office. This included four people’s care records and their medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We spoke with six people about their experience of the care provided. We spoke with six members of staff including the registered manager and provider.
After the inspection
We spoke with two family members and continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
3 August 2022
About the service
Nightingale Holistic Services is a domiciliary care agency which is registered to provide personal care and support to people in their own homes including supported living settings. At the time of our inspection the service was supporting ten people in their own accommodation in one large supported living setting. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. Ten people were being supported with personal care at the time of our inspection.
People’s experience of using this service and what we found
Right Support:
• The model of care and setting maximised people’s choice, control and independence.
People were encouraged to have control in their daily lives and staff ensured people were able to live as independently as possible. People were encouraged to be as independent as possible which had a positive effect on their self-esteem. Staff were committed to enabling people to live their lives in a way which was as close to their choosing as possible. For example, people had been supported to learn new skills such as preparing meals, budgeting and planning their day to day schedules. Risks were managed well to keep people safe while promoting their independence and staff supported people to access healthcare services when they needed them.
Right Care:
• Care was person-centred and promoted people’s dignity, privacy and human rights.
People experienced continuity of care and we saw they engaged confidently with members of their support team. Staff knew people well and ensured that people received the support they needed to keep them safe and to meet their individual care needs. People's rights were promoted, and they were protected from discrimination. People were treated with dignity and their privacy was respected. Staff were kind and caring, treated people with respect and encouraged them to make decisions about their care and support. The support staff provided was flexible to take into account people's needs and preferences.
Right Culture:
• The ethos, values, attitudes and behaviours of leaders and care staff ensured people
using services lead confident, inclusive and empowered lives.
Staff and the management team ensured that people and their families were at the centre of the delivery of care. People told us they felt they were treated as individuals whose life and experiences were considered and factored into planning their care. Their family members told us they still felt included in their relative’s day to day life. People were involved in planning their own care and were encouraged to give their views about the support they received. People’s families were also able to give their feedback about the support their family members received and their views were listened to.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Rating at last inspection
The last rating for this service was good (published 04 June 2019.)
Why we inspected
The inspection was prompted in part due to concerns received about financial and sexual abuse, poor infection prevention protection and control practice and limited social activities for people. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, effective, caring, responsive and well-led sections of this full report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.