Archived: Nightingale Nursing and Care Home

Updated 12 February 2020

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

The inspection team comprised of two inspectors and an Expert by Experience. 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 Nursing and Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We contacted Healthwatch, this is an independent consumer champion that gathers information about health and social care services. We used all of this information to plan our inspection.

During the inspection-

We spoke with 10 people who used the service and five relatives about their experience of the care provided. We spoke with 11 members of staff including the operational manager, registered manager, clinical lead nurse, residential care coordinator, senior care workers, care workers, housekeeping staff, the cook and the maintenance person.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four 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 spent periods of observation in the open plan lounges and the dining area, we observed two meal times and a medication round.

After the inspection –

We continued to seek clarification from the provider to validate evidence found.

Updated 12 February 2020

About the service

Nightingale Nursing and Care Home is a nursing and residential care home providing personal and nursing care to people aged 65 and over. At the time of the inspection 33 people lived at the service. The service can support up to 49 people in one adapted building over two floors.

People’s experience of using this service and what we found

The registered manager had been in post for six months and was working with the local authority quality team, the infection control team and the medicines management team to put improvements in place.

Staff training was out of date, so we could not be sure that staff had received effective training. There were enough staff to meet people’s needs.

Peoples nutritional needs were not always met, and records were not always up to date.

End of life planning was not detailed enough. An activity program that was meaningful and personalised to people’s needs was not fully established.

People and their relatives were positive about the staff and the registered manager. People felt safe and staff had a good understanding of how to protect people from harm. People received safe care, their health needs were monitored, and staff supported people’s independence. People received their medicines safely. Staff followed infection control policies to protect people against the spread of infection, and the environment was clean and well maintained.

Risk assessment were in place to reflect people’s changing needs. People told us there were enough staff to support them and safe staff recruitment practices were followed.

People told us staff were caring and the registered manager was visible and responded to concerns. The registered manager was very motivated to improve the service. Staff were knowledgeable about people’s needs and supported people well.

There were quality assurance systems in place to monitor the service, however actions needed to be closely monitored to ensure they were followed up. The registered manager had made a number of service improvements however these were not fully established at the time of the inspection. The registered manager was well supported by the provider.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires improvement (published 19 May 2018) There were no breaches found at this inspection

Why we inspected

This was a planned inspection based on the previous rating.

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.