Archived: Nightingales Residential Care Home

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.

We saw that people experienced safe and effective care based on detailed care plans and risk assessments that met individual needs.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training in safeguarding adults. People told us that if they had any concerns they would report them to a manager.

Staff received ongoing training and supervision which provided them with the skills and knowledge to meet the needs of the people they were supporting.

The provider had effective systems in place to monitor and assess the quality of the service.

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plans.

We saw the service's training records which showed that staff were provided with training on safeguarding vulnerable adults from abuse. We saw the provider's safeguarding policy and procedure which advised staff of the signs and symptoms of abuse, and the action they should take if they were concerned that a person or people were being abused.

People were complimentary about the approach of the staff who supported them. One person said, "The staff here are superb. They are always cheerful and attentive." People told us that the staff assisted them when they needed help.

We saw evidence of a robust and comprehensive system of quality assurance. We saw records of regular audits of staff recruitment records, health & safety matters, medication, care plans, staff training and supervision, and infection control.