Nightingales Golden Care Limited

Nightingales Golden Care Limited is a domiciliary care agency which provides support and personal care to people living in their own home. Not everyone who used the service received personal care. 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. At the time of our inspection 64 people were receiving a regulated activity from Nightingales Golden Care Limited.

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

People were happy with the care they received from Nightingales Golden Care Limited and felt the service was run well. A clear management structure in place. Feedback about the service was sought from people, their relatives and staff. Quality assurance systems were in place to assess monitor and improve the service.

Appropriate safeguarding procedures were in place to protect people from the risk of abuse. There were enough staff to meet people’s needs and they had been recruited safely. Individual and environmental risks were managed appropriately. People received their medicines safely and as prescribed.

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. Staff sought people’s consent and supported people to make choices about their care. Staff received appropriate training and support to enable them to carry out their role effectively.

Staff treated people with kindness and compassion. Staff had developed positive relationships with people and their relatives and knew what was important to them. People were treated with respect and dignity. Staff encouraged people to remain as independent as possible in their daily routines.

People received personalised care which met their specific needs, Care plans were clear, detailed and person-centred, which guided staff on the most appropriate way to support them. A complaints procedure was in place, which ensured concerns were investigated and acted upon appropriately. Where required, arrangements were in place to support people in a dignified manner at the end of their life.

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

Rating at last inspection

The last rating for this service was Good, the report for which was published on 06 January 2017.

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.

Nightingales Golden Care Ltd provides domiciliary and personal care assistant support to people who live in their own homes in Portsmouth and Hampshire. Care is provided to people with disabilities and/or are elderly. At the time of inspection there were 115 people receiving a service.

The service had a registered manager who had been in post since 2009. 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 felt safe with the care and support they received from staff at Nightingales Golden Care. Staff knew how to keep people safe and were aware of how and to whom they could report any safeguarding concerns.

Staff sought consent from people before providing care or support. The ability of people to make decisions was always assessed in line with legal requirements to ensure their liberty was not restricted unlawfully. Decisions were always taken in the best interests of people when necessary.

Risk assessments were personalised and kept up to date. Care plans were written with the person and/or their families. They had been supported to be involved in identifying their care and support needs and this was recorded in their care plans.

People were well cared for and there were enough staff to support them effectively. The staff were knowledgeable about the needs of the people and had received appropriate training in order for them to meet people’s needs. The recruitment process was robust and all required checks were in place prior to staff commencing work.

Medicines were administered, stored and disposed of safely and in line with legal requirements and guidelines. There were appropriate guidance and protocols for staff when people needed ‘as required’ medicine. All staff who had undertaken training in order to administer medicines safely had all been competency assessed. One staff member had undertaken train the trainer training in order to complete the competency checks on staff.

People told us that all staff were kind and caring, and treated people with dignity and respect. There was an open, trusting relationship between the people and staff. Staff knew people well and this showed in the way they spoke with each other.

We saw people and staff members had been asked for feedback about the service they received. There was a record of what actions had been taken to address any identified concerns. Staff worked well as a team. There was an open and transparent culture which was promoted amongst the staff team.

Everyone thought the management of the service was good and felt the service was well-led. All staff said they felt supported and felt they could raise any concerns with the registered manager and they would be acted upon.

We viewed the policies and procedures and saw they were being followed. Quality assurance checks were being completed and when incidents had occurred action had been taken to try to prevent a re-occurrence.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

There were enough qualified, skilled and experienced staff to meet people's needs.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

People's needs were recorded in a plan of care that was kept under review. Risks to people's safety were assessed and plans to reduce and monitor risks to both people using the service and staff were recorded.

Staff had received safeguarding training and those that we spoke to were aware of how and when to report any concerns. People using the service told us. 'They are quick to respond if you are not happy and sort it out as soon as they can.'

In order to protect the people using the service, we saw that the agency carried out a rigorous staff recruitment process and staff received training and support suitable to their role.

Four people using the service that we spoke with were very positive about the staff team and comments included. 'I can talk to them in confidence about issues. I trust them and I am very happy with the care they provide. They are very professional but do not overstep the boundaries.'

There were processes in place to monitor accidents and incidents and the quality of service being provided. People using the service and their families were involved through annual questionnaires and spot checks.

A person using the service said. 'It has helped me to get out into the community so that I don't get lonely.'