Background to this inspection
Updated
30 November 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
This inspection was carried out by two inspectors.
Service and service type
Nightingale House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. A new manager was appointed on 22 August 2022 and had applied for registration with the CQC.
Notice of inspection
This inspection was unannounced. Inspection activity started on 15 October 2022 and ended on 7 November 2022. The inspection visit took place on 25 and 28 October 2022.
What we did before the inspection
We reviewed all the information we had received about the service. We used all this information to plan our 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. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke in person with the manager, and compliance manager. We also spoke with 7 people using the service, 2 relatives, 7 staff and 3 healthcare professionals to get their experience and views about the care provided. We reviewed a range of records. They included 3 staff files containing recruitment, training and supervision information, and 4 peoples’ files containing care and medicine records, risk assessments, care plans and reviews. We checked a variety of records relating to the management of the service, including audits, quality assurance, policies and procedures. We continued to seek clarification from the provider to validate evidence found. We requested additional evidence to be sent to us after our inspection. This included staff rotas and training information, and provider quality assurance audits. We received the information which was used as part of our inspection.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
Updated
30 November 2022
About the service
Nightingale House is a care home that provides nursing and personal care for up to 21 older people. At the time of our inspection there were 17 people using the service including those living with dementia. The care home accommodates people in one building.
People’s experience of using this service and what we found
People, their relatives and staff told us that Nightingale House was a safe place to live and work. Risks to people were regularly assessed and reviewed. This meant people could take acceptable risks, enjoy their lives and live safely. Accidents, incidents and safeguarding concerns were reported, investigated and recorded. There were enough appropriately recruited staff to meet people’s needs. Trained staff safely administered medicines and prompted people to take them. The home used Personal Protection Equipment (PPE) effectively and safely and the infection prevention and control policy were up to date.
People and their relatives said that effective care was provided, they were not subject to discrimination and their equality and diversity needs were met. Staff received good training and were supervised. People and their relatives thought staff provided good care that met people’s needs. Staff encouraged people to discuss their health needs, any changes to them and concerns were passed on to the management and appropriate health care professionals. This included any necessary transitioning to other services if people’s needs changed. People were protected by staff from nutrition and hydration risks and were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences.
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 provided people with care and support in a friendly manner and paid attention to small details that made all the difference. People felt respected and staff acknowledged their privacy, dignity and confidentiality. People were encouraged and supported to be independent and do things for themselves, where possible. This improved their quality of life by promoting their self-worth. Staff cared about people, were compassionate and passionate about the people they provided a service for.
The provider was responsive to people and their needs were assessed, reviewed and care plans were in place that included any communication needs. People were provided with person-centred care. People had choices, and were encouraged to follow their routines, interests and maintain contact with relatives, friends and interact with others living at the home so that social isolation was minimal. People and their relatives were given suitable information about the home to make their own decisions regarding whether they wished to move in. Complaints were recorded and investigated.
The home’s management and leadership were visible with a culture of openness, positivity and honesty. The provider’s vision and values were clearly set out, understood by staff and followed by them. Areas of staff and management responsibility and accountability were identified, at all levels and a good service maintained and regularly reviewed. Thorough audits took place and records were kept up to date. Where possible community links and working partnerships were established and kept up to further minimise social isolation. The provider met Care Quality Commission (CQC) registration requirements. Healthcare professionals told us that the service was well managed and met people’s needs in a professional, open and friendly way.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This service was registered with us on 19 April 2022 and this is the first inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Nightingale House on our website at www.cqc.org.uk