Nightingale Group ltd. Trentham Care Centre

Updated 8 March 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection prevention and control measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 5 inspectors, 3 medicines inspectors, 1 specialist nurse and 2 Experts 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 Group ltd. Trentham Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. Nightingale Group ltd. Trentham Care Centre is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post.

However, there was a manager who had submitted an application for registration.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Local authorities together with other agencies may have responsibility for funding people who used the service and monitoring its quality.

Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people living at Nightingale Group ltd. Trentham Care Centre and 8 relatives. In addition, we spoke with 26 staff members including nurses, nurse support workers, carers, care coordinators, human resource staff, the manager, maintenance staff, an external consultant and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with one visiting healthcare professional.

We spent time in the communal areas, and 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.

We looked at multiple care and support plans and medication records. In addition, we looked at several documents relating to the monitoring of the location including quality assurance audits, health and safety checks, incident and accident reports. We confirmed the recruitment checks of 5 staff members including the safe use of agency staff.

Updated 8 March 2023

About the service

Nightingale Group ltd. Trentham Care Centre is a care home providing personal and nursing care to 96 people at the time of the inspection, some of whom were living with dementia. The service can support up to 155 people. People who used the service were both younger and older adults who had mental health needs such as dementia, and physical disabilities. Nightingale Group ltd, Trentham Care Centre accommodates people across 5 different units, each of which had their own purpose-built facilities. At the time of this inspection 4 of the units were in operation.

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

People did not receive their medicines safely. Not all staff members followed best practice when administering medicines and not all medicine errors were reported in line with the providers procedures.

There were inconsistencies with the way people were treated by staff. Not everyone received empowering and valuing interactions from the staff supporting them, whilst others reported being supported by caring and kind staff.

The provider did not have effective quality monitoring processes or checks in place to ensure safe care, or to identify or meet inconsistencies in people’s experiences.

The provider had assessed the risks associated with people’s care and support. Staff members were knowledgeable about these risks. People were supported by enough staff to promptly respond to them when needed. The provider followed safe recruitment practices. The provider had effective infection prevention and control practices in place.

People were protected from the risks of ill-treatment and abuse as staff had been trained to recognise potential signs of abuse and understood what to do if they suspected harm or wrongdoing.

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

The provider, and management team, had good links with the local communities within which people lived.

The last rated inspection rating was on display at the location and on the providers website.

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 inadequate (published 23 June 2022). At that inspection there were breaches of regulation regarding safe care, safeguarding, dignity, staffing and governance processes. The provider completed an action plan after the last inspection to show what they would do and by when to improve. Although improvements were made at this inspection, we found the provider remained in breach of regulations regarding safe care and overall governance. Improvements have been required for 3 consecutive inspections.

This service has been in Special Measures since 23 June 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on actions we told the provider to take at the last inspection. As a result, we undertook a focused inspection to review the key questions of safe, caring and well-led.

We looked at infection prevention and control measures (IPC) 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 the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, caring and well-led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Nightingale Group ltd. Trentham Care Centre on our website at www.cqc.org.uk

Enforcement

We have identified continued breaches in relation to the safe administration of medicines, dignity and overall governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.