We carried out a review of the data available to us about Nightingales (Chichester) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Nightingales (Chichester), you can give feedback on this service.
Nightingales is a domiciliary care service providing personal care to approximately 29 people at the time of the inspection. People using the service were living with a range of care and support needs such as dementia and physical disabilities. 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.
People’s experience of using this service and what we found
People were not always supported to have maximum choice and control of their lives. It was not clear if staff were supporting them in the least restrictive way possible and in their best interests as they had not ensured representatives making decisions on people’s behalf had the legal authority to do so. This is an area of practice that requires improvement.
People were protected from the risk of abuse and felt safe. A relative told us they felt their loved one was, “completely safe, I have no concerns whatsoever.” People’s medicines were well managed, and lessons learned when things went wrong.
People received care from well trained and knowledgeable staff. People’s nutritional needs were understood and met by staff. Staff worked well with other professionals to meet people’s health and wellbeing needs in a timely way.
Staff were kind and caring to people and knew them well. One person told us, “They are all really kind.” People’s privacy and dignity was respected, and their independence promoted. People were supported to express their views by staff who understood their communication needs.
Staff were responsive to people’s needs and delivered their care in the way they preferred. People understood how to make complaints but had not needed to. People were supported compassionately at the end of their lives.
The service was well managed. People, their relatives and staff were complimentary of the management of the service. One person told us, “they are nice, helpful people and I have faith in them as they have never let me down.” Quality assurance and audit processes were in place and actions taken to improve the quality of the service.
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 (published 10 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 (Chichester) is a family run, domiciliary care service providing support to 72 people living in their own homes, 22 of whom were in receipt of the regulated activity of personal care. The service supports older people and people who are living with dementia or other conditions, to enable them to continue living in their own homes. Some people privately funded their care whilst others had their care funded by the local authority. The service is based in Bognor Regis and provides a service to people within the local area as well as Pagham, Chichester and Selsey in West Sussex.
The service was owned by two providers, one of which was the registered manager. 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 were asked their consent and were involved in day to day decisions. However, practice and the lack of records confirmed that there was a lack of understanding in relation to the practical application of the Mental Capacity Act 2005 (MCA). There was a lack of mental capacity assessments and best interests decisions, in relation to specific decisions for people who lacked capacity.
People were protected from harm and abuse as they were supported by staff who had undertaken the relevant training and who knew what to do if they had concerns about peoples’ safety. Risks had been assessed and managed to ensure peoples’ safety. People told us that they felt safe, one person told us, “Definitely, when I go in to have a shower, I don’t have to worry about slipping, I just feel very safe when they’re there”. Another person told us, “I’m not very good on my legs and they make sure I’m safe, I’ve not fallen down for a long time”. People received their medicines on time from staff with the necessary training and who had their competence assessed. Peoples’ health needs were assessed and met and they had access to medicines and healthcare professionals when required.
People were supported by skilled, experienced and competent staff that had access to relevant training. One person told us, “Oh yes, they’re very proficient, they do everything I want them to do”. People and their relatives, if appropriate, were fully involved in the planning, review and delivery of care and were able to make their wishes and preferences known. Care plans documented peoples’ needs and these were reviewed and updated regularly to ensure that they were current. One person told us, “Oh yes, somebody came to the house to discuss what I wanted done and things like that”. Staff worked in accordance with peoples’ wishes and people were treated with respect and dignity. It was apparent that staff knew peoples’ needs and preferences well. Positive relationships had developed amongst people and staff. One person told us, “I can only talk about my own carer, but they’re a wonderful person, they’re like a best friend”. People were treated with respect and dignity and their privacy was maintained. One person told us, “Yes. It’s a very private sort of thing, having a shower isn’t it? But they’re always very pleasant and understanding”. Another person told us, “I’ve had no bother yet. I’ve had over 20 people in a year and I’ve had no trouble with my dignity yet”. People, when required, received appropriate support with their nutrition and told us that they were able to choose what food they had to eat.
The registered manager welcomed feedback and used this to drive improvement and change. People and relatives were aware of the procedures they needed to follow to make a comment or complaint. There were quality assurance processes in place to enable the registered manager to have an oversight of the service and to ensure that people were receiving the quality of service they had a right to expect. People, relatives and staff were complimentary about the leadership and management of the service. One person told us, “Well, I think they manage everything quite well. I’m quite happy. I would’ve changed the company if I wasn’t”. One member of staff told us, “They are brilliant, they are constantly checking to make sure we are okay. If I did have any issues I could ring them, there isn’t anything I couldn’t approach them about”.