Nightingales Home Care

Updated 22 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Prior to the inspection we looked at information about the service including notifications and any other information received from other agencies. Notifications are information about specific important events the service is legally required to report to us. We reviewed the Provider Information Record (PIR). The PIR was information given to us by the provider. This is a form that asks the provider to give some key information about the service, tells us what the service does well and the improvements they plan to make.

This inspection took place on 15, 16 and 17 January 2019 and was announced. The provider was given 48 hours’ notice of the inspection because the service provided was domiciliary care in people’s own homes and we wanted to make arrangements to contact people.

The inspection included looking at records, speaking to people who use the service, talking with staff and phone calls and emails to relatives and health professionals. The inspection was completed by an adult social care inspector and an Expert by Experience (ExE). An ExE is a person who has personal experience of using services.

We spoke with the provider of the service and five members of care staff. We spoke with 12 people who used the service. We also spoke with five relatives of people using the service and one health and social care professional who has regular contact with the provider.

Updated 22 February 2019

This inspection was completed on 15, 16 and 17 January 2019 and was announced. The provider was given 48 hours’ notice of the inspection because the service provided was domiciliary care in people’s own homes and we wanted to make arrangements to contact people.

Nightingales Home Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults. Not everyone using Nightingales receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. There were 45 people receiving the regulated activity of ‘personal care’ at the time of the inspection.

There was no registered manager in post at the service. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run. The service was in the process of recruiting a new manager who would register with the Care Quality Commission. A representative of the provider was acting as manager at the time of the inspection.

The previous inspection was completed in October 2017 and the service was rated ‘Requires Improvement’ overall. At that inspection we found one breach of the regulations. The records relating to the management of medicines were not always complete, and quality assurance systems at the service were not always effective in identifying shortfalls in the service.

At this inspection, we found improvements had been made and the service has been rated ‘Good’ overall.

People received safe care and treatment. Staff had been trained in safeguarding and had a good understanding of safeguarding policies and procedures. The administration and management of medicines was safe. There were sufficient numbers of staff working at the service. There was a robust recruitment process to ensure suitable staff were recruited.

Risk assessments were updated to ensure people were supported in a safe manner and risks were minimised. The staff we spoke with had a good understanding of people’s needs and the risks associated with their care. Where people had suffered an accident, themes and trends had been analysed, and action had been taken to ensure people were safe and plans put in place to minimise the risk of re-occurrence.

Staff had received training appropriate to their role. People were supported to access health professionals when required. They could choose what they liked to eat and drink and were supported on a regular basis to participate in meaningful activities.

People were supported in an individualised way that encouraged them to be as independent as possible. People were given information about the service in ways they wanted to and could understand.

People and their relatives were positive about the care and support they received. They told us staff were caring and kind. We observed staff supporting people in a caring and patient way. Staff knew people they supported well and could describe what they liked to do and how they liked to be supported.

The service was responsive to people’s needs. Care plans were person centred to guide staff to provide consistent, high quality care and support. Daily records were detailed and provided evidence of person centred care. Where required, people were supported to make decisions about end of life care which met their individual needs and preferences.

The service was well led. People, staff and relatives spoke positively about the management. Quality assurance checks were in place and identified actions to improve the service. The service sought feedback from people and their relatives to continually improve the service.