Nightingale Nursing and Care Home

Updated 12 January 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.

As part of this inspection we looked at the infection control and prevention 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

The inspection team comprised of one inspector, a specialist advisor nurse and an Expert 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 Nursing Home 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and the local clinical commissioning group about the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

During the inspection we spoke with two people who used the service and observed how care and support was given generally. We got feedback from three care staff, including nurses, and five staff involved in activities, maintenance and catering. We spoke with the registered manager, the deputy manager, and the provider's nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We looked at a range of records including five people's care records and how medicines were managed for people. We also looked at staff training, and the provider's quality auditing system. During the inspection visit we asked the provider to give us additional evidence about how the service was managed, which they sent to us.

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.

After the inspection

We spoke with eight relatives and two care staff after the inspection visit to get feedback from them about the quality of the service. We continued to seek clarification from the provider to validate evidence found and reviewed the evidence they sent us.

Updated 12 January 2022

About the service

Nightingale Nursing Home is a nursing and residential care home providing personal and nursing care to people aged 65 and over. At the time of the inspection 28 people lived at the service. The service can support up to 49 people in one adapted building over two floors.

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

People’s needs were assessed, and any risks associated with their health conditions documented. Staff knew about risks associated with people’s health conditions and understood how to provide care which kept people safe. Risks associated with the service environment were assessed and mitigated. There were enough staff to keep people safe. People received their prescribed medicines safely. The service was clean and the approach to cleanliness and infection control had improved since we last inspected. People were protected from the risk of abuse. Accidents and incidents were reviewed and monitored to identify trends and to prevent reoccurrences.

Staff got the right training to meet people’s needs. People's needs and choices were assessed in line with current legislation and guidance in a way that helped to prevent discrimination. People were supported and encouraged to have a varied diet that gave them enough to eat and drink. People were supported by staff to access healthcare services when required. The provider ensured the environment was suitable for people's needs.

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.

People were supported to express their views about their care and daily lives and make their own decisions as far as possible. Relatives felt they were kept informed about their family member’s care. People’s confidential personal information was stored securely, and the staff team were clear about who should have access to this. We saw staff ensured people's privacy and dignity were respected.

People said that staff knew their likes and dislikes and respected their choices. Care plans were personalised and contained information about people's likes and dislikes. People's communication needs were clearly identified in their care plans; this helped staff understand how best to communicate with each person. The service had a policy and process for managing complaints, which was displayed clearly in the home. People and relatives were supported to discuss their end of life care, and staff knew how to support people and their relatives in the way they wanted.

The service was well-led. The provider and registered manager undertook regular audits of all aspects of the service to review the quality of care. These were effective in identifying areas where improvements were needed. Regular feedback was sought from people, relatives and staff about the quality of the service. Any issues raised were acted on promptly, and everyone was told what action was taken so they could see what had been improved. The registered manager and manager and provider’s nominated individual were open with the inspection team about where improvements had been made, and where there was still further work to do.

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 August 2021) and there were breaches of regulations. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 23 August 2021. 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 action we told the provider to take at the last 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.

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

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.