Nightingale Home Care

Updated 1 October 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 Health and Social Care Act 2008.

Inspection team

The inspection was completed by one inspector 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

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. 72 people were receiving regulatory activity of personal care at the time of the 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 that 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 a registered manager in post.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection and that they could gain consent for us to contact people or their relatives about the service.

Inspection activity started on 2 August 2022 and ended on 8 August 2022. We visited the location’s offices on 4 August 2022.

What we did before the 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 reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used all this information to plan our inspection.

During the inspection

We spoke with 14 people and relatives by telephone to gain their views on the service. We spoke with seven staff including the registered manager, three office based staff, who were responsible for planning the service, and three care workers. We looked at the provider’s systems for managing the service, staff training and recruitment information, and records relating to people’s care and support.

Updated 1 October 2022

About the service

Nightingale Home Care is a home care service providing personal care to people in their own homes. The service provides support to older people, people with dementia and younger adults with disabilities. At the time of our inspection there were 77 people using the service. 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

Records were not always up to date and accurate. The provider’s systems for monitoring the quality of the service had not identified these shortfalls. The registered manager explained how improvements to the provider’s systems, including the introduction of an electronic care monitoring system, would support improvements in recording and quality assurance systems.

People and their relatives told us they were happy with the standard of care and support they received. One person told us, “The carers are worth their weight in gold, care is provided at an outstanding level.”

Risks to people were assessed and monitored. People told us staff helped them to feel safe because they had regular care workers, they described a reliable service. There were enough suitable staff to cover all the care visits. Staff understood their responsibilities for safeguarding people and concerns were reported appropriately.

People’s needs and preferences were identified and assessed. Staff received the training and support they needed to provide effective care. People told us they were supported to access health services when they needed them. Staff supported people to have enough to eat and drink.

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 spoke highly of the kind and caring attitude of the staff. They described being involved in making decisions about their care and support and were encouraged to express their views. Staff respected people’s privacy and dignity and supported people to remain as independent as possible.

People were receiving a personalised service from staff who knew them well and responded to changes in their needs. One person told us, “I couldn’t ask for more, they are wonderful.” Staff supported people with care at the end of life when they chose to be at home. The provider had systems for recording complaints and addressed any concerns when they arose.

Staff were clear about their roles and responsibilities and spoke with pride about the service they provided. One staff member said, “This is the best agency I have worked for.” People were satisfied with the service they received and spoke highly of the quality of the support and the management of the service. One person told us, “I have recommended this company to a friend because they have only experienced bad care from other agencies.”

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 4 January 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of record keeping and quality assurance. We will continue to monitor information we receive about the service, which will help inform when we next inspect.