Nightingale House

Updated 30 November 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 carried out by one inspector.

Service and service type

Nightingale House is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Nightingale House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave a short period of 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.

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 professionals who work with the service. 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 looked at notifications we had received from the service. A notification is information about important events, which the provider is required to tell us about by law. We used all this information to plan our inspection.

During our inspection

We spoke with 5 people, the registered manager, the deputy manager, the directors, 1 senior care staff, and 3 care staff. We looked at 7 people’s care plans, 3 staff recruitment files, medicines administration records, end of life records, staff rotas, staff training, supervision records and minutes of meetings. We also looked at audits and a variety of records relating to the management of the service, including policies and procedures.

We were not able to get the views of some people who used the service due to their needs. 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. Following the inspection, we continued to seek clarification from the provider to validate evidence found. We also spoke with 3 relatives to obtain their views of the service.

Updated 30 November 2022

About the service:

Nightingale House is registered to provide accommodation to 43 older people who may have dementia and requiring nursing or personal care. At the time of our visit, there were 32 people using the service.

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

People were positive about the care and support they received from staff. There were systems to reduce the risk of abuse and to assess and monitor potential risks to people who used the service. People were protected by safe recruitment procedures. There were enough staff to meet their care and support needs. The provider had a system in place to record and monitor accidents and incidents. Medicines were managed in a safe way. People were protected from the risks associated with the spread of infection.

People were supported by staff who had received appropriate training and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service did support this practice. People's needs were assessed before they started to use the service. People were encouraged to have a healthy diet.

Staff knew people who used the service well and they provided care and support to them in a kind and compassionate way. People were treated with respect and were given information regarding their care and their views were taken into account. Staff were aware that people's information should be treated confidentially. People received care and support in accordance with their preferences, interests and diverse needs.

People received personalised care and support that was tailored to their individual needs. Care plans were informative and had sufficient instructions for staff on how to deliver care and support to people, in accordance with their wishes. Care plans were reviewed and updated in a timely manner. People were supported to engage in meaningful activities of their choice and were involved in the local community. People and their relatives knew they could speak with staff or the management team if they had any concerns.

There was an open culture within the service, which was focussed on people. Staff were clear about their roles and responsibilities and had access to policies and procedures to inform and guide them. The provider had system in place to assess, monitor and improve the quality and safety of the services provided. The provider continually sought feedback about the service from people, relatives, staff and other professionals. The management team worked closely with other health and social care professionals to ensure the people received the care and support they needed.

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 requires improvement (published 30 July 2022) and there were breaches of Regulations 12 (safe care and treatment) and 17 (good governance). As a result, we served a warning notice to ensure the service was compliant in these areas.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found improvements had been made and the provider was no longer in breach of regulations.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.