Nightingale Care and Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

People’s equality related needs had been considered and staffing levels were adjusted to ensure that these needs are met. Where people were receiving end of life care, relatives had been involved in the planning of this care. People were not always involved in decisions; it was identified that this had affected their experiences in the care they had received. This had been previously identified and the provider has introduced systems to ensure people are actively involved in planning their care.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff provided person centred support, for example communicating with people in their preferred language. Arrangements were in place to support this person’s preferences with their dietary requirements. On the whole, staff understood what person-centred care meant. However, there were some examples in which person-centred care was not always provided. For example, the decision to move everyone onto one floor. Some staff reflected on the difficulties this had on people’s moods and experience, whereas others reflected on the move making their roles easier.

Staff were observed to be kind and caring. Staff knew people well and were able to distract and comfort them. For example, staff were considerate when providing support, staff checked with the person throughout the support to ensure they felt safe and comfortable. People were observed to be offered choices. For example, at mealtimes, there were multiple choices of food and drink offered.

Relatives told us that staff were kind and empathetic. Relatives told us of a time a staff member visited [family member] on their day off when [family member] was in hospital.

The provider worked with local partners to ensure a continuity of care. Action plans were in place to drive improvements. The partner agencies told us they are continuing to work with the service.

The provider had continuity plans in place for staff and leaders. This outlined procedures to follow within emergency situations.

Relatives told us that there had been some slight improvements with working with professionals, however improvement were still needed. Relatives told us of weekly visits from the community nurse or GP.

Staff understood that other professionals were involved in people’s care, for example, district nursing and dietetic input. They demonstrated an understanding of the sort of support this may be and how their role in providing the relevant support based on recommendations ensures people receive the right care and support. Systems were in place to ensure the sharing of information.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Leaders explained their process for dealing with complaints. They demonstrated an understanding of the duty of candour, explaining they apologised to people and their families when things went wrong.

Relatives told us that leaders had made some improvements at the service. One relative told us "The interim manager has turned things around quite a lot. I can certainly see there has been quite a lot of improvement.” Relatives did not consistently feel that they are kept informed. One relative did tell us "They do keep us informed about [family member] care and health. They call us about once a month with an update. Always very helpful. We know that [family member] is very happy there.” Another relative told us “No. I am never told anything. If you want to know, you have to ask, then they do tell you”.

The provider had implemented systems of ‘you said, we did’ to gather feedback from people and their relatives. People and relatives had been involved in key changes at the service following the previous CQC inspection. For example, the service had identified that people and relatives wanted people to have key workers, this had not yet been fully implemented.

Policy and procedures were in place to assist staff to ensure that people had access to the appropriate care, support and treatment when they needed it. This covered processes to follow in urgent and non-urgent situations. Additional training had been provided to senior members of staff as further development. At the previous CQC inspection, it was identified that the home did not have signage to identify people's bedrooms. During the on-site visit for this assessment, this had still not been actioned. This meant that people may have difficulties identifying where their bedroom was located.

We observed a staff member speaking to a person in their preferred language. This reassured the person and put the person at ease. Staff confirmed they had received Equality Diversity Human Rights training. Examples were provided in relation to a service user with diverse needs and how they work as a staff team to understand their needs. One staff member explained how they utilised the electronic care records system’s data to be able to provide relevant information on people’s support needs when a person may not be able to voice these issues. For example, weight loss.

The provider had a community nursing team and GP visit the service on a weekly basis. We were given mixed feedback from relatives about being kept informed of contact with professionals involving their family member. One relative told us "It is always after the event. Last time [family member] was in hospital, I was told after [family member] came out".

Partners shared they were working with the provider to improve people's access to appropriate care and support. This included actions around improved documentation and leadership oversight.

Staff feedback focused on one individual with diverse needs, which included speaking a different language to the majority of people and staff at the service. Some examples were provided on how they tailor their own communication to ensure that this person is involved in the same way. Staff who did speak their language were always on shift wherever possible. Staff told us they were teaching English speaking staff.

One relative told us of improvements since the new manger had been in post. The relative stated “They seem now to be very inclusive and forth-coming”.

People’s preferences and religious needs had been identified. The provider had built staffing levels to meet people’s equity-related needs. The provider complied with legal equality and human rights requirements, including avoiding discrimination, having regard to the needs of people with different protected characteristics and making reasonable adjustments to support equity in experience and outcomes.

We spoke with relatives of a person on end of life care, they fed back that overall they were satisfied with the care and support provided to [person] reaching the end of their lives and staff were compassionate. For example, visiting when in hospital.

Staff were aware who was in receipt of end-of-life care. Whilst they showed a basic understanding of the support this person currently required, not all staff provided specific examples of what care would look like for the person when they were reaching the end of their life.

Only 1 person was considered to be reaching the end of their lives. We reviewed their end of life care plan which was more person centred and detailed how the person wished to be cared for at the end of their lives, also considering any religious requests. There was evidence that family had been involved in this care planning.