Archived: Nightingale House Care Home

Nightingale House Care Home is a care home without nursing providing accommodation and personal care for up to 21 older people, including people with dementia. The premises are in the form of a large residential home with ordinary domestic facilities. At the time of inspection there were 16 people living in the home.

At our last inspection on 13 June 2016 we rated the service ‘good.’ At this inspection we found the evidence continued to support the rating of ‘good’ overall. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were protected from avoidable harm by a staff team trained and confident to recognise and report any concerns. Potential risks to people were assessed and minimised.

Staff were only employed after satisfactory pre-employment checks had been obtained. There were enough staff to ensure people’s needs were met safely and in a timely manner.

The service managed the control and prevention of infection well. Staff followed correct policies and procedures and understood their role and responsibilities for maintaining high standards of cleanliness and hygiene. Medicines were well managed, with staff displaying a sound understanding of the medicines administration systems, recording and auditing systems.

Deprivation of Liberty Safeguards and the key requirements of the Mental Capacity Act 2005 were understood by the manager and acted on appropriately.

People at risk of poor nutrition and dehydration were sufficiently monitored and encouraged to eat and drink. The quality of the food was good, with people getting the support they needed and the choice that they liked.

Staff knew the people they cared for well and understood, and met, their needs. People received care from staff who were trained and well supported to meet people’s assessed needs. Staff had the skills and knowledge to provide effective care.

People were assisted to have access to external healthcare services to help maintain their health and well-being. Staff worked within and across organisations to deliver effective care 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 supported this practice. People were fully involved in making decisions about their care and support. People and their relatives were involved in the setting up and review of their or their family member’s individual support and care plans.

Staff treated people in a kind and friendly way. Staff respected and promoted people’s privacy, dignity and independence. People’s individual needs were assessed and staff used this information to deliver personalised care that met people’s needs. People’s religious and cultural beliefs were respected and supported.

Staff supported people to have the most comfortable, dignified, and pain-free a death as possible. Staff worked in partnership with other professionals to ensure that people received appropriate care.

People’s suggestions and complaints were listened to, investigated, and acted upon to reduce the risk of recurrence.

Staff liked working for the service. They were clear about their role to provide people with a high-quality service and uphold the service’s values.

The registered manager sought feedback about the quality of the service provided from people. Audits and quality monitoring checks were carried out to help drive forward improvements.

Further information is in the detailed findings below.

Nightingale House Care Home is a care home without nursing providing accommodation and personal care for up to 21 older people, including people with dementia. The premises are in the form of a large residential home with ordinary domestic facilities. At the time of inspection there were 18 people living in the home.

The home was managed by a manager who had applied to the Care Quality Commission (CQC) to be registered. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection, carried out on 2 March 2015 we found that people were not adequately protected against receiving care or treatment that was inappropriate or unsafe because their needs and preferences had not been taken into account. We also found that the registered manager had not put in place safe moving and handling training for staff and did not have adequate systems to monitor and assess the quality of the service or to have regard to the views of people living in the home.

We asked the provider to submit an action plan detailing the improvements to be made. These actions have been completed and on this inspection we found that the relevant requirements were being met.

People's feedback about the safety of the service described it as good and that they felt safe. People were safe because the service had provided training to staff and had systems in place to protect them from bullying, harassment, avoidable harm and potential abuse.

Staff protected people's dignity and rights through their interaction with people and by following the policies and procedures of the service Feedback from people was that staff were caring in their attitude and responsive to people's needs. A caring attitude was observed during the inspection and personalised care, dignity and respect formed part of staff training.

There was a structure and system in place for regular staff supervision and each member of staff had a training record which was relevant to their role.

The service managed the control and prevention of infection well. Staff followed correct policies and procedures and understood their role and responsibilities for maintaining high standards of cleanliness and hygiene. Medicines were well managed, with staff displaying a sound understanding of the medicines administration systems, recording and auditing systems.

Deprivation of Liberty Safeguards and the key requirements of the Mental Capacity Act 2005 were understood by the manager and acted on appropriately.

People at risk of poor nutrition and dehydration were sufficiently monitored and encouraged to eat and drink. The quality of the food was good, with people getting the support they needed and the choice that they liked.

Care, treatment and support plans were seen as fundamental to providing good person centred care. Care planning was focussed upon the person's whole life, including their goals, skills, abilities and support needs.

The service protected people from the risks of social isolation and loneliness and recognised the importance of social contact and companionship. The service enabled people to carry out person-centred activities within the service or in the community and encouraged them to maintain hobbies and interests. This was supported by policies and procedures which emphasised the rights of people which enabled staff to work in a person-centred way.

People and relatives described the responsiveness of the service as good. People received personalised care, treatment and support and were involved in identifying their needs, choices and preferences and how they are met. People's care, treatment and support was set out in a written plan that described what staff needed to do to make sure personalised care was provided.

Improvements had been made to quality assurance systems to ensure that people's views were sought and that quality audits take account of the experience of people living at the home. Records and personal information were kept in a secure and confidential manner.

During our visit we observed that windows and the door to the garden were open and people could go where they wanted to. The home was bright and airy and some areas were being re painted. Staff told us, “People have choice; they choose what they want to do”.

People who used the service and relatives we spoke with told us the staff were kind and always available to chat to and they felt they could raise any concern or suggestion freely.

Visiting professionals told us, ‘we have found people to be well looked after and generally in very good health, people get good personal care here’

We saw that staff had regular team meetings and could access a variety of training.