Nightingales Residential Home

Updated 31 August 2023

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

This team that carried out the inspection on 28 July 2023 consisted of 1 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. The inspection team returned on 2 August 2023. On the second day of our inspection the inspection team consisted of 2 inspectors.

Service and service type

Nightingales Residential Home 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. Nightingales Residential Home 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 not a registered manager in post. The service was run by a manager who told us they were going to register with us. The manager had been in post for 2 days on the second day of our inspection.

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 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 used all this information to plan our inspection.

During the inspection

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.

We spoke with 5 staff members, including the manager, the deputy manager, senior carers and regular carers. We spoke with 5 people living at the service, 1 visitor and 2 visiting healthcare professionals. We reviewed a range of records. These included care records for 4 people and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service.

Updated 31 August 2023

About the service

Nightingales Residential Home is a residential care home providing personal care to up to 23 people. The service provides support to older people, people with physical disabilities and sensory impairments. At the time of our inspection there were 15 people using the service.

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

People told us they felt safe and were supported by a group of consistent staff who knew them well. People were provided with care by appropriately recruited staff who had received training in how to support them safely and effectively. Staff were aware of the risks to people and were kept up to date with changes in people's care needs. Staff had received training in how to recognise signs of abuse and were aware of their responsibilities to report any concerns they may have. People received their medication as prescribed.

People were supported to maintain a health and balanced diet and they were encouraged to make choices about food they ate. Care and support were person-centred and people's bedrooms were personalised to their tastes. People were supported to have maximum choice and control of their lives and staff provided them with care in the least restrictive way possible; the policies and systems in the service promoted this practice. People were enabled to access a variety of healthcare services to assist them in maintaining good health, and the local GP conducted regular rounds. The service provider had a training programme to support staff to improve their skills and knowledge.

People were happy with the care they received. Staff were kind and compassionate and supported people to maintain their dignity and independence. We observed lovely interactions between staff and people.

People had electronic care plans in place that were up-to-date, detailed, and person-centred. This enabled staff to understand and meet their needs and expressed people’s wishes and preferences. Staff ensured they communicated and shared information with people in a way they could easily understand. There was a complaints process which people and relatives were aware of and they had information about the procedure to follow.

People living at the care home, their relatives and staff working there were all complimentary about the way the service was managed. The management team had auditing systems to maintain ongoing oversight of the service and make improvements where necessary.

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 7 December 2019).

Why we inspected

The inspection was prompted in part due to concerns received about lack of completed risk assessments and care plans, poor governance, unwitnessed falls and people being at risk of dehydration. A decision was made for us to inspect and examine those risks.

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.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective, caring, responsive and well-led sections of this full report.

Follow up

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