Nightingale Care and Nursing Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The service did not have a Registered Manager in post, and this was undergoing recruitment processes. An interim manager was in post at the time of assessment, currently supported by the providers senior leadership team. It was identified that governance systems were not robust in identifying risks and sufficient actions had not always been taken to mitigate risks. This is an ongoing breach of Regulation 17 (Good governance) and placed people at risk. Whilst systems had not been fully embedded at the service, staff and leaders were keen to drive this improvement forward.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders reflected on the progress since the last inspection and had been working with the provider on the service development plan which has ensured staff and leaders are clear on the direction of the service and improvements required. Staff were aware of the improvement plans and direction of the service. Staff shared they met with the manager regularly to discuss the progress of the action plan. Staff reflected on changes since the last inspection, with feedback that there seemed to be more organisational structure meaning staff understood their roles and responsibilities much better. One staff said, “Our residents are our number 1 priority.”

The providers website outlined their vision and strategies to meet the needs of their customers. We were able to review positive progress the provider has made since the previous CQC inspection. Although improvements had been identified, it was had not yet been fully embedded into the service, Staff have policies and procedures in place to work alongside. These set clear expectations that the provider expects from staff.

The provider had appointed an interim manager at the service to support with the driving improvements. Advertisement was in place for the recruitment of a Registered Manager to sustain and drive the improvements forward. The management team have introduced further and continuing training and development for the senior carers at the service.

Leaders shared they were well supported by the provider’s senior leadership team. Leaders understood their regulatory responsibilities. All staff fed back positively about the leadership of the home and felt leaders were fair and approachable. Staff felt many of the service improvements were due to the new management.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Systems and processes were not always effective at identifying areas for improvement or ensuring improvements had been made in a timely manner. For example, medicine audits had identified fridge temperature records had not been completed. We found they had continued to not be completed at the time of our site visit.

Leaders felt that audits were now more effective. They provided an example of the medicines audit, which in December was around 60% compliant, to more recently achieving 90% compliance. They explained audits were done regularly, and leaders held monthly governance meetings. Leaders explained a new system that has been introduced to allow oversight of the electronic system which involved alerts being raised when a planned interaction was not completed, which was flagged with leaders quickly who could then speak with the staff member to follow up why the action was not completed, and ensure it was.

Leaders worked alongside a range of professionals, including the local authority, Integrated Care Board and safeguarding professionals. Leaders explained work has been done and the relationships are positive. Leaders demonstrated an understanding of the importance of sharing information with partners.

The provider had action plans in place to identify key areas of improvement. The provider has worked with stakeholders and local commissioners to drive the improvement. This had not been fully embedded at the service.

The provider worked in partnership with relevant stakeholders to identify and drive improvements.

Relatives told us that they did not always feel involved in the care and treatment of their family member. This feedback was however mixed and some relatives told us they had been invited to meetings to contribute to care plans.

Whilst we identified some improvements since the last inspection, we found systems and processes to drive improvement were not always effective or embedded. For example, following falls, action had not always been taken to improve safety. This left people at risk of harm.

Leaders understood the findings of the last inspection and the improvements required. They ensured staff had been informed of the inspection findings and service development plan to drive the improvements.