Archived: Nightingales

We found the following examples of good practice.

People used clear washroom bags to keep their toiletries in. This meant that people’s personal items were kept separate when using the communal bathroom and helped to reduce the risk of spreading infection.

People’s loved ones were kept updated about visiting guidance through a newsletter and regular calls with staff. Systems were in place to support people to have contact with loved ones safely through phone calls, video calls and garden visits.

Staff had received additional training in response to the COVID-19 pandemic. This included clinical skills training which informed the staff team how to monitor people to identify any deterioration in their health.

Staff were wearing PPE in line with Government guidance. Signs in the home prompted the staff team to maintain good infection control practices.

People’s experience of using this service:

People were supported by staff that were caring, compassionate and treated them with dignity and respect. Any concerns or worries were listened and responded to and used as opportunities to improve.

People received person centred care and support based on their individual needs and preferences. Staff were aware of people's life histories and individual preferences. They used this information to develop positive, meaningful relationships with people. Staff were very knowledgeable about people’s changing needs and people and their relatives confirmed that changing needs were addressed.

People told us they felt well cared for by staff who treated them with respect and dignity and encouraged them to maintain relationships and keep their independence for as long as possible.

People were supported by staff who had the skills and knowledge to meet their needs. Staff understood and felt confident in their role. People told us the atmosphere at the home was relaxed and calm.

Staff liaised with other health care professionals to ensure people's safety and meet their health needs.

Where people lacked capacity, staff worked with the local authority to make sure they minimised any restrictions on people's freedom for their safety and wellbeing.

Staff spoke positively about working for the provider. They felt well supported and that they could talk to management at any time, feeling confident any concerns would be acted on promptly. They felt valued and happy in their role.

Audits were completed by staff and the registered manager to check the quality and safety of the service.

The registered manager worked well to lead the staff team in their roles and ensure people received a good service.

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 29 March 2017).

Why we inspected: This was a planned comprehensive inspection based on the rating of good at the last inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Nightingales is a residential home providing accommodation for up to 13 people with support needs including some people living with early onset dementia. At the time of our visit 11 people were living at the home.

The manager, who is also the provider, was registered with the Care Quality Commission (CQC), as required by law and was present during the day. 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 improvement was needed because we found that some people, living at the home, were being restricted without the correct legal processes being in place. The provider’s and staff members’ understanding of what could constitute a restriction of somebody’s liberty also required some improvement. At this inspection we found the provider had taken suitable action when they had identified people who did not have capacity to consent to their care or treatment. Applications had been made to authorise restrictions on people's liberty in their best interests and staff had received updated training.

People and relatives told us they felt the home was a safe environment for people to live in. Staff spoken with could identify the different types of abuse and explained how they would report abuse. People were protected from the risk of harm and abuse because staff knew what to do and were effectively supported by the provider’s policies and processes. Risks to people were being monitored and staff identified risks to people and explained how those risks should be managed. Staff had a good understanding of the risks and the action that was required. Appropriate equipment was in place to ensure the risk of harm to people was minimised. The care plans and risk assessments were reviewed and updated regularly.

We saw all staff were busy but were available to provide support to people when needed. This included support for people to eat, drink and move around the home safely. Requests for assistance from people were responded to promptly. The provider’s recruitment processes ensured suitable staff were safely recruited.

People received appropriate support to take their prescribed medicines and records were kept of the medicine administered to people. Medicines were stored securely and consistently at the recommended temperature given by the manufacturer and were safely disposed of when no longer required.

People were assisted by suitably trained staff that told us they received training and support which provided them with the knowledge and skills they needed to do their job effectively. People and relatives felt staff were knowledgeable on how to support people effectively and that staff possessed the necessary skills.

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 complimentary about the quality of food and were supported in their choice of meal. We saw people accessed snacks and hot and cold drink at regular times throughout the day. Health care professionals visited the home on a regular basis and people received treatment when needed which helped to promote their health and well-being.

People's care records contained information relating to their specific needs and there was evidence that the care plans were updated when people's needs changed. People and relatives told us they were involved in developing and reviewing their care plans. People were supported by caring and kind staff who demonstrated a positive regard for the people they were supporting. Staff understood how to seek consent from people and how to involve people in their care. We saw staff interacting with people in a friendly and respectful way and that staff respected people's choices and privacy.

We found there had been no complaints about the service since our last inspection. People and relatives told us they had no complaints but were confident if they did, that the provider would deal with the issue effectively.

The registered manager/provider carried out audits and checks to ensure the home was running properly to meet people's needs and to monitor the quality of the care people received.

Some of the people who lived at the home had dementia care needs. People with dementia are not always able to tell us about their experiences so we looked at records relating to their care and observed staff caring for them.

People told us and we saw that that people's views were sought and acted upon. Staff spoken to was able to tell us about people's needs so that they received care in a way that they preferred. Both relatives told us they were consulted about their relative's care and kept informed about their relative's health so they felt involved in their care. One relative said 'I have been involved in the care planning of my relative's care.'

Medicines were prescribed and given appropriately to the people who used the service. One person said, 'I always get my medicines on time.'

There were systems in place to monitor how the home was run, to ensure people received a quality service. A relative told us, 'They provide an excellent service.'

People's complaints and concerns were fully investigated and resolved where possible. One person said, 'If I had any concerns it wold be sorted straight away."

Some of the people who lived at the home had dementia care needs. People with dementia are not always able to tell us about their experiences so we looked at records relating to their care and observed staff caring for them.

People told us and we saw that that people's views were sought and acted upon. Staff spoken to was able to tell us about people's needs so that they received care in a way that they preferred. Both relatives told us they were consulted about their relative's care and kept informed about their relative's health so they felt involved in their care. One relative said 'I have seen X's care plan and attended care reviews'

We saw that people were relaxed in their environment and that systems were in place to keep people safe from harm. A relative told us 'Staff are friendly and helpful.' Staff received a range of training so that they had up to date knowledge and skills in order to support the people who lived in the home.

There were systems in place to monitor how the home was run, to ensure people received a quality service.