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Care at Home Group Ltd Requires improvement Also known as Care At Home Group

Inspection Summary

Overall summary & rating

Requires improvement

Updated 27 June 2019

About the service:

Nightingales UK Limited provides care and support to people in their own homes. The provider has renamed the service ‘Care at Home’ but it remains registered in the original name. They work with people who are elderly, disabled or have additional needs to help them remain independent at home. Not everyone using Nightingales UK Limited receives regulated activity; The Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection there were 151 people using the service.

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

Staff supported people to take their medicines safely and people told us they felt safe with the staff providing this support. However, we found some inconsistencies in the record keeping of records for medications, so it was difficult to identify accurate administration of prescribed treatments.

Staff noted improvements to the service since the provider had taken over the service. They felt supported and listened to by the new management team and the provider. However, we found that some staff had not received support and training necessary for their role. The provider had actions in place to update staff with training and to provide all staff with regular supervision and appraisals which had recently commenced.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. However, some staff had not received training in the principles of the Mental Capacity Act, 2005; and care files lacked enough information to show these principles of support had been taken into consideration.

Care records had been recently updated and captured personalised and important information regarding people’s histories, families and preferences. However, we found various issues with the lack of updates regarding people's records which created risks in managing accurate care planning.

Staff were knowledgeable of local safeguarding procedures. The service had learnt from recent safeguarding incidents however improvements were still needed in the recording and auditing of safeguarding incidents to show a transparent process and clearer audit trail in managing incidents.

Governance systems had not always identified areas needing improvement. The provider had taken recent actions to improve the management of the service and employed specialist staff to help them develop improved quality assurance systems of the service.

People who used the service and their relatives spoke positively about their experience and the care provided by staff. Staff treated people with kindness and respect and supported their dignity in a sensitive manner. We received mixed comments from relatives regarding consistency of staffing levels. We received two complaints from people during the inspection which we referred to the provider to review.

Staff knew people well. They understood their needs and the manager had recently tried to reorganise rotas and increase recruitment of staff to help provide better consistency in providing the same staff to people receiving support.

More information is provided in the full report.

Rating at last inspection: Good (report published April 2017)

Why we inspected: This was a scheduled inspection based on the previous rating from the last comprehensive inspection. We had received information of concern prior to the inspection from two safeguarding incidents that had been reviewed by Warrington local authority.

Enforcement: We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Follow up: You can see what action we told the provider to take at the back of the full version of the report. We will continue to monitor intelligence we receive about the service until we retur

Inspection areas


Requires improvement

Updated 27 June 2019

The service was not always safe. Details are in our Safe findings below.


Requires improvement

Updated 27 June 2019

The service was not always effective. Details are in our Effective findings below.



Updated 27 June 2019

The service remained caring. Details are in our Caring findings below.


Requires improvement

Updated 27 June 2019

The service was not always responsive. Details are in our Responsive findings below.


Requires improvement

Updated 27 June 2019

The service was not always well-led. Details are in our Well-Led findings below.