Nightingales Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

When incidents or accidents had occurred, the registered manager was transparent with people. When concerns had been raised during this assessment, the registered manager had immediately shared these with staff and acted to mitigate the risk.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Prior to people moving into the service, a pre-admission assessment was carried out to ensure the service could meet people’s needs. Relatives told us if their family member needed support from a health professional, this was arranged and documentation we saw evidenced this. If people required admission to hospital, detailed and person-centred information to support health professionals to make decisions was provided.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they were safe and cared for. One person said, “I am as safe as I can be.” One staff member told us, “Yes, I think people are safe. [Nightingales is] equipped to deal with people’s needs.” One staff member commented, “No concerns with bad practice here. [Registered manager] is quick to deal with any issues.”

The provider investigated safeguarding incidents and shared concerns quickly and appropriately with the relevant authorities. Staff had received safeguarding training and knew how to identify and report abuse.

Where people needed to be deprived of their liberty to keep them safe, the provider ensured a deprivation of liberty safeguard (DoLS) was applied for through the relevant local authority.

While staff provided care to meet people’s needs that was safe, and supportive, care plans did not consistently contain personalised and accurate information.

Care plans and risk assessments did not always include consistent information or guide staff how to manage risk or escalate concerns. Two people had contradictory information in their care plans around pain management and capacity. One person was identified as having episodes of poor mental health. Documented strategies on how staff would support this person to remain safe were unclear. However, staff could tell us how they supported the person and manage the risk effectively.

During a recent heatwave, the registered manager had introduced a shorts-term care plan and risk assessment to increase fluid intake for people and for staff to observe people for any heat related illnesses.

The provider did not always control potential risks in the care environment. They made sure equipment, and technology supported the delivery of safe care. Parts of the premises required updating.

The provider had a refurbishment plan. The registered manager was able to show areas of the home that had been updated and shared plans for upcoming improvements. However, some facilities were not well maintained. The cover from one over the bed wall light was hanging off leaving the bulb exposed. Some radiator covers were loose and broken in places. Radiator covers can prevent people from getting accidental burns or catching themselves on sharp corners and edges. When the inspection team informed the registered manager about issues with some fire doors they ensured these issues were addressed straight away.

Staff had good knowledge of fire safety procedures, and every person had a personal emergency evacuation plan (PEEP). The purpose of a PEEP is to ensure that all people can evacuate the building safely and promptly in the event of an emergency, regardless of their level of mobility or other health conditions.

Equipment was available and maintained to meet people’s needs. We saw evidence fire equipment, lifting equipment and electrical safety checks were completed as required by regulations such as Lifting Operations and Lifting Equipment Regulations 1998 (LOLER).

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider followed recruitment procedures to ensure all required checks were completed before staff started work at the service. Enhanced Disclosure and Barring Service (DBS) checks were carried out. DBS checks provide information about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

The provider used a dependency tool to help assess the number of staff required to support people. People told us, “There is always someone at hand.” And, “Most times they do [have enough staff] and they are not so bad at weekends.” During the assessment we saw people were helped quickly if they needed support and staff were calm and supported people with patience and understanding.

Staff told us they had regular supervision and appraisals. They said these were useful andenabled them to discuss training, their performance, and any concerns they had.

The provider did not always assess or manage the risk of infection. They did not always control the risk of it spreading.

There were dedicated housekeeping staff who had cleaning schedules to follow. However, not all areas of Nightingales Nursing Home were clean. Dining room chair legs were dirty with a build-up of black grime. We saw chipped paintwork throughout the home which would make effective cleaning and infection prevention difficult. This placed people at risk of avoidable harm as a dirty environment significantly increases the risk of infections dueto the presence of bacteria and viruses. The registered manager took action to mitigate the risk.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were stored safely, including those that required cold storage and extra security. People received their medicines safely and as prescribed. If people took medicines on an “when required” basis, written instruction to help staff identify when these should be administered was available. Appropriate arrangements for the ordering and disposing of medicines were in place and known by staff.

A variety of regular medicines audits were carried out and any shortfalls were identified with actions taken to minimise the risk of re-occurrence.