Nightingale Court Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s care plans included their health, wellbeing and communication needs, including how to support people to maintain their independence. Care plans were reviewed regularly, with relatives involved in the process. However, some care plans did not contain the level of detail to ensure people were supported consistently. The registered manager was working on this.

Relatives were positive about the effectiveness of their relatives’ care. For example, 1 relative told us, “This is definitely the best home for my relative to be in. My relative has picked up and is calmer and more lucid than they have been for quite a while. My relative is happy and settled here which has helped them to become quite compliant which I believe is definitely down to the staff assessing them and quickly getting them on the right medication”.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, they did not always do this in line with legislation and current evidence-based good practice and standards.

We have outlined in the Safe domain of the report, best practice was not always followed in relation to moving and handling and managing people’s contractures. In addition, pain assessment tools were not used to determine if people who were unable to verbalise were in pain, and staff did not always assure us of how they would recognise pain for some people.

People’s nutrition and hydration needs were assessed and met. When required, people were referred to a speech and language therapist (SALT).We observed their guidance was followed. People and their relatives were very complimentary of the food they received. 1 relative told us, “I feel certain that the food is good as every time I see [Person’s name] eating a meal, they have enjoyed the food so much that they eat every scrap on their plate.” The chef took pride in their work and meals were presented in an appetising way, including for people who required a modified diet. An evidence-based tool was used to help to identify those at risk of malnutrition and appropriate action was taken. We also saw skin assessment tools were used effectively.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The service worked collaboratively with local health partners to ensure people’s needs were understood and consistently met. One healthcare professional was extremely positive about the working relationship they had with staff in the home and provided feedback that stated, “’Fantastic, professional experience … Excellent handover, friendly and made our job so much easier. This is probably one of the best care homes I have visited in a long time.”

Relatives were also positive about how staff in the home worked with partner agencies. Comments included, “There are regular GP visits, and I am contacted straight away if there are any medical situations with my relative which reassures me.” and “The home has also worked with the GP and got my relative’s medication changed which are proving more effective. I’m really pleased with how effective this home is with my relative.”

Staff told us they worked well together and were a good team who communicated well, genuinely cared about people and did a good job. Staff had access to the information they needed to assess, plan and deliver people’s care. The service used an electronic recording and planning system. This meant people’s information was easily accessible to staff.

Overall, the provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives.

Relatives provided examples of how the staff in the home had supported people to improve their health. Examples included, “My relative was struggling to eat before they came here but the staff have taken their time with my relative and got them eating again.” and “My relative’s personal care had deteriorated but the staff here managed to get them in a bath within 2 weeks which was amazing. I cannot thank them enough for that. My relative always looks clean in themselves now and their clothes are clean on every day.”

Staff used an evidence-based tool to monitor people’s health to anticipate and determine if people required clinical support. Appropriate escalation of incidents and timely referrals helped support people with immediate needs.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The electronic recording system used by the service supported oversight of people’s outcomes. The nominated individual and registered manager told us they regularly checked this to ensure people’s needs were met. They had good oversight of areas such as people’s weight, fluid intake and social engagement, and ensured appropriate action was taken if needed. The provider had recognised the electronic care plan system did not always lend itself to recording personalised information and were working with staff to improve this.

The provider kept a file which highlighted successful outcomes for individuals. For example, 1 person had experienced improved wellbeing due to the measures implemented by the team, and another had improved hygiene, which in turn improved their overall presentation and self-esteem.

Relatives were positive about people’s outcomes and how staff monitored their care. One relative said, “All the staff are good, and they are monitoring my relative’s liquid intake for example but as my relative is bed bound the staff also have to monitor them for bed sores and so far, my relative has not had any, thankfully, which proves to me that they are being effective.” Another relative told us, “[Person’s name] is putting some of the weight on that they lost [prior to being admitted into the home] when they were not eating properly, I really believe that my relative is getting the help they need here.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff respected people’s choices and consistently sought consent before providing support. People told us they had choices, could spend the day as they wished and staff respected their decisions.

Where people lacked capacity to make specific decisions, capacity assessments had generally been completed and best-interest decisions made in consultation with those involved in the person’s care. Where we identified an area where assessments had not been completed, the provider took prompt action to address this.