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Inspection Summary

Overall summary & rating


Updated 13 June 2018

This inspection took place on 19 and 20 April 2018. The first day was unannounced. We told the provider we would be visiting on day two. At our last inspection on 15 March 2017 we rated Nightingale Hall as Requires Improvement. We found the provider had breached one regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to medicines administration. Risks to people arising from their health and support needs were not always assessed and plans were not always in place to minimise them. The service was not involving night staff in fire drills.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question of safe to at least Good.

At this inspection, we found medicines were administered safely. Risk assessments were in place, which gave staff the guidance needed to meet people’s needs safely and plans were in place to minimise risks. Fire drills included all staff at the service.

This service is now rated as Good.

Nightingale Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Nightingale Hall is a large adapted property and accommodates up to 42 older people, some of who may be living with dementia.

A registered manager was in post. 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.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of the action they should take if abuse was suspected. They were confident the registered manager would address any concerns.

Medicines were stored and administered safely and the premises were well maintained to keep people safe.

Risk assessments were completed to reduce the risk of harm. Accidents and incidents were analysed to reduce the risk of reoccurrence.

There were safe recruitment and selection procedures in place and appropriate checks had been undertaken before staff began work. Staff received the support and training they needed to give them the necessary skills and knowledge to meet people's assessed needs. Staffing levels were sufficient to meet those needs.

People were provided with sufficient food and drink to maintain their health and wellbeing and staff supported people to access healthcare professionals and services.

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.

Staff knew people well and promoted their independence. Care was person centred and people were provided with choice. Staff were kind and treated people with dignity and respect. People told us they felt safe and well cared for. End of life care was provided sensitively.

Care records contained information about people's needs, preferences, likes and dislikes. Staff understood people were individuals and would inform managers if they thought people were being discriminated against.

Complaints or concerns were taken seriously and action was taken to address them. Feedback about the quality of the service was sought from people, relatives and staff.

The registered manager and the provider regularly monitored the quality of service to ensure that people received a safe and effective service which met their needs.

Inspection areas



Updated 13 June 2018

The service was safe.

There were sufficient staff to keep people safe and meet their needs.

Medicines were managed safely and people received their medicines as prescribed.

Staff reported any concerns and were aware of their responsibilities to keep people safe from harm.

People were kept safe; risks were identified and well-managed.



Updated 13 June 2018

The service was effective.

Staff received training and supervision to enable them to fulfil their role.

People were supported to make choices in relation to their food and drink and to maintain good health.

The staff and registered manager understood the principles of the Mental Capacity Act 2005 and acted in people's best interests where required. Appropriate applications to deprive people of their liberty had been made.



Updated 13 June 2018

The service was caring.

People were treated with dignity and respect.

Staff were caring and kind towards the people they supported.

People and their relatives were involved in planning their care.

Staff promoted people's independence was promoted.



Updated 13 June 2018

The service was responsive.

Care plans described how people should be supported and were person centred.

People were supported to make choices about their care and support and relatives contributed to this.

People had opportunities to take part in activities of their choice and were supported and encouraged with their hobbies and interests.

People told us they felt confident to speak with the registered manager or staff if they had any concerns.



Updated 13 June 2018

The service was well-led.

The service had a registered manager who understood the

responsibilities of their role.

People and staff we spoke with told us the registered manager was approachable and they felt supported in their role.

People were regularly asked for their views and their suggestions were acted upon.

Quality assurance systems were in place to ensure the quality of care was maintained.