Nightingale Homecare East Sussex Ltd

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.

This is the first assessment for this newly registered service. This key question has been rated good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. A thorough pre-assessment process was completed for people before they started using the service. These were carried out by experienced staff, and all aspects of people’s care and support needs were assessed and any risks identified and discussed with the person and their families. A relative told us, “The pre-assessment was very thorough, took about an hour. Covered the environment as well. Looked at trip points. And they do regular checks of fire alarms and personal alarms she keeps under her pillow, very impressed with that.” Support needs were regularly reviewed and changes made where needed. The deputy manager told us about recent examples where the number of care calls to people had increased because their support needs had increased. These decisions were always made with the person and their relatives. Other professionals for example, occupational therapists and GP’s were consulted where people’s needs changed. Care plans and risk assessments recorded the reviews and reflected any changes to instruct care staff.

The registered manager planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. People were involved in the planning and delivery of their care and support. People had their preferences and preferred routines respected by staff who always put people at the centre of any decision making. Some people had complex support needs. In some cases, this involved up to 4 separate care calls a day, the use of specialist equipment and frequent reviews of needs. The service did not routinely use the malnutrition universal screening toll (MUST) to monitor people’s weight or Waterlow scoring which measured people’s likelihood of developing pressure sores. However, staff were trained in these areas, and the tools were available to use if there was a clinical need.

The registered manager 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. Positive working relationship had been established with other health and social care professionals. Where people required additional support, this was quickly put in place by the registered manager liaising with the relevant teams. The registered manager told us, “We have a good rapport with the local authority and all other others especially the occupational therapy team. Referrals work well. No back log.” A professional added, “Communication with both management and staff has always been effective and timely. They are open, transparent, and work collaboratively with our team, ensuring that relevant information is shared and that we are kept informed of any concerns or changes in a person’s needs.”

The registered manager supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Some people were supported with their nutrition and hydration needs. Some had specific dietary requirement for example, limitations on some food types or a need to have food modified for easier consumption. Staff supported people and recorded in daily notes quantities and volumes consumed. The registered manager told us they worked with the speech and language team (SALT) and dieticians to support some people with specific needs. People’s food preferences, likes, dislikes and allergies were all recorded within care plans.

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. Staff knew people well. They were able to detect any changes in people’s health and presentation and reported any changes to their line managers. This ensured that where necessary, interventions to improve people’s health were made quickly and help sought from other professionals as needed. A member of staff said, “If someone is unwell or I think they need more support I’ll let the managers know and they do respond quickly.”

The registered manager told people about their rights around consent and respected these when delivering person-centred care and treatment. Some people supported by the service needed help with some decision making with day-to-day tasks and activities. Staff knew the importance of gaining consent from people before engaging in any of these tasks, to make sure that people understood and were happy for them to proceed. People’s ability to understand varied from person to person but staff treated people as individuals and respected their wishes. Comments from staff included, “We have a routine and they expect what happens each day but I never rush and ask their permission to do things,” “I support people with dementia. I get consent by prompting and reassuring. I would do this 3 times but would not carry out task if still refusing” and “I always ask permission to do things, but they do understand quite well and are still quite independent.”