We carried out a review of the data available to us about Nightingale Homecare East Sussex Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Nightingale Homecare East Sussex Ltd, you can give feedback on this service.
Nightingale Homecare East Sussex Ltd is a Domiciliary Care Agency (DCA) that provides personal care and support to 63 people living in their own homes, some of whom were older people, and/or had physical disabilities, and some people who were living with dementia.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
People’s medicines were managed safely. People were protected from avoidable harm and abuse. Safeguarding policies and procedures were embedded within practice and were consistently followed. Staff had recognised signs of abuse and had recorded their concerns.
People told us they were happy with the care they received, and that staff helped them to feel safe.
Risk assessments and care plans guided staff in how to provide care safely and in the way the person preferred. There were enough suitable staff employed to cover all the care visits. People said they received their calls on time and for the duration that they expected.
People received care that was tailored to meet their individual needs and choices, while staff were responsive to changes in their needs. Care plans guided staff about people's needs and how to meet them. People’s concerns and complaints were listened to and used to improve the service they received. When people wished to discuss their end of life wishes, these were captured and carried out by staff.
Systems for monitoring quality and managing risks had been improved. There were arrangements to support governance and to provide management oversight. People, their relatives and staff told us that communication was good and that staff listened to them and involved them in their care.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 3 August 2019). There were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out a comprehensive inspection of this service on 14 June 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Responsive and Well Led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Nightingale Homecare East Sussex Ltd on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Nightingale Homecare East Sussex Ltd is a domiciliary care agency in Eastbourne. It provides support with personal care to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
Improvements were needed to ensure risks to people in relation to some aspects of medicines management and risk assessments were managed safely.
People’s care plans were task-based and did not reflect the person-centred support people received. Improvements were needed to ensure staff had all the information they needed in provide end of life care.
There was a quality assurance system, but this had not identified the shortfalls we found.
People received the care and support they needed because staff knew them really well and understood their needs. They were able to tell us about people as individuals, their choices and preferences as to how they liked their care delivered. People were treated with kindness, respect and understanding. They were enabled to make their own decisions and choices about what they did each day.
Staff had a good understanding of safeguarding and how to protect people from the risk of harm or abuse. There were enough staff who had been safely recruited to look after people.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff received training that enabled them to deliver the care that people needed. Staff received support from the registered manager and their colleagues. People's health needs were met, they were supported to have access to healthcare services when they needed them.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (Report published 19 October 2016).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified a breach of regulation in relation to risks to people, including medicines. We also found a breach of regulation in relation to people's records and the quality assurance system.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
East Sussex Helping Hands is a domiciliary care agency based in Eastbourne. They provide support and care for 83 older people living in their own home in Eastbourne, Polegate, Pevensey, Westham and Hailsham. East Sussex Helping hands provides support for people who require a range of personal and care support related to personal hygiene, mobility, nutrition and continence. Some people were living with dementia and other long term health related conditions including anxiety and depression.
The service had a registered manager. 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.
People told us they felt safe receiving the care and support provided by East Sussex Helping Hands. Staff understood and could recognise the signs of potential abuse and knew what to do if they needed to raise a safeguarding concern. Training schedules confirmed staff had received training in safeguarding adults at risk.
Robust recruitment and selection procedures were in place and appropriate checks had been made before staff began work at East Sussex Helping Hands. There were sufficient levels of staff to protect people’s health, safety and welfare consistently and reliably.
People said staff were caring and kind and their individual needs were met. One person told us, “They are my guardian angels.” Another person said, “The staff are so polite.” Staff knew people well and had a good understanding of their needs and choices.
Care plans and risk assessments reflected people’s assessed level of care needs. People were encouraged to be as independent as possible. One person told us, “I can do most things myself, but if I need any further help I can just ask for it.”
Staff felt supported by management, said they were well trained and understood what was expected of them. Staff were encouraged to provide feedback and report concerns to improve the service. A member of staff told us, “I love my job. We have a good team.”
There was a complaints policy and information regarding the complaints procedure was available. Complaints were listen to and investigated in a timely manner and used to improve the service.
Regular audits were in place to measure and monitor the quality of care and service provided.
People and staff surveys were positive about East Sussex Helping Hands. One person commented, “We cannot fault our care.” A member of staff told us, “It is a good company to work for.”
We spoke with people who used the service, and their relatives/Next of Kin (NoK).
We looked at care documentation and saw that care plan reviews had taken place. People we spoke with told us 'I am happy with everything' and 'I love my carers, and everyone associated with them.'
Staff had attended safeguarding training, and displayed knowledge of how to recognise and report concerns. On the day of the inspection staff were attending a Mental Capacity training refresher.
Staff records showed that appropriate checks had taken place before people commenced employment.
The provider had systems in place to assess and monitor the quality of the service provided.
The inspection team was led by a CQC inspector and joined by an Expert by Experience, (someone who has personal experience of using or caring for someone who uses this type of service).
We used telephone interviews and home visits to talk with people who used the service and their main carers (relatives or friends) to gain their views about the service.
We visited four people in their own homes and spoke with a relative of one of the people we visited. We also spoke with four care workers, the manager and the provider of the service.
All of the people we spoke with were positive about the service and felt that their care needs were met. One person said 'I'm over the moon, staff are so good with me, they are on the ball.' People using the service understood the care choices available to them and they told us 'The carers do everything that I want them to and then ask if they can do anything else before they leave,' and 'had regular carers for 12 years they are wonderful.' People told us that they felt respected, one person said 'Staff are very pleasant, they treat me with respect and they have become like friends."