About the service
Nightingale Court is a residential care home providing personal care to up to 63 people. At the time of our inspection there were 31 people using the service.
Nightingale Court accommodates 43 people in one adapted building across three floors.
People’s experience of using this service and what we found
Aspects of the home’s environment posed a potential risk of harm to people. Environmental shortfalls had not been identified by the provider in order to mitigate potential risk of harm. Staff were not fully competent of what procedures they would follow in the event of a fire and how to safely evacuate people. The manager put immediate steps in place to ensure staff’s knowledge in this area improved.
People's medicines were mostly managed in a safe way; however, improvements were needed to ensure medication that was given in disguise in food or fluid was administered in a safe way. Medication was stored and disposed of in a safe way.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
The provider systems were not consistently applied or robust to identify shortfalls in a timely way. We found areas that required improvement. In addition to this, the providers systems had not identified that notifiable events must be reported to the CQC had not been consistently submitted in 2021.
People told us they felt safe and supported by the staff who worked in the home. Relatives felt their family member was safe and cared for in the right way. Staff recognised different types of abuse and how to report it. The manager understood their safeguarding responsibilities and how to protect people from abuse.
Potential risks to people's individual health and wellbeing had been identified and were managed safely. People, and where appropriate, their relatives, had been involved with decisions in how to reduce risks associated with people’s care.
There were sufficient staff on duty to keep people safe and meet their needs.
Safe practice was carried out to reduce the risk of infection.
People's care needs had been assessed and reviews took place with the person and, where appropriate, their relative. Staff had the training and support to be able to care for people in line with best practice. People were supported to have a healthy balanced diet and were given food they enjoyed. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people following best practice.
People told us staff were kind and treated them well. Relatives felt the staff cared for their family member in a caring and supportive way. Staff treated people as individuals and respected the choices they made. Staff treated people with care and respect and maintained their dignity.
People's care was delivered in a timely way, with any changes in care being communicated clearly to the staff team. People were supported to maintain their hobbies and interests. The manager told us their plans to improve activities for people who lived with dementia. People had access to information about how to raise a complaint. People's end of life care needs were met in line with their preferences in a respectful and dignified way.
The provider had supported the new manager by employing a previous registered manager of the home, to provide checks and support to the new manager. All people, relatives and staff felt the service was well run. The manager was visible within the home and listened to people's and staff's views about the way the service was run. The manager had put checks into place to monitor the quality of the service provision.
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 good (published 17 January 2018).
Why we inspected
The inspection was prompted in part due to concerns received about staffing and care and treatment of people who lived in the home. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-Led sections of this full report.
Following our findings on inspection, the manager took prompt action to rectify shortfalls and put plans in place to improve the service.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Nightingale Court on our website at www.cqc.org.uk.
We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.