Nightingale

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

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 service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. A culture of openness and transparency empowered people at Nightingale. Staff promptly reported incidents, felt confident raising concerns, and trusted the registered manager’s clear risk management procedures. All incidents were recorded on the electronic governance system, reviewed, and audited to identify trends and improvements. Safety issues were consistently investigated and used as learning opportunities. Staff described a supportive environment with ongoing training, supervision, and reflective practice, feeling empowered to share ideas for improvement. Partner organisations praised the team’s responsiveness and cooperation, and relatives confirmed they were kept informed. One relative said, “It is a very honest setup, and they inform me about everything”.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Relatives and staff said that care decisions were clearly explained and that referrals were made quickly when needed. The registered manager had good relationships with external professionals. One professional commented, “I feel the residents at Nightingale are safe. They have individualised care plans, risk assessments, and support systems in place, which staff are very familiar with and follow appropriately.’’ Regular team meetings allowed open discussions about care and safety.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.People said that they felt happy, safe and cared for. One person said, “Staff make me feel safe.’’ Relatives also expressed trust in the service. One relative said, “My loved one feels safe because there are staff who have been there for a very long time and know people well. We are happy to keep our loved one there.’’ During the inspection we observed staff working in a safe and caring way. Safeguarding procedures were well established. Staff told us they understood how to raise concerns and were confident these would be taken seriously by the registered manager. A professional praised the service’s strong understanding of safeguarding, noting that they responded quickly. The service followed the principles of MCA and all DoLS applications were managed appropriately, including notifying the Care Quality Commission (CQC), as required by law. The registered manager kept oversight of authorisations, and staff received training to help protect people from harm.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.People had care plans and risk assessments to guide staff while promoting independence and choice. People were encouraged to take positive risks, such as going out into community and joining activities they enjoyed. Staff managed any potential anxiety or distress carefully so people could still take a part in meaningful experiences. During the inspection, one person returned from an outing looking happy and relaxed. A relative shared, “[Staff name] had done amazing work with activities. Our loved one is doing so much more.’’

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.People and their relatives spoke positively about the service, describing it as homely, clean, and well maintained. The environment was suitably adapted for young adults with complex needs, and people appeared relaxed and comfortable in shared areas. Staff interactions were warm and supportive, creating a calm atmosphere. The registered manager ensured the environment was safe, with systems to identify and manage risks. Maintenance staff were trained in areas such as fire safety and health and safety, while external contractors completed regular checks, including gas and fire inspections. Fire drills, including nigh time evacuation, were held regularly and each person had up to date personal emergency evacuation plans. The fire alarm was tested weekly. This meant the system remained in good working order, ensuring the safety of everyone inside.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.Recruitment checks were in place before staff started work. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions. Staffing levels were sufficient to meet people’s needs safely. One relative said, “I think Nightingale do their best to keep our loved ones safe. Staff are incredible and respectful.’’ People received 1-to-1 or 2-to-1 support, allowing them to make choices about their daily activities. Staff received training in areas such as learning disabilities, autism, epilepsy, life support, safety interventions, and positive behavioural support. A staff member said, “Training is very interesting. We are learning and becoming more enlightened on how to communicate with people and give them better support.’’ Regular supervision, appraisals, and a structed induction helped staff maintain the skills and confidence needed to provide safe and effective care.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff received training in infection prevention and control (IPC) and had access to appropriate personal protective equipment (PPE). The service had a dedicated staff member to maintain cleanliness according to set schedules. The environment was clean, tidy, and well-maintained, and people and relatives expressed confidence in hygiene standards. We observed the premises to be clean and free of unpleasant odours throughout our site visit, with staff wearing PPE as required.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.People received their medicines as prescribed, and staff understood safe medicines practices. Each person had guidance for ‘as required’ medicines and paraffin-based skin products as these have an increased fire risk. Medicines were administered safely, respecting people’s needs and preferences. Stock levels were accurate, and people were involved in the medicine planning. Safe procedures covered ordering, storage, administration, and disposal. Staff received training and regular competency checks, and audits by the registered manager. Staff members and the external pharmacy ensured procedures were consistently followed.