Archived: Nightingale Homecare Norfolk (Brooke)

Nightingale Homecare Norfolk (Brooke) is a domiciliary care service. They provide personal

care and support 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. At the time of our inspection the service was providing a regulated activity to 45 people.

People’s experience of using this service and what we found

People’s end of life care needs were not routinely assessed. We have made a recommendation that the provider review how it meets people’s end of life care needs.

People were protected from the risk of harm. Risks to people were assessed and staff took action to help mitigate identified risks. People were supported staff who had been recruited safely. People received support from fairly regular and consistent staff. The provider had recently implemented new systems which would help them to provide more regular and consistent visits for people. People’s medicines were managed safely and people received these as prescribed. People were supported by staff who had a good understanding of proper hygiene and infection control. Incidents that occurred in the service were reviewed. Appropriate actions to mitigate the likelihood of a repeat incident were taken.

Holistic assessments of people’s needs were carried out. People were supported by competent and trained staff. Where people required support with their meals this was done appropriately and staff supported people to eat the food they liked. People’s health care needs were assessed and staff supported people in this area where required. 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.

People were supported by kind and caring staff, who often gave up their own free time and resources to help enhance the quality of people’s lives. People’s independence was respected and supported. There were meaningful opportunities for people to discuss and make decision about the support provided.

People received person centred care which met their individual needs and preferences. People’s preferences and wishes in relation to the service provided were accommodated where possible. People had care plans in place which provided guidance and information for staff, although in some areas would have benefited from more person centred detail. People’s communication needs were assessed and supported. Staff understood the importance of social inclusion and supported people with social needs, this included facilitating the sharing of information with relatives when appropriate. People and relatives felt able to discuss any concerns about the service with staff. Staff took responsive action in response to any issues raised.

People and relatives felt some aspects of the service required further work. This was in relation to communication from the office and consistency of calls. The provider and registered manager were committed to seeking feedback from people using the service so they could make changes which would result in improved outcomes for the people using it. The provider had recently implemented changes to help improve communication and consistency of calls. There was good oversight of the service delivery by both the provider and registered manager. The provider had recognised the service could be strengthened by the development of a more formal governance system, plans were in place to address this. Staff felt happy and supported working in the service.

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 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

There was a registered manager 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.

The service was safe. Staff had assessed risks to individuals and mitigated them appropriately. Staff were aware of safeguarding procedures and knew how to report any concerns they had. There were enough staff and people’s visits were always covered. Staff were recruited safely.

Staff supported people safely to take their medicines and the records were clear. Where needed, staff provided prompting for people to take their own medicines.

People received a high standard of care from trained staff. Staff received supervisions regularly and felt supported at work. They sought consent before delivering care and were aware of individual’s mental capacity to make decisions. Staff supported people to access healthcare services when required.

Staff supported people with their meals when they needed, and encouraged people to drink enough. These needs were also specified in people’s care plans.

People were cared for by staff who knew them well and communicated effectively with them. Staff went above their expected duties to ensure that people maintained as much comfort and well-being as possible. People were involved and consulted about their care, and their independence, privacy and dignity was promoted.

People received individualised care according to their own needs, and when they changed, staff responded and were flexible. People were asked for their feedback on the service they received and knew how to raise a concern and who to, if they needed to.

The service had a positive staff team, and good leadership was in place. There were systems in place to ensure that high quality care was delivered continuously and any potential problems would be identified in a timely manner.