CQC report explained · a residential care home
What the CQC found at Nightingale Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People received safe care and treatment, with enough staff, safe recruitment, appropriate safeguarding and well-managed risks. Some staff needed more support to understand certain safety procedures and spoken English.
- Effective?
- Requires improvement
- This key question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- The home had strong quality checks, an improvement plan and a positive, inclusive management culture. Managers sought feedback from people, relatives and staff.
What inspectors found, June 2023
Rated Good; inspectors found safe, kind care and stronger management, but some staff needed more support with spoken English and care procedures.
This was an unannounced focused inspection, including some out-of-hours checks of night care. Inspectors spoke with people, relatives, managers and care staff. They reviewed care plans, medicines records and records about safety and quality.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe recruitment, suitable risk management, safe medicines practice and effective safeguarding. People and relatives gave positive feedback about the care and kindness.
Some staff needed further support with spoken English and understanding certain procedures. The provider had already started language support and further training. Inspectors also noted a damaged section of flooring, occasional lack of staff presence in one lounge and one medicines record needing review.
This inspection focused only on Safe and Well-led. The other key question ratings were carried over from the previous inspection. The overall rating improved from Requires Improvement in 2019 to Good, and the previous breach was no longer in place.
Kind and reassuring care
People and relatives spoke positively about the care. They described staff as kind, welcoming and attentive to individual needs.
“I feel safe with the carers, they put me at my ease and make you feel welcome.” from the report
Safe staffing and recruitment
Inspectors found enough staff to meet people's needs and saw that recruitment checks had been completed safely.
“There were enough staff to meet people's needs.” from the report
Risk management
The home assessed risks such as falls, choking and pressure ulcers, and used equipment and professional advice to reduce them.
“We saw action was taken to reduce risk where possible.” from the report
Medicines handled safely
Staff were trained and checked as competent to administer medicines. Inspectors saw medicines being given safely and found accurate records overall.
“Medicines were well managed, and the provider kept accurate records.” from the report
Active quality monitoring
Managers used audits, feedback and an improvement plan to monitor the service and identify further work.
“Audits fed into an overarching service improvement plan.” from the report
Spoken English and staff understanding
needs fixingSome staff needed more support with spoken English and their understanding of particular safety procedures. The provider had started language support and planned refresher training.
“Some staff required further development and support to be confident in their skills and in their spoken English.” from the report
Gaps in safety procedure knowledge
needs fixingSome staff did not fully understand the added risk of internal bleeding for people taking blood-thinning medicines, fire evacuation arrangements or how to make external safeguarding referrals.
“The additional falls risk of internal bleeding for people taking blood thinning medicines was not well understood by 2 members of staff.” from the report
Occasional unattended lounge
minorOne main lounge was occasionally without a staff member for a few minutes. Managers said staff were nearby and agreed to keep this under review.
“One of the main lounges was left without a staff presence occasionally for a few minutes at a time.” from the report
- 01What language support and refresher training have staff received since the inspection?
- 02How do you check that staff understand the risks of internal bleeding for people taking blood-thinning medicines?
- 03Has the damaged upstairs flooring been replaced, and how was the trip risk managed while work was pending?
- 04How do you make sure the main lounge has suitable staff oversight at all times?
- 05What action was taken after the medicines record needing review was identified?
This was an unannounced focused inspection of Safe and Well-led, including some night-time care; the other ratings were carried over from the last inspection. This explanation was written from the published report of 15 June 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2021
Inspected but not rated; inspectors were assured that infection prevention and control arrangements were safe.
This was an unannounced, targeted inspection about infection prevention and control during the coronavirus pandemic. Inspectors visited on 09 December 2020 and continued some inspection work remotely until 17 December 2020.
Inspectors were assured that the home was managing visitors, admissions, shielding, social distancing, PPE, testing, cleaning and infection outbreaks. They also found that the infection prevention and control policy was up to date.
The home was clean during the visit. Staff were seen wearing PPE correctly, risk assessments were in place, and people living in the home and staff were receiving COVID-19 tests.
The service was inspected but not rated. This means the report does not give a Good, Requires improvement or Inadequate rating for the service overall.
PPE was available and used
Staff were observed wearing PPE in line with government guidance. PPE was available in different parts of the building.
“Staff were observed to be wearing Personal Protective Equipment (PPE) in line with current government guidelines.” from the report
Clean environment
Inspectors found the home clean. Staff had helped with domestic duties when members of the domestic team were off sick.
“The service appeared clean throughout the visit. Staff informed us that they had been supporting with domestic duties to cover sickness of the domestic team, ensuring the service remained clean at all times.” from the report
Risk assessments
Risk assessments were in place for staff and people living in the home.
“Risk assessments were in place for both staff and people who used the service, ensuring that both staff and the people using the service remained safe at all times.” from the report
COVID-19 testing
Staff and people living in the home were receiving COVID-19 tests in line with government guidance.
“All staff and people who use the service were receiving COVID-19 testing as per government guidelines.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you currently making sure PPE is available in all the areas where staff need it?
- 02How often are risk assessments for residents and staff reviewed?
- 03What arrangements are currently in place for visitors and for admitting new residents safely?
- 04How are COVID-19 testing arrangements managed for residents and staff now?
- 05How would you manage an infection outbreak, and how would families be kept informed?
This was a targeted inspection of infection prevention and control practices only; the service was inspected but not rated and the other four areas were not assessed. This explanation was written from the published report of 21 January 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Nightingale Care Home
6 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- June 2023Goodcurrent ratingSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- January 2021Inspected but not ratedSafe: Inspected but not rated
- November 2020Inspected but not ratedSafe: Inspected but not rated
- April 2019Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- June 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: InadequateResponsive: Requires improvementWell-led: Inadequate
- October 2017Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Registered with the Care Quality Commission on 15 September 2014.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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