CQC report explained · a residential care home
What the CQC found at Nightingale Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2023
Inspected but not rated; inspectors found people were kept safe, but communication and incident reporting needed improvement.
This was an unannounced, targeted inspection on 27 June 2023. Inspectors checked concerns about people's safety and staffing levels, and looked at infection prevention measures. They spoke with people, staff and managers and reviewed care and other records.
Inspectors found that risks were monitored and managed, and that there were enough staff to keep people safe and meet their needs. Staff said unplanned absences sometimes made shifts busier. Some staff also felt an extra worker on day and night shifts would improve the quality of care.
Communication between staff was not always open or transparent. Inspectors also found that some incidents that should have been reported to the CQC were not submitted on time.
This inspection did not give new ratings. Safe and well-led were both recorded as inspected but not rated. The previous overall rating was requires improvement, and that rating remained unchanged.
Risk management
People's care risks and plans reflected their current needs. Staff understood these risks and supported people to make choices safely.
“Risks associated with people's care were monitored and managed in a way which kept them safe.” from the report
Staffing safety
People and staff told inspectors there were enough staff to meet people's needs and keep them safe. Staff were visible and attentive in communal areas.
“People we spoke with felt there were enough staff to meet their needs and keep them safe.” from the report
Recruitment efforts
The manager was recruiting and retaining staff, with less reliance on agency workers. Additional day and night staff were planned for the coming weeks.
“The registered manager had been continually recruiting staff into the team and there was less reliance on agency staff.” from the report
Communication between staff
needs fixingStaff concerns were not always shared openly with managers, which could make it harder for the home to investigate problems and improve.
“Communication within the staff group needed improving, as openness and transparency were, at times, lacking.” from the report
Incident reporting
needs fixingSome incidents that should have been reported to the CQC were not submitted promptly. The home's reporting systems needed strengthening.
“The provider's systems for notifying CQC of incidents and events that had taken place in the home required strengthening.” from the report
Unplanned staff absences
needs fixingShort-notice absences could leave staff busier, even though staff and inspectors found people were kept safe. Some staff felt an extra worker on day and night shifts would improve care.
“They told us sometimes they would be short-staffed due to unplanned absences, that could not always be filled at short notice.” from the report
- 01What extra day and night staffing has been put in place since the inspection?
- 02How do you make sure staff can raise concerns openly and have them acted on?
- 03How do you check that incidents are reported to the CQC within the required timescale?
- 04How do you cover short-notice staff absences?
- 05When will the next comprehensive inspection assess the areas that were not covered here?
This was a targeted inspection of specific concerns about safety and staffing, with some infection control checks; it did not assess the full Safe or Well-led questions, and did not assess Effective, Caring or Responsive. This explanation was written from the published report of 19 July 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, March 2023
Requires Improvement; inspectors found safer care in several areas, but unsafe staff recruitment practices remained a serious concern.
This was an unannounced focused inspection on 9 and 13 February 2023. One inspector spoke with people, staff and health and social care professionals, and checked care, medicine, training, staffing, recruitment and quality records.
The home had improved since the previous inspection. Risks in the building were better managed, staff training had improved, and legal applications about restrictions on people's freedom had been submitted where needed. People said they felt safe, received their medicines and had enough staff support.
However, checks before employing some newer staff were incomplete. Four files did not contain references from previous employers, employment histories were not thorough, identification checks were incomplete and one staff member was working without a full DBS check. The home breached Regulation 19, so the overall rating remained Requires Improvement.
Enough staff
People said there were enough staff, and inspectors saw staff paying attention to people. Staffing was reviewed when people's needs changed.
“People we spoke with felt there was enough staff to meet their needs and keep them safe.” from the report
Improved safety
Risks in the building were better controlled than at the previous inspection. Staff understood how to evacuate people, window restrictors had been improved and access to an unsafe top floor was better managed.
“At this inspection staff had received training and understood how to evacuate people in the event of a fire.” from the report
Good staff training
Staff had training suited to people's needs, including training about dementia and safe moving and transferring.
“At this inspection we saw good practice where people required support to move and transfer.” from the report
Food and drink support
People were offered suitable food and drinks, alternatives were provided when needed, and staff supported people to eat at their own pace.
“We saw mealtimes were a positive experience for people.” from the report
Improved legal safeguards
Applications had been submitted where people were thought to be deprived of their liberty. Records showed best-interest meetings and plans for conditions attached to authorisations.
“At this inspection improvements had been made, and applications had been submitted where it was felt people were being deprived of their liberty.” from the report
Incomplete recruitment checks
seriousRecruitment records did not consistently include previous employer references, full employment histories or complete identification checks. One staff member was working without a full DBS check, creating a potential safety risk.
“Without robust recruitment checks in place unsuitable people may be recruited as a result, which may place people at potential risk of harm.” from the report
Missed incident notifications
needs fixingThe home did not initially report some allegations of abuse to the CQC. These notifications were submitted retrospectively after the inspection, showing that reporting arrangements were not fully understood.
“We found gaps in the manager's and provider's knowledge of when these types of notification should be sent.” from the report
No registered manager in post
needs fixingThere had been no registered manager since January 2022. The manager in post had applied to register, and the CQC was still assessing that application.
“The provider had not had a registered manager in post since January 2022.” from the report
- 01Have all staff files now been checked to make sure previous employer references, full employment histories and identification checks are complete?
- 02Is every staff member now working with a full DBS check, and how are any DBS-related risks monitored and reviewed?
- 03What system is now used to make sure allegations of abuse and other notifiable incidents are reported to the CQC on time?
- 04Has the manager's application to become registered been approved, and if not, who has formal responsibility for the home?
- 05What further work remains on the home's environment, including the bathroom and other areas still being improved?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 22 March 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.
Every inspection of Nightingale Court
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- July 2023Inspected but not ratedcurrent ratingSafe: Inspected but not ratedWell-led: Inspected but not rated
- March 2023Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2022Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- January 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- November 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- July 2011
Registered with the Care Quality Commission on 21 July 2011.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Worcestershire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 85 can care for a couple. 9 years' experience on average.
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.