CQC report explained · a residential care home
What the CQC found at Nightingale House Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. The inspectors found suitable risk assessments, safe medicines systems, appropriate recruitment checks, enough staff and a clean environment.
- Effective?
- Good
- Care was delivered in line with guidance and people's needs. Staff were trained and supervised, people received support with food, drink and healthcare, and consent was sought.
- Caring?
- Good
- Staff were observed treating people with kindness, dignity and respect. People were offered choices and encouraged to remain independent.
- Responsive?
- Good
- Care plans were personalised and kept up to date. The home supported communication needs, activities, complaints and sensitive end of life care.
- Well-led?
- Good
- The home was well managed, with quality checks used to identify improvements. People, relatives and staff were involved in giving feedback and shaping the service.
What inspectors found, April 2019
Nightingale House Care Centre was rated Good in all five areas, with safe, kind and personalised care found.
This was an unannounced planned inspection on 28 February 2019. One inspector reviewed care records, medicines, staff files, training, staffing rotas and quality records. They also spoke with people living in the home, relatives, staff and a visiting healthcare professional.
The inspectors found that people were protected from harm, received their medicines safely and had enough staff support. Staff were trained, people's health and dietary needs were supported, and the home worked with other health and social care professionals.
People were treated with kindness, dignity and respect. Their care plans reflected their needs and choices. Activities, communication support, complaints handling and end of life care were also found to be responsive.
The home was rated Good for Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating as the previous inspection, published on 13 September 2016.
Enough staff
The inspectors found that staffing levels were sufficient to meet people's needs, and recruitment checks were completed before staff started work.
“There were enough staff deployed to support people with their needs.” from the report
Safe medicines
Medicines were ordered, stored, recorded, given and disposed of safely. Records showed people received medicines as prescribed.
“Medication administration records showed that people had received medicines as prescribed.” from the report
Kind and respectful care
People described staff positively, and inspectors saw staff being kind, caring, thoughtful and respectful.
“We observed staff approach was kind, caring, thoughtful and helpful.” from the report
Personalised support
Support plans were individually developed and updated as people's needs changed. People were supported to make choices about their care and daily lives.
“People's support plans were individually developed with information on different aspects of their care.” from the report
Good leadership
The provider used quality checks to identify shortfalls and make improvements. People, relatives and staff had opportunities to give their views.
“The provider's quality assurance system was consistently operated to identify any shortfalls in service delivery and make improvements to it.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you update our relative's care plan if their needs or preferences changed?
- 02How do you make sure medicines continue to be given safely and recorded correctly?
- 03What activities and communication support would be available for our relative's interests and needs?
- 04How would you involve us in decisions about care, including end of life preferences?
- 05What were the two ongoing complaints mentioned in the report, and what action was taken in response?
This was a planned inspection covering all five CQC questions, including both the premises and the care provided; the previous overall rating was Good. This explanation was written from the published report of 10 April 2019 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, September 2016
Rated Good overall; inspectors found kind, safe care, but the home was Requires Improvement for being well-led because records and some checks were not reliable.
The inspection was unannounced and took place on 8 August 2016. Inspectors observed care, spoke with people, relatives and staff, and checked care plans, training, audits and medicines records.
People were cared for safely and staff were kind, respectful and responsive. Inspectors found that medicines were handled safely, people had access to healthcare, food and activities, and staff supported people's choices and dignity.
The main weakness was management checking. Care records were incomplete, one person's allergy information did not match the medicines records, and some policies and information were out of date or missing. The home was rated Good overall, with Good ratings for Safe, Effective, Caring and Responsive, but Requires Improvement for Well-led.
Prompt, safe care
Inspectors saw staff respond promptly. People and relatives said they felt safe, and medicines were stored and administered safely.
“We observed staff responded to people promptly.” from the report
Food and nutrition
People had meal choices, suitable alternatives and support with eating and drinking. Special dietary needs, allergies and dislikes were recorded for staff.
“People were offered a choice of three meals.” from the report
Kind and respectful staff
Staff supported people calmly and sensitively. Inspectors saw staff respect privacy, dignity, preferred names and individual choices.
“We saw that staff interacted in a positive manner with people and that they were sensitive to people's needs.” from the report
Activities and relationships
People could take part in a range of activities or receive one-to-one time in their rooms. Relatives were welcomed and supported to maintain relationships.
“People had access to activities and leisure pursuits.” from the report
Open management
Staff felt supported and able to raise concerns. Meetings, surveys and some action plans were used to involve people and improve the service.
“The registered manager created an open culture and supported staff.” from the report
Incomplete and conflicting records
seriousAll four care files checked contained incomplete documentation. In one file, allergy information did not match the medicines administration records, making it harder for staff to check medicine safety.
“We also found in one care record the person's allergies listed did not match with the medicine administration sheets.” from the report
Weak quality checks
needs fixingThe home's checks had not identified the problems with care records. This was the main reason the Well-led rating was Requires Improvement.
“In all the files we looked at we found incomplete documentation.” from the report
Missing keypad policy
needs fixingThe building used a keypad, but there was no policy to make sure the entry number was monitored and changed regularly. Inspectors said this could allow inappropriate access.
“the provider did not have a policy in place to ensure that the allocation of the number was monitored and changed regularly in order to safeguard people against intruders.” from the report
Care records not always secured
needs fixingCare records were kept in an office, but the door was not always locked. The registered manager said there were plans to provide more secure storage.
“the care records were not always stored in a locked area to ensure people's personal details were protected.” from the report
Limited life-history information
minorThe care records did not include people's past life experiences. Staff knew people's likes and dislikes, but the report said this information would help them plan suitable activities.
“The care records we looked at did not detail people's past life experiences.” from the report
- 01How do you now check that every care record is complete and up to date?
- 02How do you make sure allergy information always matches the medicines administration records?
- 03Has a policy been introduced for monitoring and regularly changing the external door keypad number?
- 04How are care records kept securely when the office is not occupied?
- 05How do you record people's past experiences and use them to plan activities?
This was an unannounced inspection covering all five CQC questions, using observations, discussions with people, relatives and staff, and checks of four care plans and other records. This explanation was written from the published report of 13 September 2016 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 House Care Centre
2 rated inspections over 3 years: the service has held its Good rating throughout.
- April 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Nightingale House Care Centre →
- September 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Nightingale House Care Centre →
- September 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 12 January 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.
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9 live-in carers within about an hour of Lincolnshire
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.
8 can care for a couple. 10 years' experience on average.
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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.