CQC report explained · a residential care home
What the CQC found at Nightingale House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough appropriately skilled staff, safe recruitment, safe medicine systems and suitable infection control. They noted that not all dates were recorded on some records.
- Effective?
- Good
- Care plans were regularly reviewed and reflected people's needs and choices. Staff supported people with food, healthcare, communication and specialist equipment.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Relatives were involved in decisions about care and staff knew people's preferences.
- Responsive?
- Good
- Care and activities were tailored to people's needs and interests. Staff supported communication, family relationships and cultural needs.
- Well-led?
- Good
- The manager promoted a person-centred culture, used audits and welcomed feedback. The report says the manager planned to develop better systems for updating relatives.
What inspectors found, April 2022
Rated Good; inspectors found safe, kind and personalised care, with some records and family communication still being improved.
This was the first inspection since the home registered. It was unannounced and took place on 23 March 2022. Two inspectors spoke with five people, five staff members and four relatives. They also reviewed care, medicine, recruitment and management records.
The home supports up to 12 people with complex health needs, acquired brain injury, learning disabilities, autism or sensory impairment. Inspectors found enough trained staff, safe medicine management, good infection control and care plans that reflected people's needs and choices.
People were treated with kindness, dignity and respect. They were supported to stay healthy, see relatives, communicate in ways they understood and take part in activities suited to their interests. The manager was described as open to feedback and focused on improvement.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors noted that some records did not have all dates recorded. The manager also agreed to improve regular updates for relatives.
Personalised rooms
People could personalise their rooms and choose décor that reflected their interests and hobbies.
“People's rooms were very personalised, and people were able to decorate their room to reflect their interests and hobbies.” from the report
Kind and respectful care
Inspectors found that staff understood people's individual needs and protected their privacy, dignity and independence.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Safe medicines
Medicines were stored and given safely by trained staff. Regular checks were used to identify errors and reduce risk.
“Best practice guidance in the management of medicines was consistently followed. Records showed there were regular audits carried out on the way people's medicines were managed.” from the report
Activities and communication
People were supported to enjoy activities suited to their interests and to communicate in ways they understood.
“We observed staff interacting with people throughout the day in the sensory garden, they were enjoying different activities.” from the report
Open management
The manager welcomed inspection feedback and used it to identify improvements to communication and activities.
“The registered manager was very open and honest about what improvements were required and welcomed the inspection as an opportunity to learn.” from the report
Incomplete dates in records
needs fixingSome records did not include all dates. The manager said this would be corrected.
“However, not all dates were recorded on records and the registered manager told us this would be rectified.” from the report
Updates for relatives
needs fixingRelatives wanted more regular information about how people had spent their day, their activities and their mood. The manager said new systems would be developed.
“The key theme was relatives wanted to be regularly updated about how people had spent their day, activities and mood.” from the report
End-of-life planning
minorThe manager understood end-of-life planning, but had not been able to involve relatives in planning because of the age of people using the service and the sensitivity of the subject.
“The registered manager was knowledgeable about end of life care planning but had not been able to engage relatives in planning due to the nature of the service and the sensitivity when people using the service were so young.” from the report
- 01How have you corrected the records where dates were missing?
- 02What system do you now use to update relatives about daily activities, mood and wellbeing?
- 03How will you involve our family member and relatives in end-of-life planning if this becomes relevant?
- 04How do you make sure staffing levels change when people's needs change?
- 05How are communication methods agreed and reviewed for people who cannot communicate verbally?
This was the first full inspection of the newly registered home and covered all five CQC areas, including infection prevention and COVID-19 vaccination requirements. This explanation was written from the published report of 12 April 2022 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 2022
Targeted inspection, not rated; inspectors were assured about infection control during the COVID-19 pandemic.
This was an unannounced, targeted inspection on 16 February 2022. Inspectors looked mainly at infection prevention and control, visiting arrangements, and whether COVID-19 staffing pressures affected the home.
Inspectors were assured that the home used personal protective equipment safely, arranged testing, followed infection control guidance and kept its policies up to date. They also saw regular cleaning, including a weekly deep clean.
When people tested positive, the home supported them to isolate in ways suited to their needs. The home had stopped offering short-term respite care during the pandemic to reduce risks to people receiving long-term care.
The service was inspected but not rated. This report does not provide a full overall rating or ratings for most areas of care.
Managing infection
The home followed guidance when people tested positive and adapted isolation arrangements to individual needs.
“This worked well and meant that the person was kept safe and this minimised cross contamination.” from the report
Staff training
Staff had training in infection control, hand washing and the safe use of protective equipment. Their practical skills were checked.
“Staff had been trained in infection prevention and control, food hygiene and COVID-19.” from the report
Cleaning
Inspectors saw cleaning throughout the day, regular cleaning of touch points and a weekly deep clean by external cleaners.
“Every Wednesday external cleaners came into the home to carry out a deep clean to minimise the risk of infection and cross contamination due to the vulnerable nature of those living at the service.” from the report
Testing and vaccination
The home had regular COVID-19 testing for staff and residents. Staff had received COVID-19 vaccines and boosters.
“A regular programme of testing for COVID-19 was in place for staff and people who lived in the service.” from the report
Respite care was unavailable
minorThe home had been unable to offer short-term respite care during the pandemic. This was described as a measure to reduce risks to people receiving long-term care, but families needing respite should check whether it has resumed.
“The service had been unable to offer their short-term respite care service for people.” from the report
- 01Is short-term respite care now available, and if not, when is it expected to resume?
- 02How would you manage a COVID-19 outbreak or a person testing positive today?
- 03How do you manage staff shortages, and could staffing pressures affect the care provided?
- 04How often are staff trained and checked in infection prevention, hand washing and the use of personal protective equipment?
- 05What are the home's current visiting and testing arrangements?
This was an unannounced targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; it was not a full inspection and the service was not rated. This explanation was written from the published report of 11 March 2022 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
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- April 2022Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2022Inspected but not ratedSafe: Inspected but not rated
- December 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2019
Registered with the Care Quality Commission on 1 April 2019.
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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