CQC report explained · a nursing home
What the CQC found at Nightingale Nursing and Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2022
Rated Good; inspectors found safe, kind and personalised care, after the home improved from Inadequate and left Special Measures.
Inspectors visited without notice on 8 and 13 December 2021. They spoke with people, relatives, staff and managers. They observed care and checked care records, medicines, training and quality checks.
They found all five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People were generally safe, staff understood their needs, and medicines, food, healthcare and infection control were managed well.
The home had made improvements since the previous inspection, including better risk records, staffing, cleanliness, care planning, staff training and management checks. The previous inspection was rated Inadequate, but the home was no longer in breach of regulations or Special Measures.
Improved safety systems
Risk assessments and care plans were reviewed and updated. Staff understood the risks linked to people's health conditions.
“Risk assessments and care plans were reviewed regularly with people and relatives and updated when required.” from the report
Medicines and infection control
Inspectors found that medicines were managed safely and that cleanliness and infection control had improved since the previous inspection.
“Staff told us, and evidence showed that overall, medicines were documented, administered and disposed of in accordance with current guidance and legislation.” from the report
Kind and respectful care
Staff knew people well and protected their privacy and dignity. People were supported to make choices about their care.
“People looked clean, well presented and at ease in the presence of the staff who supported them.” from the report
Active management of improvements
The provider and managers used audits, feedback and action plans to identify and address improvements.
“These were effective in identifying areas where improvements were needed.” from the report
Some concerns about staffing levels
minorAlthough inspectors found enough staff overall, three relatives said there were occasions when staffing did not appear sufficient. They said staff were available when called.
“Three relatives said they felt there were occasions when there did not appear to be enough staff, but said if they called on staff, they were available.” from the report
- 01How many staff are planned for each shift, and how do you respond when staffing levels fall short?
- 02What refurbishment work is still outstanding, and how will you limit disruption to residents?
- 03How are risk assessments and care plans checked to make sure they still reflect each person's current needs?
- 04How do you monitor whether the improvements made after the previous inspection are being maintained?
- 05How are residents and relatives involved in reviewing care plans and giving feedback?
This was an unannounced follow-up inspection after the previous Inadequate rating, with infection prevention and control also checked under Safe. This explanation was written from the published report of 12 January 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, August 2021
Rated Inadequate and placed in special measures; inspectors found serious risks in care, medicines, staffing and management.
This was an unannounced inspection on 1 and 2 June 2021. Inspectors spoke with people, staff, managers and relatives. They observed care and checked care records, medicines, training and quality audits.
Inspectors found people were at risk because care risks, medicines, staffing, food and fluids were not always managed safely. Fire safety, building damage, dirty equipment and poor storage also created risks. Staff were usually kind and knew people's needs, but did not always have enough support or training.
The home was rated Inadequate overall. Safe and Well-led were Inadequate. Effective, Caring and Responsive were Requires Improvement. The service was placed in special measures, with CQC planning further monitoring and a reinspection.
Kind interactions
Relatives described care staff as approachable, friendly and kind. Inspectors saw people being treated warmly and with good humour.
“Care and support was offered by staff with warmth and good humour to everyone we saw.” from the report
Safeguarding awareness
Staff knew how to recognise and report abuse. They had safeguarding training and said they felt confident raising concerns.
“Staff understood how to recognise and report concerns or abuse. Staff received training in safeguarding and felt confident to raise concerns.” from the report
Food choices
People said the food was good and varied. Options were available for people with specific dietary requirements and some preferences were met.
“People told us the quality and variety of the food was good.” from the report
Access to healthcare
People could access GPs, dentists and other healthcare professionals. Records showed staff contacted health professionals when concerned about someone's wellbeing.
“People had access to GP, dentist services and other healthcare professionals.” from the report
Pressure ulcers and falls
seriousCare plans did not always explain how to prevent pressure ulcers or reduce falls. This left people at risk of avoidable harm.
“This put people at risk of developing pressure ulcers or existing wounds deteriorating.” from the report
Staffing and training
seriousThere had been periods of short staffing, and some people waited a long time for essential care. Staff had also missed required training in areas including fire safety, moving and handling and safeguarding.
“There were times when there was not enough staff to meet people's needs safely.” from the report
Building and cleanliness
seriousSome areas were damaged and difficult to clean. Equipment, including wheelchairs and pressure cushions, was dirty or stained, and some hazardous areas were not secured.
“Areas of the building were visibly damaged and therefore unable to effectively be cleaned to reduce the risk of infection.” from the report
Weak management checks
seriousAudits and other management systems did not identify or resolve important risks. Feedback and known problems were not acted on quickly enough.
“The provider had not ensured systems and processes to assess risk and monitor quality were sufficient and effective in driving improvements.” from the report
Involvement and privacy
needs fixingPeople were not always involved in care planning or reviews, especially if they had difficulty communicating. Personal information was not always kept securely.
“People were not always involved in reviews of their care, particularly where they were less able to communicate their needs.” from the report
- 01What has changed to prevent pressure ulcers and to review care plans after falls?
- 02How are medicated patches, oxygen therapy, medicines and missed doses now checked?
- 03What staffing levels are in place on each shift, and how are absences covered?
- 04Which staff have now completed the missing training, including fire safety, moving and handling, safeguarding and tissue viability?
- 05How do you check that care records, complaints, building safety and infection control problems are identified and resolved?
This was an unannounced inspection covering all five key questions, including infection prevention and control, with observations, discussions and checks of care, medicines, training and management records. This explanation was written from the published report of 21 August 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 Nursing and Care Home
7 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- January 2022Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Nightingale Nursing and Care Home →
- August 2021Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
Read what inspectors found at Nightingale Nursing and Care Home →
- February 2020Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2018Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- February 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2014Inspected but not rated
- March 2020
Registered with the Care Quality Commission on 4 March 2020.
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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