CQC report explained · a residential care home
What the CQC found at Nightingale
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found enough staff, suitable risk assessments, safe recruitment, safe medicines systems and a clean home.
- Effective?
- Good
- Staff were trained and supported, and people's health, nutrition and hydration needs were met. The home worked with health professionals and followed the principles of the Mental Capacity Act.
- Caring?
- Good
- Staff were kind, respectful and familiar with people's personalities and needs. People were supported with dignity, choice and independence.
- Responsive?
- Good
- Care was personalised and adapted as people's needs changed. There was a wide range of activities, communication support and a complaints process that people and relatives trusted.
- Well-led?
- Outstanding
- Leadership was exceptional. Inspectors found a positive, welcoming and inclusive culture, strong community partnerships and robust systems for improving care.
What inspectors found, March 2020
Nightingale was rated Good overall, with Outstanding leadership and inspectors finding safe, kind and highly personalised care.
This was an unannounced planned inspection on 12 February 2020. One inspector and an Expert by Experience spoke with eight people, 10 relatives and seven staff. They reviewed care and medicines records, staff files, management records and the building.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, safe medicines systems, suitable training, kind and respectful care, personalised support and many activities. People were supported to make choices and stay involved in their care.
Well-led was rated Outstanding. Inspectors found exceptional leadership, strong links with community organisations and a culture where people's ideas were acted on. The overall rating remained Good, the same as at the previous inspection in June 2017.
Exceptional leadership
Inspectors found unusually strong leadership and a clear focus on person-centred care. The management team used feedback and audits to improve the service.
“The registered manager demonstrated clear and effective leadership skills.” from the report
Meaningful activities
People had many activities inside and outside the home. Staff helped people try new experiences and stay connected with the local community.
“There was a wide range of activities on offer to people living at Nightingale, both within the home and in the local community.” from the report
Kind and personalised care
Staff knew people well, respected their choices and encouraged independence. Inspectors observed positive interactions and reassurance when people were upset or anxious.
“Staff demonstrated a good knowledge of people's personalities, individual needs and what was important to them.” from the report
Safe medicines and staffing
Inspectors found enough staff to meet people's needs promptly. Medicines were ordered, stored, given and disposed of safely.
“People's medicines were ordered, stored, administered and disposed of safely, in accordance with good practice guidelines.” from the report
Strong community links
Partnerships with health services, education providers and community groups created more opportunities for people and supported coordinated care.
“The registered manager had forged excellent links with other organisations in the community, such the local university, college, and various schools, churches and children's groups.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure the wide range of activities still matches each person's interests and abilities?
- 02How are medicines checked and reviewed, and how are families told if there is a medicines error?
- 03How often are care plans updated when a person's needs change?
- 04How will you involve my relative and our family in decisions about care, activities and the home?
- 05How do staff support people with dementia to find their rooms and move around the home safely?
This was an unannounced planned inspection covering all five key questions, with the previous overall rating of Good carried forward and Well-led improving from Good to Outstanding. This explanation was written from the published report of 18 March 2020 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, June 2017
Rated Good; inspectors found safe, kind and personalised care, with a few minor issues needing attention.
Inspectors visited the home without warning on 6 April 2017. They spoke with residents, relatives, managers and care staff. They observed daily care and mealtimes, and checked care records, staff recruitment files, medicines records, policies and audits.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, suitable staff checks, support with food and drinks, access to health professionals and care that respected people's choices and dignity.
The home had improved since the previous inspection in May 2016. Earlier concerns about staffing, person-centred care, food and drinks, and staff supervision had been addressed. Inspectors still found a few isolated issues, including one wheelchair transfer and one care plan that needed updating.
Improved staffing
Inspectors found that the earlier staffing shortage had been addressed. Staff were visible in areas where people were present, and a new hostess role helped care staff respond to individual needs.
“At this inspection we saw that this had been addressed. More staff had been employed and staff were deployed in creative ways, to meet people's needs.” from the report
Kind and respectful care
Staff appeared to know residents well and supported their choices about when to get up, what to wear and where to sit. Inspectors saw staff treating people with dignity and patience.
“We saw people were treated with dignity and respect, and that staff were kind and attentive to people's needs.” from the report
Good food and drink support
People were offered choices and received help to eat and drink when needed. Records and specialist advice were used where there were concerns about nutrition or swallowing.
“At this inspection we saw that the provider had addressed this and people were being provided with a good choice of food and drink to meet their needs.” from the report
Approachable management
Residents, relatives and staff said the new manager was available and responded to concerns. The home used audits, meetings and questionnaires to gather views and make changes.
“The manager actively sought the views of people living, working and visiting Nightingale, and took action to rectify any concerns raised.” from the report
Wheelchair transfer
needs fixingOne person was moved in a wheelchair without their feet on the footplates. The manager said this would be followed up with other services about a suitable alternative.
“However, we saw one person being transferred in a wheelchair, when their feet were not on the footplates.” from the report
Care plan not updated
needs fixingOne person's records showed improvement in wound management, but the related care plan had not been changed. The manager said it would be amended straight away.
“However, we noted in one person's records the evaluation identified improvement in their wound management, but this had not been updated in the corresponding care plan.” from the report
Overflowing garden bin
minorAn outside bin used by staff and residents who smoked was overflowing. It was dealt with when inspectors raised it.
“We did note that a bin in the garden, used by staff and people who used the service when smoking, was overflowing.” from the report
- 01How do you check that wheelchair transfers are carried out safely and that the correct equipment is used?
- 02How quickly are changes in people's wounds, health or support needs added to their care plans?
- 03How do you make sure staffing levels remain sufficient on every shift, including when staff are absent?
- 04Who is the registered manager now, and how are residents and relatives involved in checking the quality of the home?
This was an unannounced inspection of the overall service and all five CQC areas, with observations, interviews and checks of care, medicines, staffing and quality records. This explanation was written from the published report of 21 June 2017 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
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- March 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Outstanding
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 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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