We carried out a review of the data available to us about Nightingales Homecare on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Nightingales Homecare, you can give feedback on this service.
Nightingales Homecare is a domiciliary care agency. At the time of our inspection, the service was providing care to 160 people who were living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People's experience of using this service and what we found
There were processes in place to monitor the safety and quality of the service. Medicines were managed in line with good practice guidance.Staff assessed risks to people's health, safety and wellbeing and put plans in place to manage these risks.
People received support from a regular team of staff which meant care was consistent. People's calls were usually on time or staff called if they were going to be late. The provider monitored care staff attendance at calls using electronic call monitoring.
People and relatives told us staff were kind and caring in their approach. People told us staff communicated well with them and acted in an open and transparent way.
Care plans needed to be more person-centred to provide staff with the information they needed to provide care and support in a way that met people's needs and preferences. The service arranged to gather this information during the inspection. People felt confident to raise any complaints they might have. We saw complaints were identified, investigated and used to improve the service.
The management team had the knowledge and experience to operate the service safely and effectively. They demonstrated a good understanding of all aspects of managing the service.There was a positive culture where staff and management took pride in the care and support that they provided.
The service had a registered manager in post at the time of our inspection.
The service met the characteristics of good in all areas. More information is in the full report.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Good (12 July 2018).
Previous breaches
At the last inspection we identified one breach of the Health and Social Care Act regulations in relation to good governance. At this inspection we found improvements had been made and the provider was no longer in breach of this regulation.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
The service had a registered manager in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
This was the first inspection of this service at their current address, but we had inspected Nightingales Homecare in December 2014. At that inspection we found a breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) in that the recruitment records for new staff did not contain enough information to determine their suitability to work with vulnerable people. At this inspection we found that safe recruitment policies had been adopted, with all employment checks undertaken.
During this inspection however, we found that there were no systems in place for the registered manager and owner to evaluate and improve practice, or undertake audits and checks to monitor and improve service delivery This was a breach of Regulation 17 of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014.
People who used the service and their relatives told us that they felt safe. They said that staff were attentive to people’s safety, especially when leaving people’s homes. Care staff understood how to keep people safe, and any potential risks were assessed as an ongoing process. We saw that care staff were given time to complete their tasks, and had some flexibility with their rotas so that they could arrange visits at times most convenient to the people they supported. When we asked, people who used the service and their relatives were happy with the times of their visits and the continuity of their care.
All staff new to care completed the Care Certificate, and we saw all staff employed by Nightingales Homecare had, or were working towards appropriate health and social care qualifications. Staff understood the importance of infection control and had been trained to administer medicines safely. They were knowledgeable about diet and nutrition, and when we asked people for whom care staff prepared meals they told us the food was cooked to their liking.
People were well cared for by friendly and accommodating staff, who, we were told, always asked for consent before completing tasks. Staff were not rushed and spent time talking with the people they supported, and ensured that care was delivered the way people wanted it to be. The care staff we spoke with could tell us how they had supported people nearing the end of their life to die with compassion and dignity. The service had received few complaints, but when people did complain about the service we saw that appropriate action was taken to follow up and respond to the complainants.
There was information in people’s care records to guide staff on the care and support needs required and this included information about their likes and preferences. However, care plans kept in people’s own homes were not always up to date, and contained some incorrect details about the care and times of visits. Although care plans were reviewed on a regular basis, the reviews emphasised the delivery of care rather than focussing on any changes in need for the person.
People who used the service and the staff we spoke with told us the service was well run. They informed us that they were listened to, and felt comfortable speaking to any of the staff if they had any concerns. Staff worked in small teams which meant that the number of people providing care and support was kept to a minimum and people were supported by staff who knew them well.
The home had a registered manager who was respected by staff, residents and their relatives, and had a visible presence throughout the home.