Nightingale Home Care retained a Good overall rating with positive feedback on safe, effective, caring and responsive personalised care from regular staff. Well-led was downgraded to Requires Improvement due to inaccurate MAR charts, record-keeping inconsistencies and quality assurance systems that failed to identify these shortfalls.
Concerns (4)
moderate
Record keeping
: “Records were not always up to date and accurate. The provider's systems for monitoring the quality of the service had not identified these shortfalls.”
moderateMedication management: “some medicine administration records did not accurately reflect the medicines that were prescribed. Discrepancies had not been identified through the provider's quality assurance systems.”
moderateGovernance: “There were management systems in place to assess, monitor and improve the quality of service people received. However, these were not always effective and had not identified concerns found by the inspector.”
moderateIncident learning: “There was no system in place to provide an overview that would support analysis of patterns or trends across the service. This meant opportunities for making improvements and learning could be missed.”
Strengths
· People and relatives described feeling safe with regular, reliable care workers who knew them well
· Staff understood safeguarding responsibilities and reported concerns appropriately
· Holistic risk assessments and care plans included people's views and least restrictive options
· Safe recruitment with DBS checks and sufficient staffing to cover visits consistently
· Staff received training including the Care Certificate and regular supervision
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Learning lessons when things go wrongNot rated
safe: Staffing and recruitmentNot rated
safe: Preventing and controlling infectionNot rated
safe: Using medicines safelyNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Supporting people to live healthier lives, access healthcare services and supportNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Supporting people to develop and maintain relationships to avoid social isolationNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Working in partnership with othersNot rated