Nightingale House Care Centre

Who the service is for

The service supports older people, including people living with dementia.

Our view of the service

We carried out this assessment on 11 and 20 September 2026. This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.

People told us they felt safe and staff understood how to recognise and report safeguarding concerns. Risks to people were assessed and managed, and incidents were reviewed to identify learning. The environment was mostly clean and well maintained, with systems in place to monitor fire safety, health and safety and infection prevention and control. Medicines were generally managed safely. We found a patch used to treat symptoms of dementia was not being rotated between application sites in line with guidance. Following feedback, the provider took prompt action to address this. The service was staffed in line with the provider’s planned staffing levels. However, feedback from staff and relatives was mixed about whether there were always enough staff to meet people’s needs, particularly at busier times and weekends. Staff were recruited safely, although recruitment processes were strengthened during the assessment to ensure employment histories were complete and any gaps were explored and explained. Staff received training relevant to their roles and records showed good levels of training compliance. Systems were in place for staff supervision, and staff told us they felt supported by the management team and able to speak up and raise concerns.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions they had choice, control and freedom over their lives.

People’s needs were assessed and care was planned around their health, wellbeing and individual preferences. Relatives spoke positively about the assessment process and said staff gathered information about people’s needs, backgrounds and preferences. Staff worked closely with health and social care professionals to support people’s care and treatment. Professional feedback was consistently positive, describing staff as responsive, proactive and knowledgeable about people’s needs. Professionals gave examples of staff recognising changes in people’s health and wellbeing, seeking advice when needed and adapting their approach to achieve positive outcomes. One professional described how staff adapted support around a person’s fluctuating cognition and presentation, while maintaining their mobility and independence. People’s health and wellbeing were monitored, including their nutrition and weight. Care records identified people’s needs and risks, although some information was inconsistent or required further personalisation. Staff understood the principles of the Mental Capacity Act 2005 and supported people to make their own decisions. Some records needed strengthening to better reflect people’s capacity, consent and choices.

People were treated with kindness, compassion and dignity. We observed positive interactions between people and staff, who spoke to people respectfully and supported them at their own pace without rushing them. Professionals were consistently positive about the caring approach of staff and described people as being treated with dignity, courtesy and respect. People were supported to maintain their independence and make choices about their daily lives. Staff encouraged people to do what they could for themselves and respected their preferences about how and where they spent their time. People were supported to take part in activities and maintain relationships that were important to them. We observed activities which were well attended and engaging. However, feedback about weekend activities was mixed. Some staff and relatives told us there were fewer opportunities, particularly for people who needed staff support to participate or socialise.

People received person-centred care which reflected their individual needs and preferences. Staff knew people well and adapted their approach to achieve positive outcomes. People’s religious and cultural preferences were respected, and they were supported to maintain community connections that were important to them. Some care plans required further review to ensure they were fully personalised and reflected how people wished to be supported. People and their relatives were listened to and involved in their care. The provider sought people’s views through meetings and surveys, including easy-read surveys to support people to give feedback. Relatives told us they were kept informed when significant events occurred and described management as approachable and responsive. Professionals praised the service’s responsiveness, with one describing the team as, “Highly supportive and collaborative.” Others told us staff responded promptly to requests and worked effectively with people, families and professionals.

The service had a positive and supportive culture. Staff spoke positively about working at the service and told us they felt supported and able to raise concerns. Relatives and professionals described the management team as approachable, responsive and open. Professionals were particularly positive about partnership working and the management team’s advocacy for people. Governance systems were in place to monitor the quality and safety of the service. The management team had oversight of people’s needs and worked with health and social care professionals to support good outcomes. The provider responded to issues identified through monitoring and feedback and took action where improvements were needed. There was a focus on learning and improving the service. Staff were encouraged to raise concerns and contribute to improvements, and the provider was receptive to feedback during the assessment. Learning was shared with staff and changes were made where areas for improvement were identified.