Nightingale Care and Nursing Home

Staff and leaders did not take effective of prompt action to mitigate risks to people, leaving people at risk of harm. Staff did not always complete as and when required medication records and therefore could not evidence that people required the medication. Leaders had not ensured that people were supported in line with their individual care plans. We observed that some areas of the service were not clean. However, evidence highlighted that there were enough staff deployed and staff had received suitable training to support people safely. People were protected from the risk of abuse because staff and leaders understood their responsibilities in relation to safeguarding.

The provider had introduced systems to ensure people’s care plans and risk assessments were being developed with the inclusion of the people, their relatives, and staff. However, these had not been fully embedded, and relatives had not always been involved in this process. Arrangements were in place to support people receive care and treatment in an appropriate way based on their protected characteristics. Staff and leaders were working towards ensuring that people were at the centre of their care.

Partner agencies had identified areas of improvement in relation to documentation. Staff has not always responded to people’s needs quickly. Staff were observed to deliver care and support in a dignified and caring manner. People's diverse needs and experiences were equally respected. People were encouraged to express their views and make decisions about their care. People's privacy, dignity and independence were well respected and promoted.

People’s equality related needs had been considered and staffing levels were adjusted to ensure that these needs are met. Where people were receiving end of life care, relatives had been involved in the planning of this care. People were not always involved in decisions; it was identified that this had affected their experiences in the care they had received. This had been previously identified and the provider has introduced systems to ensure people are actively involved in planning their care.

The service did not have a Registered Manager in post, and this was undergoing recruitment processes. An interim manager was in post at the time of assessment, currently supported by the providers senior leadership team. It was identified that governance systems were not robust in identifying risks and sufficient actions had not always been taken to mitigate risks. This is an ongoing breach of Regulation 17 (Good governance) and placed people at risk. Whilst systems had not been fully embedded at the service, staff and leaders were keen to drive this improvement forward.