Nightingale Homecare Norfolk (Norwich)

When we inspected, 127 people were using the service, 90 of whom were receiving the regulated activity of personal care.

There was a registered manager in post. 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.

Medicines were not always recorded and administrated safely; allergies not always recorded consistently across Medicines Administration Records (MARs) and care plans, and there was not always up to date information in care plans to reflect what medicines were prescribed.

Management checks did not always identify shortfalls in the care records, recruitment files and medicines administration.

Some risks to people's health were not fully planned for, for example, related to conditions such as diabetes or multiple sclerosis (MS) or a significant risk of chest infection. Care plans did not always contain comprehensive guidance for all staff to follow as to how they should reduce the associated risks.

We have made a recommendation about care planning.

Despite the above areas highlighted for improvement these risks had not led to harm of people or staff, but needed to be further mitigated. Where we had specific concerns about people's health needs, the provider took prompt action to mitigate the risks.

There were enough trained staff to meet people's needs and they had good knowledge of safeguarding. People felt safe when staff supported them.

Staff used Personal Protective Equipment (PPE) as required by current guidelines and followed good infection control practices.

Staff had a good knowledge of consent and issues regarding mental capacity. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were caring, compassionate and kind. People felt listened to and involved in their care, from planning to delivery. People received care that respected their privacy, dignity and independence.

People received care that was assessed and planned for, and responsive to their individual needs and preferences, by consistent staff. Changes were made to people's care as needed, and people were involved in their care.

People, relatives and staff were positive about the management in place, and complaints and concerns were investigated and resolved.