About the service:

Nightingales Home Care Service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to 27 people.

People’s experience of using this service:

People told us they felt safe with the service they received from Nightingales Home Care. The staff demonstrated a good understanding of how to meet people’s individual needs. People’s outcomes were known, and staff worked with people to help achieve these. People were supported and encouraged to maintain their independence and live their lives as fully as possible.

People were supported to maintain contact with those important to them including friends, family and their community. Staff understood the importance of these contacts for people’s health and well-being. Staff knew people well and what made them individuals.

The management of the service were respected. Staff had a good understanding of their roles and responsibilities and were supported to reflect on their practice and pursue learning opportunities. The staff team worked and got on well together demonstrating team work and flexibility.

Quality and safety checks helped ensure people were safe and protected from harm. This meant the service could continually improve. Audits helped identify areas for improvement and this learning was shared with staff.

The service met the characteristics of good in all areas; more information is in the full report

Rating at the last inspection:

At the last inspection the service was rated good (23 November 2016).

Why we inspected:

This inspection was scheduled and based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the home until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection was announced and took place on 27 October2016. We gave the provider short notice of the inspection as we needed to make sure we were able to access records and gain permission from people who used the agency to telephone them.

The last inspection of the service was carried out on 5 February 2014. No concerns were identified with the care being provided to people at that inspection.

Nightingales Home Care Service is a domiciliary care provider in Swanage, Dorset. Nightingales Home Care provides support to people in their own homes. Nightingales provides help with personal care and domestic tasks. At the time of the inspection they were providing personal care and support for 44 people in their own homes.

There is 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.

The provider of the service was a partnership where one partner was the registered manager with overall responsibility for the service. The partners worked together to co-ordinate the day-to-day running of the service. They worked together when recruiting new staff and making decisions about taking on new work.

People and their relatives were very complimentary about the quality of the service provided and of the management and staff team. They felt the care was exceptionally good. One person told us, “My carer is excellent I look forward to them coming, and I have never been so happy since using Nightingales”. A relative said, “I would comment that the Nightingales standards of care and service is of a very high quality”.

The provider had a clear vision, which was to provide a service which was influenced by the needs and wishes of the people who used it. There was a commitment to providing high quality care which was tailored to people’s individual wishes. Their vision and values were communicated to staff through staff meetings, supervisions and a regular newsletter. People’s views were gathered by regular monitoring visits and phone calls and by satisfaction surveys.

People had positive relationships with the staff members who supported them. Staff knew people’s individual histories, likes and dislikes and things that were important to them. People had their privacy and dignity respected and information personal to them was treated in confidence.

Care was planned and delivered in a way that was personalised to each person. Staff monitored people’s healthcare needs and, where changes in needs were identified, care was adjusted to make sure people continued to receive care which met their needs and supported their independence.

Risk assessments included the risks associated with people’s homes and risks to the person using the service. Staff had access to care plans and risk assessments and were aware of how to protect people from risks of harm associated with their care.

The agency had a recruitment procedure that ensured staff were thoroughly checked before they began work. Staff knew how to recognise signs of abuse and all said they were confident that any issues raised would be appropriately addressed by the registered manager. People felt safe with the staff who supported them. One member of staff told us, “My recent training really made me think how important it is to stay updated with training. I recently completed safeguarding refresher training, it really opened my eyes to the different kinds of abuse there are today.

People received help with their medicines from staff who were trained to safely support them and who made sure they had their medicine when they needed it. The provider undertook regular competency checks on staff to ensure they followed safe practice when supporting people.

There were systems in place

During our visit we spoke with three people who use the agency’s services, and the relative of a person who uses services, via the telephone. We also spoke with three members of the agency's care staff.

People told us that they were asked to consent to the care they received. A person told us, “The care is excellent. I’m very satisfied – They ask my permission.” Another person told us, “They wouldn’t do what I didn’t want.”

We found that people's needs were assessed, and care was planned and delivered to meet people's needs. A person who used the agency’s services told us, "The care is excellent -- I have a file in my home, they write in it everytime.” We saw that people's care was regularly reviewed.

People were protected from the risk of abuse and their human rights were respected and upheld. A person told us, "I’ve never had any problems with the staff. They’ve all been very pleasant and kind."

We found that there were sufficient numbers of appropriate staff. However, we found that staff training had not been updated. A provider told us, “We do realise that staff mandatory training needs to be updated. We’ve got a bit behind with it.”

The provider had appropriate systems in place to monitor and improve the quality of care people received. A person told us, “The manager comes up regularly.”

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector joined by an Expert by Experience, people who have experience of using services and who can provide that perspective.

We used postal surveys, telephone interviews and home visits to people who use the service and to their main carers (a relative or friends) to gain views about the service.

People told us “I can only speak well of this agency and the staff. They are very respectful”, “we were recommended to use this agency and we have not been disappointed” and “we are very satisfied with the support we get”. They told us that they received the service that they expected to. “We would not be able to manage without their kind and loving support. The staff genuinely look after both of us”, “when the care worker arrives, it gives me (the spouse) the opportunity to take a break and go out, or they go out to do an activity” and “we are very well looked after and I have recommended this agency to other people we know who have similar difficulties”.

Information gathered by visiting people in their own home, by telephoning them, or by people completing survey forms concluded people were of the opinion that the care workers were kind and courteous and provided them with the help they needed. People said they felt safe whilst care was being delivered, but if they did not, they would either contact the agency, speak to a relative or friend, or the local authority. People told us that they had been provided with information booklets which listed various contact numbers to report concerns or complaints.