The inspection took place on 5 and 7 December 2016 and was unannounced.

Nightingale Nursing Home provides care and nursing care for up to 35 older residents, including those living with dementia. The home is located in Littlehampton, close to local amenities and the seafront. At the time of our visit there were 20 people living at the home, one of whom was on a respite stay. The home has two communal lounges, a fully assisted bathroom on each floor and an accessible garden.

The service has a registered manager. 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.

People felt safe at the home. Risks to people’s safety were assessed and reviewed. Staff understood local safeguarding procedures. They explained the action they would take if they were concerned that someone was at risk of abuse. People received their medicines safely.

People had developed good relationships with staff and had confidence in their skills and abilities. They told us that staff were kind and that they treated them respectfully. There was an established team of staff at the home, which offered continuity of care for people. The registered manager ensured that there were sufficient staff on duty at all times to meet people’s needs. Staff had received training and were supported by the management through supervision and appraisal.

People were involved in planning their care and in making suggestions on how the service was run. Staff understood how people’s capacity should be considered and had taken steps to ensure that people’s rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).

People enjoyed home-cooked food and were able to make suggestions for dishes they would enjoy. Staff monitored people’s food and fluid intake to ensure that they were receiving enough. Where concerns were identified, action had been taken.

Care plans provided detailed information about people and guidance for staff on how to support them. Staff responded quickly to changes in people’s needs and adapted care and support to suit them. Where appropriate, referrals were made to healthcare professionals, such as the GP or community psychiatric nurse (CPN), and their advice was followed.

There was strong leadership within the home. The registered manager and deputy monitored the delivery of care and had a system to check and review the quality of the service. There was also a plan in place setting out future improvements to the home, including increasing activity provision, additional support for families and changes to the physical environment. Suggestions on improvements to the service were welcomed and people’s feedback encouraged.

At the time of our visit to Nightingale Nursing Home there were 21 people living there and we spoke with five of them. We spoke with the manager, deputy manager, members of staff and visitors. We read through people’s care files and other relevant documents pertaining to their care that they received from the service. We noted that a number of people suffered from dementia and there were some people confined to their bed.

We found that people were receiving the appropriate level of care and treatment as agreed in their care plan. People we spoke with confirmed that they were well looked after by the team of staff and that their care needs were met. Visitors we met told us that they were satisfied about the level of care and treatment their family were receiving from the service. For example people said: “since mum had been here she is looking a lot better”, “we have nothing but praise for the staff who work very hard and always welcoming”, “my wife is well looked after and they do everything they can to help her”, “matron and the girls are a great bunch” and “we are always kept informed about dad’s health”.

We spoke with staff and found that they had the relevant training and support to enable them to carry on with their role effectively. We noted that staffs adhered to the regime of cleanliness and infection control within the home to ensure people were protected. We found that the home had an effective complaint procedure in place and people had access to it.

During our visit we spoke with four people who were using the service, three members of staff and one visiting relative. People who used the service and their relatives told us that they liked living at the home and that the service met their needs. People told us that it was "a very homely place." Comments included "I have never known care like it the care is unbelievable."

We made observations throughout the visit and saw people being offered choices as to what they wanted to eat or what activities they wanted to take part in during the day. We saw people being addressed in a respectful manner. One person told us "they even got me kippers for my supper."

We looked at peoples individual care plans and saw that the information recorded enabled staff to plan and deliver the required level of care and support on an individual basis.

We saw that regular audits of the service were completed by the provider ensuring that people who used the service benefit from a service that monitors the quality of care that people received.

Staff told us that they had received regular training and that they felt that they were supported to carry out their roles and meet the needs of people who used the service.

People said that they had no complaints about the service and that if they did they would speak to the staff or the manager