We inspected this service on 2 November 2016 and it was an announced inspection. This was because it was a domiciliary care service and we wanted to ensure someone was available for us to speak with. We last inspected this service in January 2014 and no concerns were identified.

Nightingales Golden Care Ltd provides domiciliary and personal care assistant support to people who live in their own homes in Portsmouth and Hampshire. Care is provided to people with disabilities and/or are elderly. At the time of inspection there were 115 people receiving a service.

The service had a registered manager who had been in post since 2009. 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 with the care and support they received from staff at Nightingales Golden Care. Staff knew how to keep people safe and were aware of how and to whom they could report any safeguarding concerns.

Staff sought consent from people before providing care or support. The ability of people to make decisions was always assessed in line with legal requirements to ensure their liberty was not restricted unlawfully. Decisions were always taken in the best interests of people when necessary.

Risk assessments were personalised and kept up to date. Care plans were written with the person and/or their families. They had been supported to be involved in identifying their care and support needs and this was recorded in their care plans.

People were well cared for and there were enough staff to support them effectively. The staff were knowledgeable about the needs of the people and had received appropriate training in order for them to meet people’s needs. The recruitment process was robust and all required checks were in place prior to staff commencing work.

Medicines were administered, stored and disposed of safely and in line with legal requirements and guidelines. There were appropriate guidance and protocols for staff when people needed ‘as required’ medicine. All staff who had undertaken training in order to administer medicines safely had all been competency assessed. One staff member had undertaken train the trainer training in order to complete the competency checks on staff.

People told us that all staff were kind and caring, and treated people with dignity and respect. There was an open, trusting relationship between the people and staff. Staff knew people well and this showed in the way they spoke with each other.

We saw people and staff members had been asked for feedback about the service they received. There was a record of what actions had been taken to address any identified concerns. Staff worked well as a team. There was an open and transparent culture which was promoted amongst the staff team.

Everyone thought the management of the service was good and felt the service was well-led. All staff said they felt supported and felt they could raise any concerns with the registered manager and they would be acted upon.

We viewed the policies and procedures and saw they were being followed. Quality assurance checks were being completed and when incidents had occurred action had been taken to try to prevent a re-occurrence.

During our visit we spoke with the registered manager, two members of staff, people using the service and their relatives or advocates. We also reviewed five care plans and five staff personnel files.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

There were enough qualified, skilled and experienced staff to meet people’s needs.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

The agency had policies and procedures in place that ensured people’s needs and wishes were assessed and recorded prior to them receiving care.

People’s needs were recorded in a plan of care that was kept under review. Risks to people’s safety were assessed and plans to reduce and monitor risks to both people using the service and staff were recorded.

Staff had received safeguarding training and those that we spoke to were aware of how and when to report any concerns. People using the service told us. “They are quick to respond if you are not happy and sort it out as soon as they can.”

In order to protect the people using the service, we saw that the agency carried out a rigorous staff recruitment process and staff received training and support suitable to their role.

Four people using the service that we spoke with were very positive about the staff team and comments included. “I can talk to them in confidence about issues. I trust them and I am very happy with the care they provide. They are very professional but do not overstep the boundaries.”

There were processes in place to monitor accidents and incidents and the quality of service being provided. People using the service and their families were involved through annual questionnaires and spot checks.

A person using the service said. “It has helped me to get out into the community so that I don’t get lonely.”

After we visited the service we contacted four people by telephone to ask their opinions of the service provided by Nightingales Golden Care Limited.

Everyone we spoke with was complimentary about the service they received. They told us that they were involved in decisions and that the agency supported them with their needs.

People told us that they had discussed their support and that it was flexible to meet their needs. They told us that they felt they could contribute and be part of their care planning. People said that they had no concerns about the quality of the support provided and that staff understood their individual needs. One person told us "They have been so supportive and totally understand me". Another person said "They have given me confidence".

People told us that they had no complaints and thought the management was receptive to any comments or concerns. One person said "They are open to comments and always listen to what I have to say".

People said that they knew the staff who visited them and if anyone new would be visiting then they always had the opportunity to meet them and get to know them before they supported them. One person told us "Anyone new who visits me always comes with my regular carer and they don't start visiting on their own until we are all happy".