Nightingales is a care home situated in the residential area of Thornton Cleveleys. The home provides residential and nursing care for 55 people, including people who live with dementia. The main building is a converted and purpose built extension to a farmhouse and has a ground and first floor facility. There are single and double bedrooms which all have en-suite facilities. There is a passenger lift in place. There is another residential building within the grounds and this is known as The Barn. At the time of our inspection visit there were 53 people who lived at the home.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

Although a number of people had limited verbal communication and were unable to converse with us, we were able to speak with six people who lived at the home and four people visiting their relatives. People told us they were happy and well cared for and felt safe living at the home. One person visiting the home said, “Very happy with [relatives] care. They are kind and so patient with them.”

We found staff had been recruited safely, appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care and social needs. Staffing levels were observed to be sufficient to meet the needs of people who lived at the home.

Staff spoken with and records seen confirmed training had been provided to enable them to support people who lived with dementia. We found staff were knowledgeable about support needs of people in their care.

We observed staff providing support to people throughout our inspection visit. We saw they were kind and patient and showed affection towards the people in their care.

We saw people who lived at the home were clean and well dressed. They looked relaxed and comfortable in the care of staff supporting them.

We found the service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.

The registered provider understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

People who were able told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

We found people had access to healthcare professionals and their healthcare needs were met. We saw the service had responded promptly when people had experienced health problems.

Care plans were organised and had identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

People who lived at the home had the choice of attending the services day centre where a variety of activities were organised for their entertainment. We saw people participating in an art class and one person enjoying a game of chess with a staff member.

The service had a complaints proced

This inspection took place on 29th October 2014 and was unannounced.

Nightingales is a Care Home situated in the residential area of Thornton Cleveleys. The home provides residential and nursing care for 55 people, including people who are living with dementia. The main building is a converted farmhouse and purpose built extension and has a ground and first floor facility. There are single and double bedrooms which all have ensuite facilities. There is a passenger lift in place. There is another residential building within the grounds and this is known as The Barn.

There was a registered manager in place. 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 registered manager had arrangements in place to protect people from abuse and unsafe care. The registered manager and her staff had received safeguarding training and understood their responsibilities to report any unsafe care or abusive practices. People we spoke with said they were receiving safe and appropriate care which was meeting their needs. One person said, “I feel completely safe.” One person visiting the home said, “I love my mum more than anything. I would never leave her anywhere if I thought she wasn’t being well cared for. I have nothing but praise for the manager and her staff. I always look forward to visiting the home and never leave worried about mum.”

We found people who lived at the home and were living with dementia were encouraged and supported to be as independent as possible with staff support. One member of staff was observed physically supporting a person to eat their lunch. Once the person had gained interest in their food the staff member gave them back their spoon and encouraged them to eat independently.

We looked at how the home was staffed. We found sufficient staffing levels were in place to provide the support people required. We saw the deployment of staff at lunch time was organised. People who had been identified as being at risk from poor nutrition had a care worker allocated to assist them to eat their meals. We observed staff members were attentive to the needs of people who required assistance. We saw they were kind and patient and interacted with the people they were supporting. We saw staff had time to spend socially with the people in their care and could undertake her tasks supporting people without feeling rushed.

People were happy with the variety and choice of meals available to them. Regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. The cook had information about people’s dietary needs and these were being met.

People’s care and support needs had been assessed before they moved into the home. We looked at care records for people receiving nursing and residential care. We found the care plan records were up to date and being kept under review. We noted these described the daily support people were receiving and the activities they had undertaken. The records were informative and enabled us to identify how staff supported people with their daily routines.

The environment was well maintained and clean and hygienic when we visited. No offensive odours were observed by any members of the inspection team. The people we spoke with said they were happy with the standard of hygiene in place.

We found medication procedures in place were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept and appropriate arrangements for storing were in place. People told us they received their medicines at the times they needed them.

We found recruitment procedures were safe with all appropriate checks undertaken before new staff members could commence their employment. Staff spoken with and records seen confirmed a structured induction training and development programme was in place. This included mandatory training covering health and safety, manual handling techniques, food hygiene, infection control, safeguarding, personal care and medication administration. On the day of our inspection five staff members attended a training session being facilitated by Blackpool council regarding dementia awareness.

The service had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant that people would be safeguarded as required. When we undertook this inspection two applications had needed to be submitted. Appropriate procedures had been followed and the Commission had been informed about the applications as required by law.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included annual satisfaction surveys, house meetings, relatives meetings, care reviews and audits. We found people were satisfied with the service they were receiving. The registered manager and staff members spoken with were clear about their role and responsibilities. They told us they were committed to providing a high standard of care and support to people who lived at the home.

During our inspection we looked at care, staff training records and staff supervision arrangements. We checked maintenance records, observed lunch and undertook a tour of the building. We also spoke with a number of people visiting the home and staff throughout the inspection. We observed the quality of care and support provided by staff during the inspection. We did this to confirm people were having their care needs met. We also wanted to identify that staff had been well trained and appropriate support arrangements were in place for them.

We found people were being supported by staff who had been trained and appropriate support arrangements were in place for them. The home had been well maintained and was clean and hygienic when we visited. Good care practices were observed and people were having their nutritional needs met.

The people we spoke with said their relatives were receiving safe and appropriate care which was meeting their needs. One person said, “This home is perfect for my wife. Nothing is too much trouble for the manager and her wonderful staff. The food is very good and the home is always clean and smells fresh when I visit. The staff are very good, they really care”.

During our inspection we contacted the Blackpool contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

During our inspection we looked at care records, medication procedures and the homes duty rota. We did this to confirm people were well supported and staffing levels were sufficient to meet people’s needs. We also spoke with family members of people living at the home and interviewed some staff members. We observed care practices and saw people were treated with respect and dignity. The people we spoke with said their relatives were receiving safe and appropriate care which was meeting their needs. Comments received included:

“I looked around a number of homes and had to wait to get my parents into this home. It was worth waiting for. My parents are really well looked after. The staff are so caring and gentle”.

“I cannot fault the care at all. The manager and her staff are fantastic. I would happily recommend the home to anyone”.

“The manager has been absolutely marvellous since her appointment. I have seen big improvements being made. She is very approachable and always available with a smile. I am very happy with everything”.

During our inspection we contacted the Blackpool contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

People told us they can express their views and are involved in decision making about their relatives care.

We spoke to people about their relatives experiences living in the home and were told the staff team provided sensitive and flexible personal care support.

“I visit my relative every day and I am fully involved in his care. They always keep me informed about any changes to his health. I am very satisfied with his care”.

“I visited a number of homes but always knew Nightingales was the right place for my husband. I waited months for a vacancy as I was so impressed with the manager and her staff. The staff are very friendly and helpful”.

“I have never been able to fault the care my relative receives. All the carers are wonderful. They are always available when you need them and are kind and patient. The manager and her staff are very supportive in helping me deal with my relative’s illness”.

“I am very happy with the care my relative receives and the food is wonderful. The staff are very kind and friendly. I feel I have chosen one of the better homes and wouldn't hesitate to tell people how good it is".