This inspection took place on 10 September 2015 and was unannounced. We last inspected Northlands Village Rest Home on 3 October 2013 and the service was judged to be fully compliant with the previous regulatory standards.
Northlands Village Rest Home provides personal care only, at the time of our inspection there were 15 people living at the home including one person receiving respite care. The home offers short to long term care. Accommodation is on two floors and provides fifteen single rooms. There are additional lounges, a dining room and a quiet library. A passenger lift provides easy access to first floor areas. Northlands is situated close to the village of Great Eccleston and is within easy reach of shops and local amenities, including the health centre.
There was a registered manager in place at the time of our inspection. 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 told us they felt safe at the home and with the staff who supported them. One person told us, “Yes I feel safe, it’s my home and I will stay here until the end of my days.” Another person said, “I’m very safe, they (staff) are patient, more patient than I am.”
The service had procedures in place for dealing with allegations of abuse. Staff were able to describe to us what constituted abuse and the action they would take to escalate concerns. Staff members spoken with said they would not hesitate to report any concerns they had about care practices.
We observed staffing levels to be sufficient to meet the needs of the people at the home. People we spoke with and their relatives told us they had no concerns with regards to staffing levels. We discussed staffing levels with the registered manager of the home who told us that staffing did flex according to the needs of the people in the service and we were shown examples of this.
We looked at how medicines were ordered, stored, administered and recorded. We spoke with the senior carer who had responsibility for administering medication on the day of the inspection and observed medication being given to people over the lunch time period. All the medicines given were done so in a discreet manner and it was evident that the senior carer knew people well and how best to approach people when administering their medicine. We checked medication administration records (MAR) to see what medicines had been given.
The people we spoke with told us they enjoyed the food provided by the home. They said they received varied, nutritious meals and always had plenty to eat.
A number of the staff we spoke with had worked at the home for a number of years and we saw that staff retention rates were very good. Staff we spoke with all told us that they received good support from the manager of the home and peers. We saw that staff did receive training however some key areas were out of date such as safeguarding and Infection control.
We saw that policies and procedures were in place in respect of the MCA and DoLS however staff had little understanding of either. Staff we spoke with had not received training on the MCA and DoLS. Care staff were only able to give general answers about how they would obtain valid consent and had no detailed knowledge of the MCA or DoLS. We have made a recommendation regarding this.
We saw that people were involved in every day decisions about their life and how their care was delivered. We observed staff asking people what they would like to do at various times throughout the day and people told us they could ask staff for assistance and it was received in a timely manner.
Some of the information in people’s care plans was too brief or we could not find evidence that care plans were being followed or backed up by appropriate risk assessments or reviews. We have made a recommendation about this?
We saw that advocacy services were available for people to access if they did not have relatives or friends to act as a voice for them. Details of local advocacy services were available within the entrance / reception area of the home. We were told that advocacy was discussed with those people who may want to access it when they first came in to the home or if their circumstances changed.
People we spoke with and their relatives told us they knew how to raise issues or make complaints. We saw that the home had a complaints procedure and that it was made available to people, this was confirmed when speaking with people and their relatives. It was also on display within the home.
There was a registered manager at the service at the time of our inspection and we found no outstanding registration issues during the planning of the inspection.
None of the people living at the home or their relatives spoke negatively about the owner, manager, staff or culture within the home and people and relatives told us they could approach managers or staff with any issues they had.
We found one breach of the Health and Social Care Act (2008) (Regulated Activities) Regulations 2014 relating to Fit and proper persons employed.
You can see what action we told the provider to take at the back of the full version of this report.