Northfields

Updated 23 September 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

On day one, there was one CQC inspector. On day two, there was a CQC specialist medicines inspector and an inspector. Another inspector also completed some of the telephone calls to staff.

Service and service type

Northfield is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Northfields is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced on the first visit, the second day of inspection was announced.

Inspection activity started on 26 July 2022 and ended on 08 August 2022. We visited the service on 26 July 2022 and 02 August 2022.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also liaised with the local authority to source feedback. We used information gathered as part of monitoring activity that took place on 22 June 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We reviewed a range of records, including four people's care records and six medication records. We looked at staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

We spoke with 10 members of staff, three health care professionals, three people using the service and two relatives.

Updated 23 September 2022

About the service

Northfields is a residential care home providing personal care and support to up to seven people with a learning disability and or autistic people. At the time of our inspection there were six people using the service. The service consisted of one large bungalow, with shared communal spaces, and each person had their own bedroom with ensuite bathroom.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, records relating to capacity assessments and Deprivation of Liberty Safeguard (DoLS) applications were not regularly reviewed to ensure people were being supported in the least restrictive manner. The premises were homely, and people’s bedrooms had been personalised based on their own preferences.

Right Care: Care records were under review at the time of the inspection and we identified areas where improvements were required to ensure safe consistent care was provided. People’s support was personalised and catered to their specific wants and needs. Staff provided support in a dignified way to protect people’s privacy and maintain their feeling of self- worth. Staff were trained appropriately to support people and knew them well.

Right Culture: Staff and the management team at the service spoke positively about people within the service and wanted people to live their best lives. We identified areas were governance of paper records and processes had not been maintained putting people at potential risk. Such as medicine records not clearly evidencing topical cream applications, risk assessments and care plans not being regularly reviewed or robust.

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

Rating at last inspection

The last rating for this service was requires improvement (published 14 March 2020). The service remains rated requires improvement. This service has not achieved a rating of good overall for the last three consecutive inspections.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained requires improvement based on the findings of this inspection.

Enforcement

We have identified a breach in relation to the governance and oversight of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.