Northbourne Court

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

There were safeguarding procedures in place and the registered manager staff had a clear understanding of these procedures. Appropriate recruitment checks had taken place before staff started work at the home. There were enough staff deployed to meet people’s needs. There were procedures in place to reduce the risk of infections. There were effective systems in place for monitoring, investigating, and learning from incidents and accidents. People’s medicines were managed safely.

We have made a recommendation about the management of waste medicines.

People’s care and support needs were assessed when they moved into the home. Risks to people had been assessed to ensure their needs were met safely. Staff were supported through induction, training, and regular supervision. Staff had the skills and experience to support people with their care needs. People were supported to maintain a healthy balanced diet and they had access to health care professionals when they needed them. The design of the premises was meeting people's needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and their relatives had been consulted about their care and support needs. People were provided with a range of activities to support their need for social interaction and stimulation. Staff understood the importance of working within the principles of the Equality Act and supported people in meeting their diverse needs. There was a complaints procedure in place. People had access to end-of-life care and support when it was required.

The registered manager and staff worked in partnership with health and social care providers to plan and deliver an effective service. The provider took people, their relatives, and staffs views into account through surveys and meetings. There were effective systems in place to monitor the quality and safety of the service and any learning was identified and acted on. Staff told us they enjoyed working at the home and received good support from the registered manager and deputy manager.

Rating at last inspection. The last rating for this service was good (published 28 April 2018).

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.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice:

Arrangements were in place for relatives to visit people at the home safely. All visitors, including health and social care professionals were screened for symptoms of Covid 19 before being allowed to enter the home. They were supported to follow national guidance on wearing personal protective equipment (PPE) and social distancing. There were two purpose built visiting pods in the garden and a visiting room on the ground floor with access through a separate entrance. The pods and visiting room was cleaned between visits.

The layout of the premises and use of space promoted safety and good hygiene practice. Where people at risk of falls were isolated, one to one staffing was in place to reduce the risk of them falling. The manager and staff were working with the local authority's complex falls teams on analysing and reducing falls at the home. The home was clean and hygienic throughout and was following government guidance in relation to infection prevention and control.

The provider had appropriate arrangements in place for testing people using the service and staff for Covid 19 and was following government guidance on testing. We observed staff wearing appropriate PPE and socially distancing during our visit. The provider ensured all staff had received training on Covid 19, infection control and the use of PPE. Covid 19 risk assessments were carried out with Black Asian and Minority Ethnic (BAME) staff to ensure they could work safely at the home.

The home had business continuity and Covid 19 contingency plans in place that made provisions for safe care in the event of an emergency, or outbreak of Covid 19. The registered manager and staff worked closely with health and social care professionals to provide good care outcomes for people using the service. The registered manager told us they felt well supported by staff, the deputy managers and the senior management team. They took part in the providers weekly managers meetings where Covid 19 and any lessons learned were regularly discussed.

At our last inspection on 12, 13 and 14 January 2016 the service was rated Good overall. We rated the key question ‘Safe’ Requires Improvement because we had concerns about the high level of falls at the home. At this inspection we found the provider had taken action to monitor and manage the risk of falls appropriately at the home.

The home had a registered manager in post. 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.

All of the staff we spoke with said they enjoyed working at the home. Most said they received good support from the registered manager and unit managers. However some staff felt their contributions were not always recognised or that manager’s had not listened to what they had to say. We have made a recommendation about motivating staff and team building.

People told us they felt safe living at the home. Training records confirmed that staff had received training on safeguarding and there was a whistle-blowing procedure available and staff said they would use it if they needed to. There was a good staff presence at the home and staff were attentive to people’s needs. Action was taken to assess any risks to people and risk assessments and care plans included information for staff about action to be taken to minimise the chance of accidents occurring. Medicines were managed appropriately and people received their medicines as prescribed by health care professionals.

Staff had the knowledge and skills required to meet people’s needs. The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and acted according to this legislation. Most people told us they enjoyed the meals provided to them and they could choose what they wanted to eat. People were supported to maintain good health and they had access to healthcare professionals when they needed them.

People had been consulted about their care and support needs. These needs were assessed before they moved into the home. Care plans and risk assessments included detailed information and guidance for staff about how people’s needs should be met. People’s privacy and dignity was respected. There were plenty of activities for people to partake in if they wished to do so. The home had a complaints procedure in place and people said they were confident their complaints would be listened to and acted on.

The provider recognised the importance of monitoring the quality of the service. They sought the views of people using the service, their relatives and friends through residents and relatives meetings and satisfaction surveys. The registered manager worked with other care provider’s and professional bodies to make improvements at the home.

We carried out this inspection to check whether the provider had implemented improvements following our inspection on 12 and 13 June 2013 in relation to care planning, medicines management and quality assurance. At our inspection on 11 March 2014 we found the provider had implemented most of the improvements we required. For example, a new care plan format was in place and people's needs were assessed and care was appropriately planned and delivered. Some improvements had been made to medicines management such as more robust auditing and staff training. Quality assurance processes ensured that where actions were identified, relevant improvements were implemented.

We found that people were given choices, were involved in their care and were treated with dignity and respect. People's care needs were assessed and care was planned but people did not always have care plans in place that reflected their needs. People had an adequate choice of meals and they were sufficiently supported. We found medicines management was appropriate, however we had some concerns about the timing of medicines rounds. Staff were adequately supported through induction, training supervision and appraisal. The provider had systems in place to monitor the quality of the service, however these did not always ensure the necessary improvements were implemented.