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  • Care home

Archived: Northlands Care Home (Northumberland)

Overall: Good read more about inspection ratings

21 Kings Avenue, Morpeth, Northumberland, NE61 1HX (01670) 512485

Provided and run by:
The Autumncare Group Limited

Important: The provider of this service changed. See new profile

All Inspections

7 April 2016

During a routine inspection

Northlands is situated in a residential area close to the centre of Morpeth. The service provides accommodation and personal care, including nursing for up to 35 people some of whom are living with dementia. On the day of the inspection there were 29 people using the service.

The inspection took place on 7 and 11 April 2016 and was unannounced. At the last inspection on 22 and 24 October and 3 November 2014, we found two breaches in regulations we inspected at that time, Regulation 13 medicines, and Regulation 20 record keeping. We asked the provider to take action to make improvements. At this inspection we found that appropriate action had been taken in relation to both breaches.

A registered manager was 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.

People told us they felt safe and there were policies and procedures in place relating to the safeguarding of vulnerable adults. Staff were clear about the action they would take if abuse or neglect was suspected.

Medicines were managed safely. The service was changing pharmacy provider due to some quality issues which they felt compromised their ability to respond quickly when medicines were added to a prescription.

Safe recruitment procedures were in place. Checks had been carried out by the Disclosure and Barring Service. DBS checks ensure staff working at the home have not been subject to any actions that would bar them from working with elderly or vulnerable people.

Suitable numbers of staff were on duty during the inspection. Staff told us they found their work easier due to a slightly reduced number of people living at the service at that time, and a reduction in the dependency levels of people. The registered manager told us that staffing would be adjusted in response to any increase in numbers and complexity of people's needs.

Risk assessments in relation to the physical and psychological needs of people were in place. Some risk assessments lacked detail in relation to particular conditions and the nurse said they would amend these to provide more specific instructions to staff. There were audits relating to clinical safety including wound and catheter care audits and the safety of equipment was also checked.

Accidents and incidents were recorded and analysed for any trends or concerns by the registered manager. Serious accidents had been notified to the Care Quality Commission (CQC) in line with legal requirements.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005 (MCA). These safeguards aim to make sure that people are looked after in a way that does not inappropriately restrict their freedom. The registered manager had submitted DoLS applications to the local authority for authorisation. A list was available of applications that had been authorised, those awaiting authorisation and those due to be resubmitted upon expiry. Consent to treatment policy was available and where people lacked capacity, best interest’s decisions were appropriately recorded.

People were supported with eating and drinking and told us they enjoyed the meals. Assessments were carried out to identify any dietary problems and care plans were in place to address these.

Staff told us they felt well supported and records confirmed they received regular training, supervision and appraisals. This meant their development and support needs were met.

People had access to a range of healthcare professionals. Nursing care was provided and advice sought from appropriate specialists where necessary.

We observed that staff were caring. We saw that staff spoke kindly to people and were respectful and courteous. People and relatives told us that staff were caring. Privacy and dignity were promoted and confidentiality of information was maintained.

Person centred care plans were in place which took into account people's personality, behaviour, likes, dislikes and previous experiences when planning care.

A complaints procedure was in place and we saw that records of these had been kept including copies of responses by the registered manager and actions taken to prevent reoccurrence.

The quality of the service was monitored and the views of people, relatives and staff were sought through regular meetings and customer satisfaction surveys and audits. Staff and relatives told us they thought the service was well led.

22 and 24 October 2014 and 3 November 2014

During a routine inspection

This inspection was unannounced and took place on the 22 and 24 October and 3 November 2014.

Northlands Care Home (Northumberland) is registered to provide accommodation for up to 35 people with either personal, nursing or dementia care needs. Accommodation is split over three floors and at the time of our inspection there were 33 people living at the home.

The home had a registered manager who had been registered with the Care Quality Commission to manage the service since October 2011. 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 living at Northlands Care Home (Northumberland). There were systems in place to protect people from abuse and channels through which staff could raise concerns. We saw that safeguarding matters that had arisen within the last 12 months had been handled appropriately and referred on to the local authority safeguarding team for investigation.

A process was in place to assess people’s needs and the risks they were exposed to in their daily lives. Care records were regularly reviewed, however, we found contradictory information in these records and as a result there was a risk that people may receive inappropriate care or treatment. Medicines were not administered safely. We saw nursing staff left medicines in front of people without observing they had taken them safely. Regular health and safety checks were carried out on the premises and on equipment. Recruitment processes were thorough and included checks to ensure that staff employed were of good character. Staffing levels were determined by people’s needs. The registered manager told us she had experienced difficulties in recruiting and retaining staff in recent months, which had led to some usage of agency and bank staff.

Staff records showed staff received regular training that was up to date. Supervisions and appraisals for staff were conducted regularly and staff confirmed they could feedback their views during these meetings with their manager. The environment did not reflect best practice guidance in relation to attaining the best possible health and quality of life outcomes for people living with dementia.

CQC monitors the operation of Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act (2005). These safeguards exist to make sure people are looked after in a way that does not inappropriately restrict their freedom. We saw the registered manager had applied for, and had been granted DoLS for a number of people living in the home. In addition, people’s ability to make informed decisions had been assessed, but this was not always fully documented.

People told us, and records confirmed that their general healthcare needs were met. We saw people’s general practitioners were called where there were concerns about their welfare and other healthcare professionals such as dentists and chiropodists. People told us they were very happy with the food they were served. We saw that people’s nutritional needs were considered specialist advice sought where necessary.

Our observations confirmed people experienced care and treatment that protected and promoted their privacy and dignity. Staff displayed caring and compassionate attitudes towards people and people spoke highly of the staff team. People had individualised care plans and risk assessments and staff were aware of people’s individual needs. People told us, and our own observations confirmed that regular activities took place within the home.

Systems such as audits were in place to monitor the service provided and care delivered. Where issues were identified, action plans were drafted and improvements made. We received positive feedback about the leadership and management of the home.

The registered manager had not notified the Care Quality Commission (CQC) of approved DoLS applications and other safeguarding and/or serious injury incidents that had occurred within the last twelve months. This is a breach of the Care Quality Commission (Registration) Regulations 2009 and we are dealing with this outside of the inspection process.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These were related to the management of medicines and records. You can see what action we told the provider to take at the back of the full version of this report. We will make sure action is taken and we will report on this when it is complete.

9 October 2014

During an inspection looking at part of the service

This was an inspection to check if the provider had addressed our previous findings about maintenance of the premises. Due to their health conditions and needs the people we spoke with were able to share their views about the condition of the premises. During our visit we spoke with three people who used the service. We spoke with the registered manager and inspected the second floor of the home.

We considered all the evidence we gathered under the regulation we inspected. We used the information to answer the five questions we always ask;

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found;

Is the service caring?

This was a responsive inspection to previous non-compliance against the regulations and we did not look specifically at this area.

Is the service responsive?

This was a responsive inspection to previous non-compliance against the regulations and we did not look specifically at this area.

Is the service safe?

We saw the maintenance issues identified at our last inspection had been addressed and necessary refurbishments made.

We found people living at the home were now protected against the risk of unsafe or unsuitable premises and the provider had taken steps to provide care in an adequately maintained environment.

Is the service effective?

This was a responsive inspection to previous non-compliance against the regulations and we did not look specifically at this area.

Is the service well led?

We found there was a manager in post, registered with the Commission in line with legal requirements.

4 December 2013

During an inspection looking at part of the service

We found people's needs were assessed and care was planned in line with their needs. One person told us, "I am settled." Care plans were recorded and were regularly updated and contained clear information about individuals' care. People or their relatives had been involved.

The premises were warm and comfortable but were not always clean or appropriately maintained.

At the time of this visit there were enough qualified, skilled and experienced staff available to meet people's needs. Staff responded promptly to requests for assistance.

People's personal records were accurate, fit for purpose and held securely. Other records were kept in an appropriate form.

14 November 2013

During an inspection looking at part of the service

At a previous inspection we found concerns with the home's arrangements for managing medicines. We carried out this inspection to check whether action had been taken to address these concerns. We found that improvements had been made to make sure that people living in the home were given their medicines safely.

We spoke with two people who used the service. One said 'I know what medicines I take and I always get them regularly'. The other person said 'Staff seem very confident when they handle my medicines, they know what I need'.

6 September 2013

During an inspection in response to concerns

Due to the nature of their condition not everyone who used the service was able to speak with us. We spoke with three people who used the service and three relatives. One relative with whom we spoke, told us that he was "happy" with his wife's care and treatment. However, we found that care and treatment was not always planned and delivered in a way that was intended to ensure people's safety and welfare.

People were protected from the risks of inadequate nutrition and dehydration. People we spoke to told us that the food at the home was good. One person told us, 'It's a good menu here. I enjoyed it and ate it all.' Another person said, 'The food is ok. They cater for particular needs if you have them.'

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

There were not enough qualified, skilled and experienced staff to meet people's needs.

People were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained.

11 October 2012

During a routine inspection

We spoke with six people to find out their opinions of the service. They said staff explained their care and treatment to them. They told us that staff respected their decisions. One person said, 'It's up to you what you want to do.' We concluded that people were asked for their consent before care or treatment was carried out.

People told us they were happy with the care and treatment. One person said, 'We get well looked after.' We considered that people experienced care, treatment and support that met their needs and protected their rights.

People told us that staff were efficient at administering their medication. One person said, 'I get my tablets given to me, so I don't need to worry.' We found that appropriate arrangements were in place to manage medicines.

People told us that there were enough staff to look after them. Two people told us they sometimes had to wait for attention. We saw staff giving people support throughout the visit. They did this in a calm, unhurried manner and responded to requests for assistance promptly. We concluded there were enough qualified, skilled and experienced staff to meet people's needs.

People told us they felt able to raise any concerns or comments about the service and that they had no complaints to make. We considered that people were made aware of the complaints system.

21 November 2011

During a routine inspection

People told us that they were happy living at the home. They said they were given choices about things that were important to them, such as food and daily routines. People said the staff were nice and the food was good. Visitors told us that there was good communication within the staff team and they were kept up to date with important events. Visitors said that they had noticed that people were kept clean and their clothes looked clean. People said that they had not had reason to complain but would feel able to do so if needed.