Northwood Nursing & Residential Care

Updated 7 September 2023

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Four inspectors and an Expert by Experience undertook the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Northwood Nursing and Residential Care 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. Northwood is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post since February 2023 and had submitted an application to register. We are currently assessing the application.

Notice of inspection

This inspection was unannounced on the first day of inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 used all this information to plan our inspection.

During the inspection

We spoke with 8 people that use the service and 6 relatives about their experience of the care provided. We spoke with 12 staff including the manager, director, maintenance, cook, home coordinator and care workers.

We had a tour of the building with the director. We reviewed a range of records, including records relating to medicines, staff recruitment and training, building maintenance, cleaning and equipment checks, accidents and incidents, safeguarding logs and policies and procedures. We also spent time observing interactions between staff and people living at the service.

Updated 7 September 2023

About the service

Northwood Nursing and Residential Care is a residential care home providing accommodation and nursing care for up to 27 people in one adapted building, with bedrooms over 3 floors. At the time of the inspection there were 22 people using the service.

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

Risks to people’s health and safety were not always identified and medicines were not always managed and administered safely. People spoke highly of the staff but felt there wasn’t always enough of them. People’s mobility care plans and risk assessments were not always reflective of their current needs, and some held conflicting information. Infection control processes were not always followed, and recruitment processes were not always robust, we made a recommendation about this. Staff had received training in safeguarding, and people felt safe living at the service

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, the policies and systems in the service did not always support this practice. People’s consent was not always sought, and staff had limited knowledge of DoLS. Staff received induction, training and support to carry out their role. The service had been adapted to meet people’s needs. The provider worked well with other healthcare professionals to provide joined up effective care.

Governance systems were in place but not always effective. There was limited evidence of mitigation of risk when concerns had been found. The service had policies and procedures in place, but they were not always reflective of current practices. People and their families spoke positively of the management team and of the staff. Staff described the management as fair and approachable. People were empowered to maintain their independence.

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 good (published 5 October 2022)

Why we inspected

This inspection was prompted by a review of the information we held about this service. We received concerns in relation to the management of medicines and staffing. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led only.

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 changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective, and well led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Northwood Nursing and Residential Care on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines management, risks to the health and safety of people living at the service, consent, and good governance at this inspection. We made a recommendation in relation to infection control and staffing and recruitment.

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.