Northcroft

There were clear procedures for all staff and visitors on entry to the service. Everybody had their temperature checked, were asked to sanitise their hands and wear a mask. The provider had developed a visitor’s code of conduct and had told everybody's’ families about the infection control procedures at the service.

The provider had hired a suitable venue for visits to take place during the winter. This venue was for their sole use and facilitated social distancing. Family members were requested to bring their own food and drink and people from the service did the same.

Staff working at services across the Orchard Vale Trust had developed online activities on Zoom, called ‘The Hive’. This offered Zumba, yoga and music. People’s families were able to join in.

Staff at Northcroft facilitated a holiday at home as people could not go away due to risks. People were supported to camp out if they wished and had a barbecue, camp fire and bar.

Staff members wore masks at all times and other personal protective equipment (PPE) as needed. Where possible staff maintained social distance from people. Staff arranged to have their breaks separately from people, so they could eat without increasing people’s risk of exposure.

The provider had developed policies and procedures to promote and maintain safe infection control procedures across all their services. The operations manager was in charge of sourcing all PPE. The chief executive liaised with Public Health England (PHE) and kept updated with all guidance; this was disseminated to staff.

Northcroft did not have any vacancies and had not admitted anybody since the start of the pandemic but had access to the Orchard Vale Trust policy and procedure on admission.

Staff were tested for Covid-19 weekly and people living at the service monthly. Staff had all received training in infection control. The provider had carried out an audit of infection control and implemented any identified actions. There was a regular schedule of cleaning at the service and we noted that the premises were clean, well-aired and smelt fresh.

The provider had a contingency plan in place for any outbreak or suspected outbreak of Covid-19 and had plans in place should people need to isolate.

Further information is in the detailed findings below.

Northcroft is a residential care home that provides personal care for up to eight people with learning difficulties, mental health, autism and other complex needs. At the time of the inspection eight people were living at the service. Some people had limited verbal communication, so we captured some of their experience through observations.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People told us they were happy living at the home and they felt safe. All people were comfortable in the presence of staff. Medicines were administered safely. Risks had been identified with ways to mitigate them in place. Records and processes around the management of behaviours were in place.

The provider and management had completed a range of audits to identify concerns and issues at the service. They strove to be open and constantly develop and improve the support people were received. When systems had identified issues, actions were being taken to rectify them. The registered manager was aware of their responsibility to notify the Care Quality Commission of certain events in line with their statutory obligations.

People were supported by enough staff to meet their needs and allow them to actively participate in the community. Staff had received a range of training including specialist in health and social care. People could participate in the training if they wanted to learn more about a specific topic.

People had care plans which were extremely personalised and provided a range of information for staff to use to support their needs and wishes. There were good links with other health and social care professionals which was important due to the complex needs of those living at the home.

Staff were kind and caring and knew the people living at the home incredibly well. Staff respected privacy and dignity throughout the inspection. Strong links had been developed with the community which had a positive impact for people. Independence was promoted, as were the values of treating each person as an individual.

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; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 26 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

We inspected Northcroft on 9 and 10 January 2017. The inspection was unannounced. The service was last inspected in January 2014 when it was found to be meeting the requirements of the regulations.

People told us they felt safe at the service and with the staff who supported them. For example, we were told: “I am safe here,” and a relative told us: “Northcroft has provided (my relative) with a secure, kind and well managed environment, within which they has become calmer and more balanced emotionally and has developed social skills.”

People told us they received their medicines on time. Medicines administration records were kept appropriately and medicines were stored and managed to a good standard.

Staff had been suitably trained to recognise potential signs of abuse. Staff told us they would be confident to report concerns to management, and thought management would deal with any issues appropriately. We were told by a relative “I can’t fault them (the staff).” A member of staff said “I have not seen anything concerning,” and if they did, thought management would take any concerns seriously and ensure they were fully investigated.

Staff training was delivered to a good standard, and staff received updates about important skills such as moving and handling at regular intervals. An external professional told us “ The staff are very knowledgeable about the individuals they support and seem to be well trained in the areas of the support they are providing.”

Recruitment processes were satisfactory as pre-employment checks had been completed to help ensure people’s safety. This included written references and an enhanced Disclosure and Barring Service check, which checked if a person was suitable to work with vulnerable adults.

People had access to medical professionals such as a general practitioner, dentist, chiropodist and an optician. People said they received enough support from these professionals. External professionals were very positive about the care given. Comments included “The care is definitely client centred….they (the staff) are proactive about finding a solution to benefit their resident and more than happy to learn new skills. Staff treat people with respect and value their opinions.”

There were enough staff on duty and people said they received timely support from staff when it was needed. A relative told us “There is a high ratio of staff.” We observed any requests for assistance being responded to quickly, and staff always being attentive to people’s needs.

Care was provided appropriately and staff were viewed by people and their relatives as caring. We were told “I love living here,” and were told staff were “lovely.” Two relatives separately told us “I can’t fault them (the staff),” and another added that their relative was “Lucky to be here (at Northcroft).”

People had the opportunity to participate in a wide choice of activities. People were busily involved in a range of activities on the day we visited; andwere able to attend several different centres locally, which offered up a wealth of things to do. They also have the opportunity to go on an annual holiday if they want to.

Care files contained information such as a care plan and these were regularly reviewed. The service had appropriate systems in place to assess people’s capacity in line with legislation and guidance, for example using the Mental Capacity Act (2005).

People were happy with their meals. Everyone said they always had enough to eat and drink and were provided with a choice of meals. People received enough support when they needed help with eating or drinking.

People we spoke with said if they had any concerns or complaints they would feel confident discussing these with staff members or management, or they would ask their relative to resolve the problem. They were sure the correct action would be taken if they made a complaint.

People felt the service was well managed. We were told the registered manager and assistant manager were approachable and friendly, and appeared to be “hands on”. An external professional said “We have a good working relationship (with the manager) and she is extremely knowledgeable about her residents and their conditions.”

Staff and relatives told us they had residents’ and family meetings, and relatives had been asked for their feedback about the service on a regular basis. The service had suitable systems in place to monitor and improve the quality of the service.

We spoke to three people living at Northcroft who all complimented the service provided in their home. One person said "they help me when I ask them for things."

We saw staff interacting with people at the home in a friendly manner, and we saw people asking them for help with fine manipulative tasks they struggled with. The staff helped each time when asked in a supportive manner.

The atmosphere in the home was cheerful during our visit and people left the home with staff to go to karate and pick up new prescription spectacles they had requested to have made.

We looked at the environment and saw that it was clean, warm and homely. There were pictures of the people on the walls and displays of artworks and pottery made by them.

We saw three care plans and saw that they were comprehensive in describing the needs of the individual and their diagnoses. The care plans contained charts to assist staff in spotting behaviour triggers and the best way to help the person calm down.

There were relevant risk assessments in place which had been reviewed recently and changed according to the needs on the individual they reflected.

We saw that the people living at Northcroft were supported appropriately and systems were in place to ensure that the care they received met their needs and wishes.

Everyone we spoke to told us they liked where they lived. One person told us "I'm happy to live here. I like doing jobs instead of sitting down". We observed care being provided that reflected people's needs and assessed risks as outlined in their care files.

We observed staff offering choices to people about their daily routines. One person told us "I decide for myself and talk to staff about what I want to do". On the day we visited seven people accessed activities in the community.

Staff were knowledgeable about safeguarding procedures, types of abuse and behaviour management techniques for each person. Everyone we spoke to told us they felt safe and able to talk to staff, "sometimes I get upset. If I have complaints I talk to (key worker)".

We observed staff gave time to people, worked with them around their goals and were knowledgeable about people's behaviours and needs. One person told us "staff are very good with us".

People who used the service and family carers were not asked for their views about the service in a formal, consistent way. Quality monitoring procedures were in place in an informal way, for example, staff asked for people's views in residents' meetings and acted upon these. Incidents and complaints were recorded and learning took place from these.