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Inspection carried out on 2 August 2019

During a routine inspection

About the service

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.

Inspection carried out on 9 January 2017

During a routine inspection

Northcroft is a care home which provides accommodation for up to eight people with a learning disability who require personal care. At the time of the inspection seven people were using the service.

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 the

Inspection carried out on 22 January 2014

During a routine inspection

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.

Inspection carried out on 17 January 2013

During a routine inspection

There were eight people living at Northcroft at the time of our inspection. We spoke with three people in total to get their views, one in person and two people over the telephone.

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.

Reports under our old system of regulation (including those from before CQC was created)