6 Northumberland Road

About the service

6 Northumberland Road is a residential care home providing accommodation and personal care to up to five people. The service provides support to adults of all ages who have mental health needs. At the time of our inspection there were four people living at the service.

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

People felt safe and were protected from the risk of harm and abuse because the service assessed, monitored and managed this as far as possible. Assessments were kept up to date and guidance helped staff to provide appropriate levels of support.

A new information and pre-admission process had been developed since our last inspection. This ensured people received a more individual approach which met their needs. There were enough staff to support people, and staff were safely recruited.

The environment, equipment and health and safety were regularly checked to ensure these were safe for people who lived at the service. Accidents and incidents were reviewed and lessons learned when necessary.

People were protected from infection. Staff supported people as required to ensure they received their medicines safely and as prescribed.

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.

There had been changes in the staff team, and people and staff were positive about the management of the service. Systems were in place to monitor and improve the quality of the service. Action plans ensured tasks were completed and improvements were shared with the staff team. There was a focus on engaging and involving people, their relatives and staff in the development of the service.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 17 September 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we also recommended the provider introduced a robust and effective pre-admission procedure for the service. At this inspection we found improvements had been made and a new procedure was in place and being used.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 10 August 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and governance.

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.

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 requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for 6 Northumberland Road on our 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.

6 Northumberland Road provides accommodation and support for five people with acute mental health needs.

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

Risks to people in their daily living had not always been assessed and risk assessments updated. Incidents were not always being reviewed for lessons learned and shared with the staff team to improve safety.

For one person there was a lack of suitable pre-admission planning and liaison with the organisation the person came from. This could have put people, staff and others at risk if the staff team were not made aware in detail of the person’s needs and any risk management strategies in place.

Quality assurance systems were in place, but these failed to identify or address the shortfalls found during the inspection. This placed people at risk of receiving a poor-quality service. While the provider and registered manager had an action plan to improve the service, some concerns had not been recognised until we provided feedback.

People were supported by a staff team who understood safeguarding and how to report concerns. There were enough suitably trained and skilled staff to support people safely. People were supported safely with their medicines.

Staff cared for the people they supported and valued their roles. One staff member said, “The staff that work here are amazing.” Another staff member told us “We are a good team and we always do our best for the guys and I like the team I work with.”

Rating at last inspection:

At the last inspection the service was rated good ( report published December 2017 ).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

You can read the report from our last comprehensive inspection, by selecting the 6 Northumberland Road link for on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified two breaches in relation to: safe care and treatment and good governance at this inspection. We have also made a recommendation around how the service could improve its pre assessment processes.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

You can see what action we have asked the provider to take at the end of this full report.

People using the service felt safe. Any risks associated with their care and support were assessed and measures put in place to ensure they were managed. Medicines were stored safely and administered for those people that required them. Staff shortages in the past had caused some difficulties but had been managed and were being addressed through successful recruitment.

Care and support was effective in meeting people’s needs. There were clear plans in place that had been devised with service users in relation to their mental health needs. People were supported to see health care professionals when necessary. People were able to manage their own meals and buy their food shopping independently but also had some meals together. People discussed what they would like on the menu.

Staff were kind and caring and treated people with respect. This was reflected in our observations and feedback from people using the service. People’s independence was encouraged; when able to, people managed their own medicines and cooked meals for themselves.

People had person centred support plans in place which people’s needs well and were developed in conjunction with the person concerned. People felt able to raise issues and concerns if they had them and we saw that these were responded to.

There was a temporary registered manager in post and plans in place to recruit to the post on a permanent basis. Staff told us they felt well supported and worked well as a team to ensure people’s needs were met. There was an effective system in place to monitor the quality of the service provided and to identify and act upon any shortfalls.

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Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw that people who lived at 6 Northumberland Road were treated in a respectful way by the staff who supported them with their needs. We spoke with the five people who used the service. Everyone had positive opinions about what it was like to live at the home. They also had positive views of the way they were treated by the staff.

Risks were being managed in a safe and suitable way. Care records explained how possible risks to people's safety and wellbeing had been identified. What actions were needed to minimise risks and to keep people safe had also been clearly set out. Staff understood how to assist people so that they took acceptable risks in their life. For example the role of the staff included providing support so that people were able to gain confidence in the community.

People were protected from risks from infection because there were systems in place to ensure that the environment was kept clean and hygienic. Staff received regular training so that they understood how to minimise infection control risks in the home.

Is the service effective?

Every person who we spoke with told us they were being supported with their range of needs by the staff at the home. Examples of the feedback people gave us included 'the staff are pretty good they are like a citizens advices bureau', 'I like the male carers' and 'I'd like to thank the manager for sorting out my broken bed'.

Staff were effectively supervised in their work which ensured they provided suitable care and assistance that met people's needs. They attended training courses and learning events about mental health and a range of health and safety matters. They also went on training to understand how to safeguard people from the risks of abuse.

Care plans showed clearly and in detail how to effectively support people with their particular complex mental health needs. They had been devised with the involvement of the person concerned. One person said they spoke to the manager about their care plan regularly to make sure they were in agreement with it.

Is the service caring?

The feedback from every person we spoke with was unanimously positive about the caring attitude of the manager and the staff at the home. Three people we spoke with together told us we should give the manager and the staff '10 out of 10' for their attitude.

Staff were observed communicating with people with a caring and sensitive approach. For example one member of staff spoke with one person who wanted to go to the bank in a sensitive manner.

Is the service responsive?

People told us they spoke with the manager and were able to talk with them about any concerns they had. One person told us 'the manager is very good at sorting out things if you have a complaint they know who to ring to sort it out'.

Every person we spoke with also told us that the staff spent time with them regularly to find out how they were feeling. They said staff tried to help them to resolve any concerns they had .

The people who lived at the home told us that regular house meetings were held at the home. They also told us their views were always sought by the staff about the way the home was run. For example we saw that people were regularly consulted about menu plans as well as about suggestions for social activities and outings.

Is the service well-led?

People who used the service had high opinions of the registered manager. One person told us that they were 'very caring'. Another person explained that they thought that the manager was 'very firm but friendly, very formal and professional'.

There were systems in place to ensure that the quality of care that people received and the overall standards of service were suitable for them. The views of people who lived at the home were regularly sought as part of the process of monitoring quality there.

Every person we met had positive opinions about the quality of care and support they were receiving. One person told us, 'I do like it here I'm very happy here'. Examples of the comments people made included, 'the staff are good company they are alright to me', another person told us "the staff all keep in contact with you, they ask how you are".

People who used the service were effectively supported to live a fulfilling life, that also promoted their independence in the community.

People's care plans and their risk assessment records were informative and they showed how to assist people effectively and safely with their mental health needs. This meant staff had information to use as guidance so to be able to give people the care they required.

People told us they felt confident that if they were not being treated properly they could go to the manager who would immediately address the matter. People were safeguarded as they were assisted by staff who were suitably trained to know how to protect them from abuse.

The staff were supported to undergo further training and development to make them competent to meet people's needs.

People benefited because there was a system in to quality check the service they were receiving.