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Northfield House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 5 November 2019

About the service

Northfield House is a residential care home which can provide accommodation and personal care to 25 older people. At the time of the inspection 20 people were receiving care. The home cares for older people, some who live with dementia. People are accommodated in one adapted building which has a sensory style garden and car parking.

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

At the last inspection in September 2018 we inspected the key questions Is the service safe? and Is the service well-led? We found the provider needed to make improvements to their quality monitoring system, people’s care records and how they sought and acted on feedback from people, relatives and professionals.

During this inspection we found the provider had met the actions outlined in their action plan, forwarded to us following the last inspection. However, their quality monitoring system was still not always ensuring effective and continuous monitoring of the service and improvement was still required to the quality monitoring of the service and maintenance of some records. Some areas of shortfall were not getting identified and addressed in a timely manner such as, the provision of staff supervision in accordance with the provider’s policy, consistent and effective auditing of care plan and risk assessment content, the monitoring of staff competency checks and some areas of cleaning and safety management. Although, to date, this had not impacted on people’s care and treatment, people’s safety was potentially at risk if shortfalls in service compliance and improvement progress continued to not be successfully identified and addressed.

We had received concerns that people’s health and welfare had been, and continued to be, neglected and that the management of the home supported poor practice. We followed up specific incidents, which had been reported to us. We therefore looked at the management of medicines, the general management of the home and the overall workplace culture. We found that best practice had not always applied; when responding to changes in people’s health and wellbeing and in record keeping. A lack of communication and team working had contributed to how two of the situations reported to us, had been responded to. This had contributed to a delay in people being medically reviewed. Staff actions were not the only contributing factor in this delay, ambulance waiting times and waiting to access GP advice also contributed. Ensuring staff had appropriate training, support and guidance was important so they were able to respond to changes in people’s physical and mental health effectively. There was evidence to show that action had been taken to improve staff knowledge and to ensure they had appropriate guidance. Current legislation; processes required under the Mental Capacity Act and Deprivation of Liberty Safeguards were followed. No-one in the home was being ‘wilfully imprisoned’. Action was taken by the registered manager, at the time of these incidents, to investigate and address shortfalls in practice. We found managers were not supporting poor practice.

Improvement to the quality monitoring of the service and the processes behind ensuring necessary action was taken for continuous improvement was therefore needed. For example, making sure that all support arrangements and processes were in place to ensure best practice was consistently maintained. To ensure changes in workplace culture and performance were identified and effectively addressed and, to ensure the adopted management systems and processes helped managers to remain compliant with regulations and ensure the provider’s policies and procedures are followed.

We recommended the provider seek immediate advice regarding their quality monitoring processes. You can also see what action we have asked the provider to take at the end of this full report.

People’s health and social care needs were assessed. Risk had been assessed and care

Inspection areas

Safe

Requires improvement

Updated 5 November 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 5 November 2019

The service was effective.

Details are in our effective findings below.

Caring

Good

Updated 5 November 2019

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 5 November 2019

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 5 November 2019

The service was not always well-led.

Details are in our well-Led findings below.