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Northfield House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 22 October 2020

About the service

Northfield House is a residential care home providing accommodation and personal care to 24 older people who live with dementia at the time of the inspection.

Northfield house can accommodate up to 25 people in one adapted building which has an enclosed garden.

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

Fire evacuation procedures were not in place and fire drills had not taken place to test that people could be supported to safely escape if there was a fire. This placed people at risk of harm in the event of a fire.

Whilst some improvements had been made since the last inspection in relation to governance and oversight, systems were still not always effective in identifying and addressing quality concerns. Further improvements were needed in the monitoring of people’s care records and fire safety and ensuring identified shortfalls were robustly addressed. We have received some assurances from the provider that they had started taking action to mitigate the risks identified during this inspection.

The monitoring of the medicines management had been effective and had resulted in medicine errors reducing and improved support for staff who administered medicines.

Staff were aware of how to report their concerns in relation to safeguarding and poor care. Concerns raised including about staff’s behaviour, were investigated by the provider and actions taken to address any shortfalls. However, in some cases it had taken concerns to be raised for the shortfall to be identified and the provider did not always identify shortfalls such as incomplete records, through their own monitoring systems.

Infection prevention and control processes were in place to protect people and prevent the spread of infection. There was plenty of personal protective equipment (PPE) and improved arrangements to support staffs’ use of this in relation to current PPE guidance for COVID-19. Regular COVID-19 testing of staff and people took place, support to socially distance and isolate when needed was provided and support to remain in contact with family members in a safe way.

The views of people and their relatives had been sought and, where it was practicable to do so during the pandemic, these had been considered and acted on to help improve the quality of support and services provided to people.

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 (report published 6 November 2019) and we identified one breach of regulation 17 Good Governance. 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 although some improvement was evidenced at this inspection, not enough improvement had been made and the provider remained in breach of regulation 17. We also found a new breach of regulation 12 Safe Care and treatment. The service remains rated Requires Improvement. This service has been rated Requires Improvement for the last three consecutive inspections.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. We also looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this

Inspection areas

Safe

Requires improvement

Updated 22 October 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 22 October 2020

Caring

Good

Updated 22 October 2020

Responsive

Good

Updated 22 October 2020

Well-led

Requires improvement

Updated 22 October 2020

The service was not always well-led.

Details are in our well-led findings below.