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Inspection carried out on 19 March 2019

During an inspection looking at part of the service

About the service

Northfield House provides care and support for up to eight people with a learning disability or autism in one adapted building. At the time of the inspection eight people were using the service.

People’s experience of using this service

The principles and values of Registering the Right Support other best practice guidance ensure people with a learning disability or autism who use a service can live as full a life as possible and achieve the best outcomes that include control, choice and independence. At this inspection the provider had ensured they were applied.

The outcomes for people using the service reflected the principles and values of Registering the Right Support. People's support focused on them having as many opportunities as possible for them to lead an active life.

Staff provided people with timely support to people and they knew how to intervene in the least restrictive and positive way. This approach had fostered positive relationships between staff and the people they supported.

The registered manager was keen to make changes that would impact positively on people’s lives. They had taken appropriate action to identify and minimise risks including risks associated with medicines. Where needed additional staff training and support had been provided to improve staff performance and drive continuous improvement.

Staff were safely recruited and when we visited we found the service was adequately staffed. Appropriate safeguarding procedures were followed.

People were protected by the prevention and control of infection.

Effective systems were in place for measuring outcomes for people who lived at the service. These were used to highlight areas for improvement and promote safe, consistent care.

We received positive feedback about leaders and the registered manager. Staff told us that they felt supported by the manager and senior management team.

Rating at last inspection

At the last inspection the service was rated good (published 7 December 2017).

Why we inspected

We received concerns in relation to the management of medicines and risk management. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only. No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during inspection activity so we did not inspect them. The ratings from previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection. The overall rating for the service has remained Good based on the findings and ratings of Key Questions Safe and Well-led at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Northfield House on our website at

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 10 October 2017

During a routine inspection

Northfield House is a residential care home for up to eight adults with a learning disability or autistic spectrum disorder.

We carried out an announced inspection of this service on 10 October 2017. The provider was given notice the week before we visited because the location was a small care home for younger adults who are often out during the day; we needed to be sure that someone would be in. This was the first inspection of this location since it was registered under a new provider, Action for Care Limited, in December 2016. At the time of our inspection, there were seven people using the service.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like providers, they are ‘registered persons’. 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.

Staff understood their responsibility to safeguard adults who may be at risk of abuse. Robust recruitment checks were completed and sufficient staff were deployed to provide safe care to people who used the service. We made a recommendation about medicines management although overall medicines were managed safely.

Positive behaviour support plans were used to promote people’s wellbeing and safety. The use of these had resulted in improved outcomes for people who used the service. Care plans and risk assessments were detailed and these guided staff on how to provide safe care and support.

We observed the service to be well maintained and the registered manager completed regular audits to monitor the quality and safety of the environment.

Staff had received appropriate training and support for them to fulfil their roles effectively. People were supported to have maximum choice and control of their lives and staff support people in the least restrictive way possible; the policies and systems in the service support this practice.

Staff supported people to eat a varied, nutritious diet. People had access to a range of healthcare services to maintain their health and well-being.

Staff were observed to be respectful and positive relationships had been established. Staff supported people to engage in a wide range of activities and to access the community.

Staff demonstrated a good understanding of people’s needs and could communicate effectively with people. People’s care and support was kept under review to ensure it met their needs and care plans were detailed and person-centred.

Systems were in place to gather and respond to feedback. The registered manager completed a range of audits and spot checks to monitor the quality and safety of the service. People told us the registered manager was approachable, supportive and responded to feedback.