Northfield House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of the legal regulation in relation to person centred care and safe care and treatment. Improvements were found at this assessment and the provider was no longer in breach of these regulations.
 

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Accidents and incidents were recorded. There was a proactive culture of analysis and looking for lessons that could be learned or improvements that could be made.
 

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People has access to a range of health and social care professionals. Staff spoke positively about the impact for people of health and social care partners working closely together. A professional that works with the service told us, “They are really good. They are always really receptive. If we suggest something they sort it.”
 

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff had received training in safeguarding people from abuse. They were confident that any concerns they raised would be dealt with promptly and appropriately.

Relatives told us they felt people were safe living at the home. They said, “[Person] is living in a safe place” and “Absolutely [person] is in a safe place. Staff flag up any issues.”
 

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks were well managed and care plans and risk assessments were person centred. There was a positive approach to risk taking and a ‘can do’ approach from staff and managers. Staff understood how to support people in a way that ensured risks were managed, whilst respecting and promoting people’s choices and individuality. A new electronic care records system had been introduced to improve the accuracy and accessibility of the care records. One staff member said, “The documentation has massively improved. People get the best care possible.”

The service worked with people to plan for when they experienced periods of distress. Records included clear; person centred, positive behaviour support plans. There was evidence of good support to people and staff if any incidents occurred. Records relating to recording of incidents, and staff debrief, were in the process of being developed further.
 

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The building, equipment and technology were well-maintained. The provider was in the process of centralising the overview of maintenance. During the inspection we discussed the need for introduction of regular checks for safety equipment such as alert/pressure mats and epilepsy monitoring equipment. The provider gave us assurances these would be put in place immediately. Staff understood the importance of ensuring people’s safety whilst in community-based settings. One staff member said, “All our priorities are about people being safe, on activities everyone knows what their role is, it's to protect the people.”
 

Recruitment checks were in place prior to staff starting to work at the home. Staff received a wide range of effective training and competency checks. Staff told us the training was good.

Supervisions and appraisals were in place and staff told us they felt very supported. They said, “You only have to ask people and you've got help” and “Support from managers is also excellent.”

Staff told us staffing was much improved. One staff member said, “There are enough staff. There are odd days with agency but we've had a few new starters so we're not short-staffed like we were probably about a year ago. It's much better now.”

People had individual support that was tailored around their support needs and interests. There was additional support provided when people accessed community-based activities. Relatives told us there were enough staff and that staffing levels had improved recently. They said “I think there have been lots of changes, but I can't complain. Staff turnover was high. Think it’s good now, as when we visit someone is sat with [person]” and “There are enough staff. On the whole the staff are good, some very good and some we don't know.”
 

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The home and equipment were clean and risks associated with infections were assessed and well managed. There were ample supplies of personal protective equipment ( PPE). Staff had received training in infection prevention and control.
 

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Each person had a medicines folder which contained all relevant information to help staff administer, record, store and maintain supplies of medicines safely. People had person centred and detailed information in relation to their needs and preferences. Medicines administration records were completed in full and weekly audits of stock balances were completed to ensure stock levels and administration records matched.

The use of as and when required medicines was minimal and where these were used reasons for use were recorded. However, outcomes and effectiveness were not documented. This had been identified and staff were working on improving this process. As required protocols were in place and were person centred.

Although staff could describe when people had engaged in their annual GP medicines review, records were not readily available. Managers at the home took action to ensure that a system was put in place to easily identify when these reviews were needed.

Staff were trained to administer medicines. Where medicines administration required specific training, the service had arranged online and face to face training to ensure staff were competent to administer these medicines. Six monthly medicines competency assessments were completed and all but 3 staff had completed annual medicines training, there was a system in place to ensure this was completed soon.

The home had a series of audits including weekly, monthly and 6 monthly. These were completed by a variety of staff including regional managers to ensure accuracy. Where actions were identified these were recorded on a central action plan.