This inspection took place on 19 December 2017 and was unannounced. Northwick House is a care home that is registered to accommodate up to five people who have learning disabilities and require support with personal care. The home provided respite care to people. There were 32 people assessed for respite care at the home. However, 19 of these people used the respite service regularly. At the time of our inspection, there were three people who were on long term stay at the home. Following the inspection, the registered manager advised that one of the three people had returned to their own home as they had made good progress.
The service was registered with the CQC in January 2016. This inspection on 19 December 2017 was the first inspection for the home.
There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered 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.
The majority of people who used the service could not let us know what they thought about the home because they could not always communicate with us verbally. We therefore spent time observing how people interacted with staff to check that the way staff spoke and interacted with people had a positive effect on their wellbeing. During the inspection, we observed people were treated with kindness and respect. It was evident that positive caring relationships had developed between people who used the service and care staff.
Systems and processes were in place to help protect people from the risk of harm and staff demonstrated that they were aware of these. Risks associated with people’s care had been identified and appropriate plans were in place to minimise potential risks to people.
Medicines management arrangements were in place in relation to the recording, storage and administration of medicines.
On the day of the inspection, there were enough staff to meet people’s individual care needs and this was confirmed by care staff we spoke with. We noted care staff were able to complete their tasks and did not appear rushed. We discussed with the registered manager the staffing levels during the night shift and whether this was sufficient to meet people’s needs. She confirmed that there was flexibility and they would review whether one member of staff at night was sufficient.
Regular safety and maintenance checks of the premises were carried out to ensure they were safe. Arrangements for ensuring fire safety in the home were in place.
People’s health and social care needs had been appropriately assessed. Care plans were detailed, person-centred and specific to each person and their needs. Care preferences were documented.
Arrangements were in place to ensure that the nutritional needs of people were met. People’s nutritional needs had been assessed and guidance for staff on the dietary needs of people was in place. Where people required special diets, this was provided and there was evidence that the home communicated with external professionals where necessary and followed advice.
Staff received training to ensure that they had the skills and knowledge to effectively meet people’s needs. Staff spoke positively about the training they had received and told us that they helped them to carry out their roles effectively. There was documented evidence that staff had received regular supervision sessions. Staff were due to receive their appraisals in 2018 and the registered manager confirmed that these would take place in the future.
The home was working within the principles of the MCA. The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person’s best interests. We found that appropriate authorisations were in place.
People were supported to take part in activities. On the day of the inspection, we saw care staff engaging people in various activities. One person went to the day centre in the morning. One care staff spent time reading to another person. A third person was engaged in putting a puzzle together. After lunch, care staff went out for a walk with two people.
We found the home had a management structure in place with a team of care staff, a care coordinator and the registered manager. Staff spoke positively about working at the home and said that morale was good. Staff were informed of changes occurring within the home through regular staff meetings and we saw that these meetings occurred regularly and were documented.
The registered manager explained that they were eager to obtain feedback from people and their relatives so that the home could make improvements where necessary. The service had carried out satisfaction questionnaires and reviews with relatives in order to obtain feedback.
Audits and checks were in place to monitor the quality of care. The service carried out various checks which included fire safety, health and safety, infection control, staffing and the premises. We noted that where issues were identified, this was documented along with the action required.