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Archived: Northampton Lodge Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 18 August 2016

During a routine inspection

We inspected Northampton Lodge on 18 and 19 August 2016. The inspection was unannounced. At the previous inspection in December 2014 the service was meeting the Regulations we inspected.

The service provides care and accommodation for up to four adults with learning disabilities, mental illness and physical disabilities. There were three people using the service at the time of the inspection.The service does not require a registered manager under the conditions of registration.

The provider had not ensured the safety of the premises and the equipment in it. We identified issues around maintenance, lighting, hot water checks, legionella checks and equipment. Although the provider informed us there were problems with the landlord maintaining the building it was the responsibility of the provider to ensure it was safe. The service did not support staff with risk assessments that were regularly reviewed and updated which provided clear guidance on how to address those risks. The provider had not ensured medicines were managed properly. Procedures were unclear. Records were poor and it was not possible to reconcile the quantity of some medicines with those records. Poor procedures and records increased the risks of medicines not being administered as prescribed. The provider had not ensured there were appropriate procedures in place in relation to the prevention and control of infection. Despite the interior of the building being tidy we were not satisfied with the overall cleanliness and hygiene. We found damp patches in rooms and mould in bathrooms. Both increased the risk of respiratory symptoms and infections. There was no clear leadership, policies and auditing in relation to infection prevention and control. You can see what action we told the provider to take at the back of the full report. People using the service told us they felt safe. There were enough qualified and suitable staff to meet people’s needs.

Although staff had completed appropriate training there were significant gaps in refresher training. For example there had been no refresher training or competency checks in relation to medicine’s management. There was a risk staff did not have the most up to date information to support them to provide safe and appropriate care. You can see what action we told the provider to take at the back of the full report. The service was acting within the principles of the Mental Capacity Act. People were supported with nutrition, hydration and maintaining good health. We have made a recommendation about nutrition and hydration.

People and those acting lawfully on their behalf must be actively encouraged and supported to be involved in decisions about their care and treatment. Records did not show the involvement of people or their relatives in the planning and delivery of care and support or how the service supported people to understand care options and express their views. You can see what action we told the provider to take at the back of the full report. Care was delivered in a patient, friendly and sensitive manner. Staff respected people’s privacy and dignity. People’s choices and preferences were respected by staff but were not clearly recorded. People were supported to maintain and develop independence.

People received personalised care that was responsive to their needs which were recorded in a variety of documents including assessments and reviews by relevant authorities. However, this information had not been used by the service to develop their own care plans to support and guide staff to deliver safe and effective care and support. You can see what action we told the provider to take at the back of the full report. People were involved in activities. There were opportunities for people to provide feedback about the service.

The provider did not have effective systems in place to make sure the quality of service they provided was regularly monitored and assessed to prevent inappropriate or unsafe care. The se

Inspection carried out on 22 December 2014

During a routine inspection

We visited Northampton Lodge on the 22 December 2014. The inspection was unannounced.

The service provides care and accommodation for up to four adult females with learning disabilities, mental illness and physical disabilities. The service does not require a registered manager under the conditions of registration.

People at the service felt safe and happy. Relatives of people using the service were happy with the care provided. Staff knew how to recognise and respond to abuse and had completed safeguarding of vulnerable adults training. They knew how to report safeguarding incidents and escalate any concerns if necessary. Staff were confident they could report any concerns to the provider and they would be dealt with appropriately. Accidents and incidents were recorded. The service provided a safe environment for people, staff and visitors. People’s needs were assessed and corresponding risk assessments were developed. There were sufficient numbers of staff to meet people’s needs. People’s medicines were administered safely.

Staff had the skills, knowledge and experience to deliver safe care and treatment. Mental capacity assessments had been completed to establish each person’s capacity to make decisions. The manager and staff had recently completed mental capacity training. The service had not considered it necessary to apply for any authorisations under the Deprivation of Liberty Safeguards (DoLS). People were supported to have a healthy diet and to maintain good health.

People told us they liked staff. They were supported to express their views and along with their relatives were involved in making decisions about their care and treatment. Staff respected people’s privacy and dignity and helped them to be more independent.

People received personalised care. Care plans were person centred and addressed a wide range of needs. People and their relatives were involved in the development of their care and treatment. Care plans and associated risk assessments reflected their needs and preferences. People were strongly encouraged to take part in activities to build their confidence and independence and to decrease the risks of social isolation. People and relatives were confident that they could raise concerns with staff and the provider and those concerns would be addressed.

The service was open and inclusive focussing on people using the service. Staff spoke positively about the service and the provider. Staff meetings were held in response to incidents or significant changes and included discussions about and learning from incidents. There was a system of audits and regular provider visits that monitored and assessed the quality of service provision.

During a check to make sure that the improvements required had been made

We found the provider had made the required improvements for the safe storage of medicines, implemented policies and procedures and provided appropriate training for all members of staff.

Inspection carried out on 22 November 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service. This was because some people who use the service were not able to tell us how their care was delivered.

We spoke with one person who said, "I like all the activities, staff go with us." One relative told us "I have a lot of praise for the staff and the manager and I am quite in awe of what they have done for X." The staff we spoke with demonstrated a very good understanding of the needs of the people who used the service.

We found that peoples’ needs were assessed and care was delivered in line with their individual care plans. We saw that people who used the service and their families were fully involved in making decisions about their care and welfare.

We found the provider worked in co-operation with other professionals to support people with their health and welfare needs. The GP we spoke with told us “Staff noticed when things were not right with X and brought X for an appointment.”

Medicines were prescribed and given to people appropriately. However, we found that medicines were not safely stored and we had other concerns regarding the management of medicines.

We found that there was an effective recruitment process in place so people could be confident the right people were employed in the service.

We found that people who used the service and their families were supported to raise any concerns and these were dealt with effectively.

Inspection carried out on 17 January 2013

During a routine inspection

There were two people living in Northampton Lodge at the time of our inspection. We spoke to people, staff and relatives. All spoke positively about the home.

People told us, "It's alright, yes" and "I do like living here." Staff said, "It's a pleasure to work at the home." A relative told us, "I have total and utter confidence in the home."

We saw staff treat people with dignity and respect. We observed positive, friendly and inclusive interactions between them.

We were shown redecoration and refurbishment that had improve the living space for people using the service. We were told that further improvements were planned.