We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Northenden House is a care home and provides accommodation and personal care for up to six people who have a range of needs including autism, mental health needs and/or learning disabilities. There were six people using the service at the time of this inspection.
The staff supported people to have the maximum possible choice, control and independence and they had control over their own lives. Staff supported people to take part in activities and pursue their interests in their local area. We found person centred activity programmes were scheduled for certain people to ensure their routines were safely followed. The service made reasonable adjustments for people so they could be fully involved in discussions about how they received support, including support to travel wherever they needed to go. For one person we found the service implemented a number of new routines and support mechanisms to manage this person’s particular behaviours.
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. During the inspection we observed a person becoming unwell and requiring treatment. Staff were quickly on hand to support this person and provided the care and treatment they needed in their bedroom. They understood and responded to their individual needs. People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.
Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. People and those important to them, including advocates, were involved in planning their care. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. We found the service was proactive at engaging with people’s families and worked in collaboration with health care teams to ensure bespoke care was provided to people.
We have made a recommendation about the provider considering the current guidance on Right Support, Right Care, Right Culture’ to update their practice accordingly.
Improvements were required to the safe management of medicines. There had been no medicines errors or harm caused to people; however, staff did not always follow best practice.
We found there had been improvements made to the quality and assurance system in place to monitor the safety and quality of care provided. However, further work was required to ensure incidents were fully reviewed/analysed and further quality checks on people’s medicines needed to be introduced.
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 (published 25 September 2020) and there were breaches of regulation. The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We 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 COVID-19 and other infection outbreaks effectively.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified a breach in relation to good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.