We carried out a review of the data available to us about Northleach Court Care Home with Nursing on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Northleach Court Care Home with Nursing, you can give feedback on this service.
Northleach Court Care Home with Nursing is a residential care home providing nursing and personal care for up to 40 people. The service provides support to older people, people with dementia and people with a physical disability. At the time of our inspection there were 26 people using the service.
At the time of inspection Northleach Court Care Home with Nursing was undergoing building work to expand and improve the premises.
People’s experience of using this service and what we found
Improvements had been made to the service following our last inspection. The environmental risks within the home were managed and reviewed to help keep people safe. People and staff told us they were excited about the improvements being made to the home and the provider had assessed the risk to people whilst the building work was being completed. Accidents, incidents and near misses were reported and responded to appropriately. This ensured the risk to people was reduced and there were systems in place to identify any changes in people’s risks.
People were supported in the management and administration of their medicines. As part of the inspection the provider was reviewing their processes around patch application for some people. Staff followed safe infection control practices and had access to personal protective equipment (PPE).
The provider was reviewing their recruitment policy to ensure a consistent approach when staff had worked both abroad and in the UK. Staff received induction, training and supervision to support them in their roles.
People felt safe living at the service and were protected from the risk of abuse or harm.
People’s needs and risks were assessed and regularly reviewed to reflect their changing needs. People’s risk management plans were detailed and individualised to each person.
Staff spoke passionately about their role in delivering good quality care to people in the service. People and their relatives felt staff were caring and kind.
The service adopted an open culture where good practice was celebrated and areas of improvement were shared and learned from.
The service had a number of systems in place to monitor the quality of care and safe running of the service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 13 September 2021) and there was a breach in regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we recommended that the provider develops their processes to ensure their audits and other monitoring systems are able to effectively assess, monitor and mitigate risks to people. At this inspection we found the provider had acted on this recommendation and had made improvements.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 20 July 2021. Breach of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Northleach Court Care Home with Nursing on our website at www.cqc.org.uk.
Northleach Court Care Home with Nursing is a care home providing personal and nursing care to 28 people aged 65 and over at the time of the inspection. The service can support up to 40 people.
People’s experience of using this service and what we found
Risks to people's safety were not always assessed and managed safely. People’s care plans did not always identify key pieces of information and had not always been reviewed in accordance with the provider’s policy.
Medicines were not managed safely as staff did not always follow agreed processes. Medication audits were regularly completed but did not always effectively identify areas of concern.
We received mixed feedback about adequate staffing levels being maintained. However, during this unannounced inspection, we observed there to be enough staff available to meet people’s needs.
The audits, systems and processes to monitor the service were comprehensive. However, they were missing independent checking to ensure they were being used correctly to provide an accurate reflection of the service. The provider’s governance systems had proactively identified the need for some further development, but more work was needed to ensure the effectiveness of audits to minimise risks to people.
We have made a recommendation to ensure the audits and systems to monitor the service are working effectively to assess, monitor and mitigate the risks to people.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 7 March 2020).
Why we inspected
We received concerns in relation to the management of infection control, staffing and people’s nursing care needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
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.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
You can see what action we have asked the provider to take at the end of this full report.
The provider responded immediately during and after the inspection. They confirmed they were developing their governance of the service to ensure that audits were effectively identifying and managing areas of improvement.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Northleach Court Care Home with Nursing on our website at www.cqc.org.uk.
Enforcement
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 to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified a breaches in relation to regulation 12 (Safe Care and Treatment) at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People's experience of using this service and what we found
People’s individual healthcare risks were assessed and guidance was available for nursing and care staff on how to meet these needs. Nursing and care staff understood people’s needs and how to assist them to protect them from avoidable harm.
The management team and provider had systems in place to assess and monitor people’s health and wellbeing. A representative of the provider reviewed all incident and accident audits to ensure appropriate action has been taken.
Staff kept a record of the support they provided people. The provider and management team were taking action to ensure staff ensured incidents as well as daily notes on people’s care was completed consistently.
The provider and management had ensured lessons had been learnt in relation to concerns raised by healthcare professionals. The provider had ensured management and clinical governance was appropriately implemented to ensure people’s needs were being met.
The service had infection control processes and systems in place to reduce the risk of people contracting COVID-19.
Rating at the last inspection
The last rating for this service was Good (published 7 March 2020).
Why we inspected
We undertook this targeted inspection to follow up on concerns we had received about how the nursing and care staff met people’s care needs and risks, including when people’s needs changed. A decision was made for us to inspect and examine those risks.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Further information is in the detailed findings below.
Northleach Court Care Home with Nursing is a residential care home providing personal and nursing care to 31 older people at the time of the inspection. The service can support up to 40 people in one adapted building.
People’s experience of using this service and what we found
People’s health and social care needs were assessed. Action was taken to reduce risks and to deliver care according to people’s needs and preferences.
There were enough staff in number and skill to meet people’s needs and provide care and support in a person-centred and meaningful way. Arrangements were in place to reduce risks associated with infection. People were supported to take their medicines and action had been taken to mitigate risks associated with medicine administration.
People were supported to eat and drink enough in a way which suited their individual needs.
People were provided with help to enjoy social activities and activities which more meaningful to them personally.
Managers and administration staff were approachable and accessible to people and their relatives. Staff and managers worked as one team to provide better outcomes for people. There were arrangements in place for managers to communicate with people, relatives and staff and to obtain and listen to their feedback.
The registered manager promoted an open and relaxed culture which benefitted people’s wellbeing. They empowered staff to feel able to challenge poor practices and to feel included in how the home was run.
The new provider had made improvements in relation to the premises, infection control and quality assurance since acquiring the service. A full refurbishment plan was in place for the home.
People views on the service were sought. Regular people and staff team meetings took place. Quality assurance systems were in place to enable the service to identify areas for improvement and ensure people received a good quality service.
Staff told us they had received appropriate training which supported them to carry out their role. Staff told us they could seek advice from the manager and carers. The manager and staff were passionate about the care they delivered and were driven to improve the service.
The manager acted on concerns to ensure people received care which was safe and responsive to their needs. Staff were trained in safeguarding people and protecting them from harm. Any concerns or accidents were reported and acted on.
The manager monitored the delivery of care through staff observations and feedback from people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Requires Improvement (published 27 November 2018). Since the last rating was awarded the provider has altered its legal entity and was registered by CQC under the new legal entity on 2 August 2019. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was the first inspection of the service under the new legal entity. Although the previous requires improvement rating was not awarded to this provider, they had full knowledge of the service's inspection history and were responsible for maintaining and improving the service, including addressing any issues from the last inspection. We have found evidence that the provider has made significant improvements to improve the ratings.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.