Archived: Northcott House Residential Care and Nursing Home Also known as 1-684385445

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Pre-assessments were carried out before people moved to the service so they could be sure they were able to meet the person’s needs.

Staff told us they were kept informed about new people moving to the service and that they had access to care plans. For example, one staff member said, “Management will debrief us at our daily meeting at 10am. They would explain that their pre-assessment has been completed and what this tells us about the person. We are informed of their needs, and this is handed over to all staff during daily handovers. When the person arrives, we will always have a chat with them to find out more about them and speak with their relatives. We physically assess them as well. As time goes on you get to know them better and their needs. We always make sure any changes are reflected in the care plans.”

Care plans we looked at included a range of assessments covering people’s physical and mental health and well-being. People’s communication methods were outlined within their care plans to enable them to receive care and treatment which worked for them.

Overall, people’s relatives told us they were involved in reviewing care plans. For example, one person’s relative said, “I do get involved with the care plan reviews. [The nurse] gave me [relative’s] care plan to go home and read.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Nationally recognised assessment tools were used, including an escalation tool used to assess people’s clinical condition when people became unwell. Concerns were escalated quickly and acted on. Support from specialist teams was sought when required.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us it was easy to work with other health professionals and services since the introduction of secure NHS email addresses. A staff member said, “It’s been very effective from our end. We have NHS emails where we can contact external professionals or give them a call. The relationship with the older people’s mental health team (OPMH) is good.”

People’s relatives told us they felt confident people’s health needs were met. For example, one person’s relative said, “They are pretty on the ball with [person’s] care. They have had the GP in a few times and sent [person] into Hospital. They are on top of that and tell us straight away.”

One visiting health professional said, “The staff are approachable and helpful. It feels like teamwork, and I do feel that if they [staff] were concerned about anyone, they would discuss it with us or the GP as soon as possible, rather than wait.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People and relatives told us the care received from staff met their needs. Staff understood how to deliver evidence-based care and treatment. Staff were able to explain what was important to people and supported people in line with best practice standards. Care records provided clear information and guidance and were updated to inform staff if people’s care and treatment needs had changed.

The management team and staff were working with a wide range of health professionals, such as district nurses and social workers to ensure people were receiving appropriate care and support. One person’s relatives said, “You can go to staff about anything. Like today I went and told them that I thought [person] didn’t look so good and they came and checked [person] over. If you do go to them and raise an issue or concern, you don’t feel anxious.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. People had regular reviews with external medical professionals.

Appropriate referrals had been made for people who required additional clinical support, such as the tissue viability nurse, the older people’s mental health team and speech and language therapy (SALT). The GP carried out weekly reviews. One person’s relative said, “When [person] arrived at Northcott House [they] could hardly walk, just hobbled, but the staff took time and understood [their] needs and worked on [person’s] walking and [person] is much calmer and happier now and [their] mobility has improved.”

People's care records had been reviewed regularly and amended according to their needs. Staff had knowledge of people's changing needs, and were able to tell us how these were shared with the rest of the staff team through daily meetings and handovers. For example, one staff member said, “I would like [person] to be more independent. So anytime I see staff assisting [person] with meals, I explain to staff to put the spoon in [person’s] hand, and [they] can feed themself.”

Staff told us how they monitored people’s food and fluid intake and how concerns about low intake were raised to the rest of the team. For example, one staff member said, “We monitor people daily. Before we go to the 2pm meeting we will look at food, fluid and bowel charts to raise any concerns. If a resident isn’t drinking much, we will inform the staff [to encourage people to drink more].”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Overall, people told us staff asked for their consent before supporting them and respected their choices. For example, one person said, “I can have personal care at any time, but it depends when they have time, but they are always very good. I do get a choice about going down to the conservatory but at the moment I’m not bothered.”

Staff had received training in mental capacity and consent. All staff we spoke with described how they ensured people were able to make choices and how they supported people who were unable to make decisions due to their cognitive impairment. For example, one staff member said, “I am so used to all the residents, so you get to know what works for them. They might refuse personal care because they don’t like the person or the time of day. You need to try different methods and understand how they like things and also offer encouragement.”

During the inspection we saw and heard staff asking people for their consent and offering choices. For example, we saw staff knock on bedroom doors and wait for a response before entering and heard staff ask people, “Would you like to join in with the quiz?”

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care services, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met.

All legal applications had been made in accordance with DoLS. This meant people’s rights were fully respected. The registered manager kept a record and tracker of DoLS applications and authorisations. None of the authorisations had conditions attached.