Background to this inspection
Updated
23 December 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection team consisted of 3 inspectors.
Service and service type
Northcott House Residential Care and Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Northcott House Residential Care and Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
The inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 8 people who used the service and 4 relatives about their experience of the care provided. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with 9 members of staff including the registered manager, deputy managers, registered nurses, care workers, administrator, activity staff and the chef. We received feedback from 5 healthcare professionals who have regular contact with the service.
We reviewed a range of records. This included 8 people’s care records and multiple medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including quality assurance processes, training records, a sample of policies and procedures were reviewed.
Updated
23 December 2023
About the service
Northcott House Residential Care and Nursing Home is a care home that can provide personal and/or nursing care to up to 55 people. At the time of the inspection, they were providing support to 53 people, some of whom lived with dementia and the frailties of old age.
People’s experience of the service and what we found
Risks to people were not always consistently assessed and managed. Risk assessments and care plans did not always contain the information staff needed to ensure the provision of safe and effective care.
People were not always receiving their medicines safely and according to prescriber’s instructions. Governance and management systems were not always effective in identifying shortfalls. When shortfalls were identified systems and practice was not always updated to prevent reoccurrence. The registered manager responded to the shortfalls identified at inspection and acted on them to make the service safe. These changes will need to embed into practice to be sustainable.
People, staff, and relatives remarked on a number of positive changes to the service in recent months. These included an extended activity team to aid people’s engagement and wellbeing. Changes were made to the menus following people and relatives’ meetings, and an ongoing programme of refurbishment of the building to improve the environment.
People and their relatives described staff as being kind and caring. There were safe systems in place for the recruitment of staff. Staff received a raft of training and the registered manager told us they were seeking further knowledge development opportunities for staff around supporting people living with dementia.
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 8 August 2019.
Why we inspected
The inspection was prompted in part due to concerns received about medicines, personal and nursing care and staffing. A decision was made for us to inspect and examine those risks.
We undertook a focused inspection to review the key questions of safe, effective, and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Northcott House Residential Care and Nursing Home on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safety and governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow Up
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.