26 July 2022
During an inspection looking at part of the service
Northfields is a residential care home providing personal care and support to up to seven people with a learning disability and or autistic people. At the time of our inspection there were six people using the service. The service consisted of one large bungalow, with shared communal spaces, and each person had their own bedroom with ensuite bathroom.
People’s experience of using this service and what we found
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.
Right Support: 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. However, records relating to capacity assessments and Deprivation of Liberty Safeguard (DoLS) applications were not regularly reviewed to ensure people were being supported in the least restrictive manner. The premises were homely, and people’s bedrooms had been personalised based on their own preferences.
Right Care: Care records were under review at the time of the inspection and we identified areas where improvements were required to ensure safe consistent care was provided. People’s support was personalised and catered to their specific wants and needs. Staff provided support in a dignified way to protect people’s privacy and maintain their feeling of self- worth. Staff were trained appropriately to support people and knew them well.
Right Culture: Staff and the management team at the service spoke positively about people within the service and wanted people to live their best lives. We identified areas were governance of paper records and processes had not been maintained putting people at potential risk. Such as medicine records not clearly evidencing topical cream applications, risk assessments and care plans not being regularly reviewed or robust.
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 14 March 2020). The service remains rated requires improvement. This service has not achieved a rating of good overall for the last three consecutive inspections.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
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 remained requires improvement based on the findings of this inspection.
Enforcement
We have identified a breach in relation to the governance and oversight of the service 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.