Background to this inspection
Updated
17 March 2020
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 Care Act 2014.
Inspection team
The inspection was conducted by two inspectors and an expert by experience [ExE] on the first day and two inspectors on the second day. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The ExE had experience of care for older people and those living with dementia.
Service and service type
Northbrooke House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had two managers registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Before the inspection we reviewed information we had received about the service, including previous inspection reports and notifications. Notifications are information about specific important events the service is legally required to send to us. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service and eight relatives of people about their experience of the care provided. We spoke with 11 members of staff including the registered managers, registered nurses, a deputy manager, senior care staff, a chef, and care workers. We spoke with the provider who is also the nominated individual for the service. The nominated individual is responsible for supervising the management of the service.
We reviewed a range of records. This included 11 people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including quality assurance processes, policies and procedures. 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.
After the inspection
We reviewed the evidence gathered during the inspection and continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with one professional who regularly visited the service.
Updated
17 March 2020
About the service
Northbrooke House is a care home providing personal and nursing care for people living with a variety of needs, including those with physical and nursing needs and people living with dementia. Northbrooke House accommodates 67 people across two separate wings, each of which has separate adapted facilities. One of the wings specialises in providing care to people who need nursing care and the other for people living with dementia. At the time of the inspection there were 63 people living at the home.
People’s experience of using this service and what we found
People and their relatives told us the care provided, was safe and staff were kind and caring. The environment was clean and had been adapted to meet the individual needs of people living there.
Medicines were managed safely by trained and competent staff. Medication administration records (MARs) were fully completed and regularly audited to identify any areas for development and improvement. Staff had access to medicines policies and procedures as well as best practice guidelines. Staff had received training in infection control and followed good infection control processes.
Staff understood their safeguarding responsibilities and knew how to keep people safe from harm. Safe recruitment procedures were in place to help ensure only suitable staff were employed.
Individual and environmental risks were managed appropriately. People had access to appropriate equipment where needed, which meant risks were minimised.
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.
Staff were motivated and enjoyed working in the home. Continuous learning was embedded in the home's culture. Staff had received appropriate training and support to enable them to carry out their role safely. They received regular supervision to help develop their skills and support them in their role.
People were supported by staff who showed kindness and compassion. They were treated with dignity, and their privacy was respected. People's care plans contained detailed information about their individual needs, wants and wishes, to help staff deliver personalised care. The management team reviewed the care and support provided to people to make sure it continued to meet their needs.
Staff used positive communication techniques with people, so they felt listened to and valued according to their individual needs.
There were meaningful activities available to people that were person centred. Dedicated staff were employed to provide activities, which took into account people’s choices and interests and promoted health and well-being.
The provider had systems and processes to effectively monitor the quality of the service provided within the home. The registered managers understood their regulatory responsibilities and shared information when required.
People, their relatives, staff and external professionals all told us that the provider and registered managers ensured the home was well led.
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 29 January 2019) and there were two breaches of 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.
Why we inspected
This was a planned inspection based on the previous rating.
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.