Northwick House

Northwick House is a care home registered to accommodate up to 5 people who have learning disabilities and require support with personal care. The home provides respite care to people. There were 20 people assessed for respite care at the home. At the time of our inspection, there were 4 people who were staying at the home.

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 the Care Quality Commission (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:

Staff understood their responsibilities about safeguarding and keeping people safe from harm. Medicines were managed safely. Risks of harm to people were assessed and reduced as much as possible. Staff were recruited safely. People were cared for in a safe, clean and well equipped, environment. There were effective systems to prevent and control infections.

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.

People were treated well and supported with their equality and diversity respected. People received person-centred care which met their needs and preferences. People’s communication needs were assessed and met.

Right Care:

People received kind and compassionate care. Staff respected people's privacy and dignity. People's needs were assessed and delivered in line with their choices and they were supported by staff who were trained to meet their needs. Staff worked with other health and social organisations.

People were supported by a staff team who knew them well. Care plans reflected people's needs, likes and preferences.

People were supported to develop and maintain relationships and take part in activities of interest to them.

Right Culture:

People received good quality care and support. Staff understood people’s needs and were responsive, supporting them to live a quality life of their choosing. People were supported by staff who shared a positive culture which provided them with good outcomes.

Processes were in place to record any accidents and incidents. People's privacy and dignity was respected, and their independence promoted.

Staff evaluated the quality of support and made adjustments to reflect people's needs and wishes.

Staff were clear about their roles and responsibilities. The registered manager understood their obligation under the duty of candour. Systems were in place to monitor the service which included audits and obtaining feedback from people and family members.

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 2 February 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The service was registered with the CQC in January 2016. This inspection on 19 December 2017 was the first inspection for the home.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The majority of people who used the service could not let us know what they thought about the home because they could not always communicate with us verbally. We therefore spent time observing how people interacted with staff to check that the way staff spoke and interacted with people had a positive effect on their wellbeing. During the inspection, we observed people were treated with kindness and respect. It was evident that positive caring relationships had developed between people who used the service and care staff.

Systems and processes were in place to help protect people from the risk of harm and staff demonstrated that they were aware of these. Risks associated with people’s care had been identified and appropriate plans were in place to minimise potential risks to people.

Medicines management arrangements were in place in relation to the recording, storage and administration of medicines.

On the day of the inspection, there were enough staff to meet people’s individual care needs and this was confirmed by care staff we spoke with. We noted care staff were able to complete their tasks and did not appear rushed. We discussed with the registered manager the staffing levels during the night shift and whether this was sufficient to meet people’s needs. She confirmed that there was flexibility and they would review whether one member of staff at night was sufficient.

Regular safety and maintenance checks of the premises were carried out to ensure they were safe. Arrangements for ensuring fire safety in the home were in place.

People’s health and social care needs had been appropriately assessed. Care plans were detailed, person-centred and specific to each person and their needs. Care preferences were documented.

Arrangements were in place to ensure that the nutritional needs of people were met. People’s nutritional needs had been assessed and guidance for staff on the dietary needs of people was in place. Where people required special diets, this was provided and there was evidence that the home communicated with external professionals where necessary and followed advice.

Staff received training to ensure that they had the skills and knowledge to effectively meet people’s needs. Staff spoke positively about the training they had received and told us that they helped them to carry out their roles effectively. There was documented evidence that staff had received regular supervision sessions. Staff were due to receive their appraisals in 2018 and the registered manager confirmed that these would take place in the future.

The home was working within the principles of the MCA. The CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person’s best interests. We found that appropriate authorisations were in place.

People were supported to take part in activities. On the day of the inspection, we saw care staff engaging people in various activities. One person went to the day centre in the morning. One care staff spent time reading to another person. A third person was engaged in putting a puzzle together. After lunch, care staff went out for a walk with two people.

We found the home had a management structure in place with a team of care staff, a care coordinator and the registered manager. Staff spoke positively about working at the home and said that morale was good. Staff were informed of changes occurring within the home through regular staff meetings and we saw that these meetings occurred regularly and were documented.

The registered manager explained that they were eager to obtain feedback from people and their relatives so that the home could make improvements where necessary. The service had carried out satisfaction questionnaires and reviews with relatives in order to obtain feedback.

Audits and checks were in place to monitor the quality of care. The service carried out various checks which included fire safety, health and safety, infection control, staffing and the premises. We noted that where issues were identified, this was documented along with the action required.