4 December 2023
During an inspection looking at part of the service
Northlands Care Home (Northumberland) is a residential care home providing accommodation and personal and nursing care and treatment of disease and disorder to up to 39 people. The service provides support to people with a physical disability or medical need and older people, including people who are living with dementia. At the time of our inspection there were 37 people using the service.
People’s experience of the service and what we found:
People were not always protected from risk and actions to mitigate risks were not always in place. Lessons were not always learned when there had been accidents or incidents. The home was in organisational safeguarding because the local safeguarding team had identified a number of concerns. Actions had not always been taken to address these concerns or keep people safe. People told us there were enough staff to support their daily care needs. However, staff were not always deployed efficiently, and some areas of the home were not always well observed. We found some minor issues regarding support with medicines and infection control.
People were not always supported to access appropriate food and fluids. Care records did not always reflect the most up to date advice and fluid intake records indicated recommended fluid intake levels were not always met. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. People were subject to restriction on their freedom. Whilst these restrictions were to ensure their safety, actions had not been taken in line with the requirements of the Mental Capacity Act. Staff training required further action to address previously identified shortfalls.
Quality monitoring at the home was not consistent. Checks and audits failed to identify shortfalls in care and incomplete records. The provider had not written formally to individuals, offering explanations and apologies following accidents or untoward events. People were involved in care decisions and said staff treated them well. The provider was looking to address the shortfalls and had recently appointed a new quality manager who was working on improvements.
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 12 September 2019)
Why we inspected
The inspection was prompted in part due to concerns received about keeping people safe, delivering the right care to support people, 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 Northlands Care Home (Northumberland) on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to managing risks at the home, ensuring people did not suffer from avoidable harm, supporting people to maintain a balanced diet, ensuring where people could not consent to care appropriate processes were followed, staff training and support, maintaining a robust oversight on the quality of care and responding to the provider’s duty under duty of candour.
We have made recommendations to the provider regarding improvements to staffing and the safe management of medicines.
Follow Up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
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.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.