The Care Quality Commission (CQC) has told Northfield House, a residential care home in Thirsk, to make urgent improvements to keep people safe following an inspection in June and July.
Northfield House cares for up to eight young adults with a learning disability and/or autism. At the time of the inspection, eight people were living at the service.
This focused inspection was carried out due to concerns received about the management of risks and incidents, medicines and staffing issues.
Following this inspection, the overall rating has dropped from good to inadequate. It has also been rated inadequate for being safe, effective and well-led. At the last inspection in March 2019, these areas were all rated as good. The service is now in special measures and will be kept under review.
Debbie Ivanova, CQC’s deputy chief inspector for people with a learning disability and autistic people said:
“When we inspected Northfield House, we were disappointed to find a service that has gone from providing good care, to a service where people are not being looked after in a safe environment that meets their needs. We expect all health and social care providers to make sure people with a learning disability are able to lead a life of their choosing that gives them the independence and control that we all take for granted. We found that the building was dirty and poorly maintained, and it needed repairs and redecoration throughout the home.
“The provider failed to ensure safe medicines management. Medicines were not stored safely or disposed of correctly, and we found tablets for a person that we couldn’t identify where they had come from or what they were for.
“The inspector saw risks in relation to how people were given their food. We were concerned that one person didn’t receive one-to-one support when eating, which they should have had to manage their risk of choking. People were offered food and drinks regularly, but they couldn’t independently access these as the cupboards and fridge were locked due to one person being restricted because of an allergy.
“During the inspection, the inspector observed the service showing signs of a closed culture which can lead to people not receiving safe and effective care. Families were being asked to escalate concerns on behalf of staff members. Northfield House cannot allow this to happen as this kind of culture is unacceptable.
“The provider has started to make changes to improve the care people are receiving, including recruiting a new manager. We will continue to monitor the service, and if we aren’t satisfied that sufficient improvements have been made, we won’t hesitate to use our enforcement powers to ensure people are safe.”
The following issues were found at the service:
- Risks to people were not identified and managed to prevent avoidable harm. Accidents and incidents were inconsistently documented by staff and not reviewed by management. There was a lack of action taken to safeguard people
- Staff had not received appropriate training, supervision and support despite working in a challenging environment
- Communication with external professionals and agencies was poor and they told us they had concerns about the service
- People were not supported to have maximum choice and control of their lives and staff did not always 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
- The service was not able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were not always encouraged to be independent where they were able
- Care was not always person-centred or appropriate to meet people's needs, taking into consideration their preferences. More could be done to include and empower the people using the service.
Full details of the inspection are given in the report published on our website.
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