CQC report explained · a nursing home
What the CQC found at Northlands House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2019
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced inspection on 12 February 2019. Inspectors spoke with people living at the home, visitors, managers and staff. They observed care, including a medicines round, and checked care plans, staff records and other management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practices, detailed care records, kind relationships and activities based on people's interests.
The home had improved since the previous inspection. Staffing levels had increased and the provider had improved how it notified the CQC about certain events. The previous inspection had rated Safe and Well-led as Requires Improvement, but there were no breaches at this inspection.
Staffing improved
Inspectors found enough staff to support people safely. Staffing had increased since the previous inspection, including an additional trained nurse and three extra roles during the day.
“At this inspection there were enough staff deployed and there was no longer a breach of regulations.” from the report
Kind relationships
People and visitors spoke positively about staff. Inspectors saw friendly, caring and respectful interactions.
“We saw caring and compassionate relationships between staff and people they supported.” from the report
Personalised care
Care plans were detailed and up to date. They reflected people's health needs, preferences, interests and communication needs.
“People's care and treatment met their needs and reflected their preferences.” from the report
Good activities
The home offered activities linked to people's interests and past experiences. Staff also found individual activities for people cared for in their rooms.
“There was a wide range of activities and entertainments which reflected people's interests, choices and previous experiences.” from the report
Strong management systems
The home used regular audits, meetings and a quality improvement plan to monitor and improve care. Staff described a positive culture and felt valued.
“Management processes were thorough and methodical, including processes to make sure people received care and support in a safe environment.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you decide the staffing level for my relative's needs, and how are call bell response times monitored now?
- 02How many staff are still being recruited, and how often do you use agency staff?
- 03Which parts of my relative's care plan will be reviewed with them and their family, and how often?
- 04What activities are available for someone with my relative's interests, mobility or communication needs?
- 05How will you record and follow my relative's wishes about future treatment and end-of-life care?
This was a planned, unannounced inspection covering all five key questions and checking improvements after the previous inspection. This explanation was written from the published report of 5 March 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2018
Rated Requires Improvement; inspectors found serious staffing delays and failures to report some incidents promptly.
This was an unannounced focused inspection on 28 and 29 November 2017. Inspectors visited because of concerns raised with the CQC and the local authority safeguarding team. They looked only at whether the home was safe and well-led.
The main problem was staffing. People sometimes waited a long time for call bells to be answered. Inspectors found response times ranging from 0 to 71 minutes in one check. Staff said they were stressed and did not have enough time to meet all care needs or talk with people.
The home had suitable systems for medicines, safeguarding, risk assessments, infection control and learning from mistakes. However, some incidents were not reported to the CQC, and death notifications were delayed. These failures were legal breaches.
The overall rating was Requires Improvement. Safe and well-led were both rated Requires Improvement. The other areas were not inspected during this visit, so their previous ratings were used in calculating the overall rating.
Medicines
People received their medicines as prescribed. Staff were trained and assessed as competent, and medicines records had no gaps.
“People received their medicines as prescribed by staff who were trained and assessed as competent.” from the report
Risk management
The home assessed risks such as falls, moving and handling, nutrition and pressure ulcers. Inspectors found measures in place to reduce these risks.
“Risk assessments identified when people were at risk from every day activities.” from the report
Open culture
The home involved people, relatives and staff in decisions. It acted on concerns about staff name badges and food temperature.
“The provider promoted an open and transparent culture in the home.” from the report
Learning from mistakes
The home investigated concerns and made changes about positioning, topical medicines and care records.
“Lessons were learnt and improvements made when things went wrong.” from the report
Too few staff
seriousInspectors found that staffing levels did not meet people's physical care needs. Call bell waits included 19, 27, 28, 40, 57 and 71 minutes.
“There were not enough staff to meet people's physical care needs.” from the report
Long call bell waits
seriousPeople and relatives reported long waits, including at weekends. Staff said they could not always respond quickly while supporting someone else.
“On one date in November, there were 22 calls in one hour, averaging a response time of 7.2 minutes, but the individual response time ranged from 0 to 71 minutes.” from the report
Incidents not reported
seriousTwo injuries that should have been reported to the CQC were not notified. Death notifications were usually sent five days to two weeks after the death.
“The provider did not ensure that all notifiable incidents were reported to the Commission.” from the report
Management changes
needs fixingThere was no registered manager at the time of the inspection, and the home had had three different managers during that period. The manager later became registered.
“The provider ensured there was management cover but there had been three different managers during that time.” from the report
Clean bedding
minorInspectors saw few clean sheets compared with the number of beds and people's continence needs. Two staff members said this could be an issue.
“During our tour of the home, we saw there did not appear to be many clean sheets relative to the number of beds and the continence needs of people living there.” from the report
- 01What are the current staffing numbers on each floor, including at weekends and when staff are off sick?
- 02What is the current average and longest call bell response time, and how is this checked?
- 03How do you make sure people receive personal care promptly when staff are using a hoist or supporting another person?
- 04What changes have been made to ensure injuries and deaths are reported to the CQC without delay?
- 05How do you make sure there are enough clean sheets available throughout the day?
This was a focused inspection of Safe and Well-led only; the other questions were not inspected and their previous ratings were carried into the overall rating. This explanation was written from the published report of 3 February 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Northlands House Care Home
4 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- March 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2018Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- December 2016Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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