CQC report explained · a nursing home
What the CQC found at Northwood Nursing & Residential Care
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2023
Northwood Nursing & Residential Care was rated Requires Improvement; inspectors found serious medicines, risk, consent and governance shortfalls.
The inspection took place on 31 May, 05 June and 14 June 2023. It was unannounced on the first day. Inspectors spoke with 8 people, 6 relatives and 12 staff, and checked care records, medicines, recruitment, training, maintenance, cleaning and incidents.
The home was not always safe. Medicines were sometimes missing or not recorded properly. Risk assessments and mobility plans were not always up to date. Inspectors also found infection control issues and concerns about staffing and recruitment.
The home was rated Requires Improvement for Safe, Effective and Well-led. Consent was not always obtained, including for CCTV, and governance systems did not reliably identify or correct problems. People and relatives generally spoke positively about staff and management, and the home worked with health professionals and met people's nutritional needs.
The previous overall rating was Good, published on 5 October 2022. This was a focused inspection of Safe, Effective and Well-led, so the overall rating changed to Requires Improvement using these findings and ratings carried over from the previous inspection.
People felt safe
People told inspectors they felt safe living at the home. Safeguarding training and procedures were in place.
“I can move around the home freely and like to do small tasks to help staff. I am very safe.” from the report
Healthcare links
The home made referrals when people's needs changed and held weekly discussions with healthcare professionals.
“The provider worked closely with a variety of professionals to ensure referrals were made in a timely manner and provide joined up effective care.” from the report
Food and drink
People's nutritional needs were being monitored. They were offered choices, snacks and a varied menu.
“People were offered a choice of what they would like to eat and drink and there was a varied menu on offer.” from the report
Positive staff relationships
Relatives and staff spoke positively about the management team, describing it as approachable and fair.
“They're very good and have been very patient.” from the report
Medicines
seriousMedicines were not always given as prescribed or recorded clearly. Some people missed several doses, including pain relief.
“One person missed 9 doses and another person missed 7 doses of pain-relieving medicines.” from the report
Risks and care plans
seriousSome hazards were present, including uncovered radiators and accessible thickening powder. Mobility plans and emergency evacuation plans were not always accurate or current.
“People's mobility care plans and risk assessments held conflicting information on how people mobilised which could lead to confusion” from the report
Consent and CCTV
seriousPeople had not been told about CCTV and consent had not been obtained. The provider put up signs during the inspection.
“People had not been informed of the CCTV use and the provider had not gained consent from those living at the service.” from the report
Governance
seriousAudits did not always identify problems or show how future risks would be reduced. Policies were also generic and did not always match current practice.
“Where concerns were found, there was limited evidence of lessons learnt following on from the audit and what actions would be taken to mitigate future risks.” from the report
Staffing and recruitment
needs fixingSome people said they had to wait for help and felt staff were under pressure. Recruitment records did not always include full employment histories or references, although this was addressed during the inspection.
“I buzz for staff and they just don't come. I think they are busy and there is not enough of them.” from the report
Infection control
needs fixingInspectors found unlabelled toiletries, shared towels and communal slippers, plus gaps in cleaning records. The provider was recommended to review its infection control measures.
“Cleaning records were in place. However, there were gaps where it looked as though cleaning had not taken place for several days.” from the report
- 01How are you checking that every medicine is ordered, administered as prescribed and recorded at the correct time?
- 02What checks now confirm that mobility care plans, risk assessments and emergency evacuation plans match each person's current needs?
- 03How do you obtain and record consent for CCTV, and how do you support people who may lack capacity to make particular decisions?
- 04What changes have you made to audits so that problems are identified, acted on and followed up?
- 05How do staffing levels ensure people do not have to wait for help, especially when staff are under pressure?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and the overall rating used ratings carried over from the previous inspection. This explanation was written from the published report of 7 September 2023 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, October 2022
Northwood Nursing & Residential Care was rated Good; inspectors found safe, kind and well-organised care, with some areas of the building needing updates.
Inspectors visited on 21 and 23 September 2022. The first day was unannounced. They observed care, spoke with people, a relative and staff, toured the building, and checked care, medicine, staffing, recruitment, training, cleaning, safety and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that risks were managed, staffing levels met people's needs, medicines were handled safely, and infection prevention arrangements were suitable.
People were generally positive about the staff, food, activities and visiting arrangements. Staff were described as kind, patient and respectful. Care plans were person-centred, complaints were investigated, and managers used audits and checks to address issues.
The inspection was prompted partly by concerns about food, care records, cleanliness, activities, training and staffing. Inspectors found no evidence that these concerns had put people at risk of harm. Some parts of the home needed updating, but refurbishment and redecoration were under way.
Kind and respectful staff
Inspectors saw staff supporting people in a friendly, patient and unrushed way. People said staff were caring and knew them well.
“Staff were observed to be busy, but to have a kind, unrushed and patient approach.” from the report
Safe care and medicines
Risks were well managed and there were suitable systems for safeguarding, recruitment, staffing, medicines and infection prevention.
“Risks to individuals and staff were identified and well managed.” from the report
Person-centred planning
Care records described people's needs, preferences and communication styles. People or their representatives had been involved in developing their care records.
“People's needs were assessed, and clear person-centred support plans and risk assessments were in place to guide staff.” from the report
Responsive activities and visiting
Most people were happy with the activities. The home also offered one-to-one activities and welcomed visitors.
“There were 1:1 activities for people who liked to spend time in their rooms or who didn't want to join in group activities.” from the report
Strong management oversight
Managers used audits, spot checks and other monitoring systems. Records showed that identified issues were acted on.
“Audits and spot checks were thorough, and records demonstrated any issues identified were addressed.” from the report
Parts of the building need updating
minorThe home was clean and free of clutter, but some areas needed updating. A refurbishment and redecoration programme was in progress.
“Some areas of the home were in need of updating.” from the report
Activities could be expanded
minorMost people were satisfied with the activities, but a staff member thought more could be offered. Ask how activities are planned for people with different interests and abilities.
“I think more [activities] could be done but there is enough.” from the report
Staff changes
minorPeople said there were enough staff who knew their needs, but some staff changes were taking place. A staff member also said covering sickness could sometimes be difficult.
“There are enough staff who know me well and know my needs, but quite a few of them keep changing” from the report
- 01Which areas of the home still need updating, and what is the timetable for the refurbishment and redecoration work?
- 02How many staff have changed recently, and how will you make sure my relative has consistent carers who know their needs?
- 03What one-to-one activities are available for someone who does not want to join group activities?
- 04How do you check that concerns about food, care records, cleanliness, activities, training and staffing are dealt with?
- 05How are my relative's food preferences, allergies, healthcare needs and end of life wishes recorded and reviewed?
This inspection covered all five CQC questions, including care, premises and infection prevention, and was prompted partly by concerns about food, records, cleanliness, activities, training and staffing; a separate infection prevention and control inspection in February 2022 was unrated. This explanation was written from the published report of 4 October 2022 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 Northwood Nursing & Residential Care
6 rated inspections over 5 years: the service has held its Requires improvement rating throughout.
- September 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Northwood Nursing & Residential Care →
- October 2022Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
Read what inspectors found at Northwood Nursing & Residential Care →
- February 2022Goodstayed GoodSafe: Inspected but not rated
- July 2021GoodSafe: GoodEffective: GoodResponsive: GoodWell-led: Good
- January 2021Inspected but not ratedSafe: Inspected but not rated
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2017
Registered with the Care Quality Commission on 6 July 2017.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Blackburn with Darwen
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 91 can care for a couple. 12 years' experience on average.
“Primrose is a very kind and compassionate healthcare professional”
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.