Northbourne

At this assessment, we found the service to be good overall. People were protected from abuse and avoidable harm. Staff understood safeguarding procedures, managed risks appropriately and knew how to raise concerns. The provider demonstrated a learning culture, and incidents, concerns and complaints were investigated and used to improve practice. People and relatives told us they generally felt safe.

People received effective care that met their assessed needs. Assessments and care plans reflected people’s health, communication needs and personal preferences. Staff worked with health and social care professionals to support people’s wellbeing and respond to changes in health. Consent to care and treatment was obtained in line with the Mental Capacity Act, and best‑interest decisions were made where required. Medicines were managed safely.

People were treated with kindness, compassion and respect, and we observed positive interactions between staff and people. However, people were not always supported consistently as individuals. Inappropriate language and depersonalising practices were identified, and some people were not always proactively supported with comfort, dignity and choice in communal areas. This included times when people were sitting for long periods without meaningful interaction or reassurance. Leaders had recognised this and acted, but ongoing oversight was needed to ensure improvements were sustained.

The service was responsive to people’s needs, and people and those important to them were involved in decisions about care. Information was provided in ways people could understand, and people knew how to raise concerns. However, opportunities for meaningful activity were not always sufficiently individualised, particularly for people living with dementia.

Leadership and governance were improving. Leaders were visible and staff felt able to speak up. We identified risks relating to environmental and fire safety and night time staffing capacity. Leaders responded promptly and proportionately, introducing interim controls and strengthened oversight which reduced immediate risks. However, not all routine checks and quality assurance arrangements were fully embedded, meaning leaders needed to further strengthen systems to provide consistent and sustained assurance over time.