North Hill House

We assessed all quality statements under the 5 key questions; Safe, Effective, Caring, Responsive and Well-led. The service is a nursing home providing support for up to 35 older people. At the time of our inspection 26 people were living at North Hill House.

We identified 3 breaches of the regulations relating to, safe care and treatment, governance and recruitment practices.

Staff recruitment practices were not entirely safe. Interviews were insufficiently robust and work histories and previous performance in care had not been fully explored. This meant there was a risk staff were unsuitable for employment in the care sector.

Care plans did not accurately reflect people’s support needs and daily records lacked information about individual’s experiences of support. Risks had not always been fully mitigated. Staff used equipment inappropriately when moving people around the service.

Areas of the service were tired, some flooring needed replacing. The medicine storage room was very warm, and prompt investigations had not been completed following identification of discrepancies in medicine records.

The service acted in accordance with the requirements of the Mental Capacity Act, made appropriate Deprivation of liberty safeguards applications and had complied with conditions associated with authorisations.

Staff protected people from all forms of abuse and were confident the manager would take action to address and resolve any safety concerns they raised. There were systems to enable people to make small purchases safely.

The service employed sufficient staff to meet people’s assessed needs and planned staffing levels were routinely achieved. There were no tools available to confirm night staffing arrangements were sufficient to meet the needs of the individuals currently using the service.

Staff had not received regular supervision. Prior to the inspection the provider had identified the manager needed additional support. As a result, an operations manager had been appointed, and the recruitment of a deputy manager and additional clinical lead was underway.

The service’s governance and quality assurance system were not sufficiently robust. This issue had been recognised prior to the inspection, and the service was engaging with the local authority quality assurance team to introduce more effective governance arrangements.