Northern Healthcare Head Office

The service had robust care planning processes in place, with people involved in their own support planning. Plans included promoting people’s safety, physical health, mental health and well-being. Individual risks were identified for people and measures were in place. Safety plans and coping strategies were outlined for individuals. Care plans and risk assessments were reviewed and updated when needed.

We found systems and processes in place to help protect people from abuse; potential safeguarding issues for people receiving a regulated activity were raised with the relevant host authority. On 2 occasions, CQC were not notified about safeguarding concerns, despite the provider requirement to do so. The service rectified this immediately. Staff were aware of who to report safeguarding concerns to. The management team were proactive in addressing any actions arising from safeguarding meetings and ensured good outcomes from lessons learned. The service shared findings with staff in staff safety huddles/meetings and supervisions.

Effective recruitment processes were in place, with support and oversight provided to the service managers from a team with recruitment/HR functions based at Head Office. Some feedback obtained from relatives indicated that there was high staff turnover. Staff received appropriate training and supervision, with positive feedback. Management undertook audits of staff files and put risk assessments in place where required.

Medicines management processes were in place, including appropriate risk assessments in relation to people self-administering medication. Storage of medicines was inside a nominated clinical room, inside a locked cabinet. Whilst premises are the responsibility of the landlord, processes were in place to ensure repairs and maintenance required on sites were reported and rectified. The 2 sites visited were fit for purpose.

When speaking to staff, it was evident good teamwork was taking place. Staff demonstrated respect for one another and shared that they felt supported from managers and head office staff. The service worked in partnership with other professionals, for the benefit of people accessing or leaving the service.

Staff also took part in daily safety huddles, were people’s changing needs were discussed. The huddles also included how best to support and promote good lifestyles choices, supporting people to make their own decisions.

We found people were supported to appointments on a regular basis. The service also had regular contact with other health professionals, including GP’s and community mental health teams to ensure people received good care and remain as well as possible.

The service demonstrated positive outcomes for people supported. 2 people had moved on from a step-down facility within a 12 week timescale. It had been identified by the service that the setting wasn’t always suitable for meeting individual needs. When this was identified, the service worked with relatives to source alternative placements.

Staff and people supported had developed good relationships. This was observed by the onsite inspector, communicated by staff in interviews and also through feedback from people gathered by the provider and supplied as evidence.

The equality and diversity of people were respected. We observed lots of positivity statements displayed on a notice board at the time of the assessment. People supported could add to these at any time. The service had also made nominations for staff at the National Care Awards.

People were supported to pursue hobbies and interests independently or with support. The service advertised local events and self-help groups within the properties. An Occupational Therapist [OT] support worker was in post and covered 2 sites. The OT provided group and 121 activities, to enable people to access the community.

We observed no restrictions on people leaving the service or visitors; people were seen coming and going throughout the days spent on site.

We found evidence of positive outcomes experienced by people, including those on a step-down programme. These people were not in receipt of a regulated activity at the time of assessment, but had received wider support and assistance, including help sourcing accommodation, dealing with finances and gaining voluntary employment.

The service engages with both people supported and their relatives. An expert by Experience role was created and filled. This person acted as a representative for people using services, reviewing policies and procedures, reviewing people’s surveys and was also present at an open day for a new service.

The organisation was well structured, with a good skill mix amongst senior leaders. Governance is at the heart of the organisation to try and drive improvements so that people supported are given opportunities to achieve positive outcomes. Senior managers regularly completed quality site audit visits.

Responsibility and accountability had been designated to senior staff, with leads, champions and mentor roles in place for existing staff, to support with new employees.

The service had a range of audit tools in place, used by the Registered Manager, Quality and Clinical Governance and Service Managers to aid oversight and management of the service. Monthly governance meetings took place and ‘safety huddles’ were held daily with service managers and staff on site. The ‘safety huddles’ were used to communicate any concerns and actions needed.

On a monthly basis, management completed lessons learned, in relation to medication, incident reporting and post incident reviews.

Staff we spoke with felt listened to. They considered the service achieved good outcomes for people they supported and was a good place to work. Staff were aware of mechanisms in place for speaking up. The service had a Freedom to Speak Up advocate in post.

Management demonstrated their awareness of informing CQC of notifiable incidents and accidents for people receiving a regulated activity. Referrals had been made to host authority safeguarding teams regarding potential abuse. On 2 occasions, it had been identified that the service had not notified CQC of safeguarding issues. However, this was addressed on site and rectified immediately.

The service had established good relationships with outside partners, including local authorities, mental health commissioners. CQC received limited feedback from partners, but all feedback received was positive.