Northfield Care Centre is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Northfield Care Centre provides accommodation care and nursing care for up to 80 people. The home consists of four separate units, one providing personal care and the other three providing nursing care. Some people receiving support at the home were living with dementia. Accommodation is provided over three floors, with the upper two floors being accessed by passenger lift. On the day of the inspection there were 37 people living in the home and three people who regularly came for care during the day.

This inspection took place on 8 October 2018 and was unannounced. This meant the people who lived at the home and staff did not know we would be visiting. Our last inspection at Northfield Care Centre took place in April 2018 when the service was rated overall as requires improvement. At that inspection, we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in Regulation 12; Safe care and treatment and Regulation 17; Good governance. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Northfield Care Centre’ on our website at www.cqc.org.uk.

During this inspection, we did not see sufficient improvement to warrant a rating of ‘Good’, which is the minimum standard care homes should be aiming to achieve for people who use their service. Due to the failure to improve, we have rated the service as ‘Requires Improvement’ for a second time.

We checked on progress with improvements the registered provider told us they would make in the action plan they sent to us after the last inspection. We found the registered provider had made some improvements. However, there were continued shortfalls and we found a repeated breach of Regulation 12, Safe care and treatment, in relation to people's medicines not being safely managed or consistently administered as prescribed. We also found further breaches in Regulation 12, Safe care and treatment, in relation to shortfalls in people’s assessments and care plans regarding risks associated with their care, as well as in day to day monitoring records kept about people’s care. We found a repeated breach of Regulation 17, Good governance in relation to the range of audits to monitor and assess the quality of the service. The registered provider had not been proactive, identified shortfalls or taken action to address them in a timely way. This had led to some risks associated with people's care not being addressed or managed effectively.

You can see what action we told the provider to take at the back of the full version of the report.

There was no registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are “registered persons”. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered provider had appointed a manager who was employed at the home and was in the process of registering with the Care Quality Commission.

There were enough staff to support people safely. However, staff were often very busy, having limited time to engage with people. The home was clean and tidy and staff had received training on reducing the risk of the spread of infection. The manager was monitoring accidents and incidents and there was evidence that trends and patterns were being identified, and some actions had been taken to reduce hazards in relation to these.

Staff received ongoing relevant training. However, some staff had not received an adequate induction when first start

Northfield Care Centre is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The inspection took place on 25 April 2018 and was unannounced. This was the first inspection of the service since the provider registered with CQC and was undertaken by two adult social care inspectors.

The service provides accommodation, nursing and personal care for up to 80 older people some of whom may be living with dementia and/or have complex nursing needs. People were accommodated over two floors with lift access. At the time of our inspection there were 29 people using the service. The service is situated in Thorne, Doncaster.

The service has a manager who was in the process of registering with CQC. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were systems and processes to assess and monitor the quality of the service provided. However, we found that audits were not always effective as they had not identified shortfalls in care records and medicines.

Staff were able to recognise signs of abuse should they occur and knew how to report concerns if they suspected a person was at risk of harm. There was a complaints procedure available in the service for people and relatives to raise concerns.

People received effective care from staff who had the skills and knowledge to meet their needs. Staff monitored people's health and well-being. People had access to healthcare professionals according to their needs.

People were cared for by staff who were observant and ensured people were comfortable. People told us, and we saw, that staff were kind and caring.

Staff knew the needs and preferences of the people they cared for and promoted people's rights to privacy, dignity and independence.

The provider assessed people's capacity to make their own decisions if there was a reason to question their capacity. Staff spoken with had an understanding of the Mental Capacity Act. Where possible, they supported people to make their own decisions and sought consent before delivering care and support.

People's diversity was respected and staff responded to people's social and emotional needs. People told us their needs were met because they were supported and cared for in accordance with their wishes and choices. People and staff were positive about the culture of the service. People felt the staff team were approachable and polite.

People gave positive views about the food they received and pleasant mealtimes. There were activities for people and people were supported to take part in these where they wished.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.