This was an unannounced inspection which took place on 19 July 2018. This meant the staff and provider did not know we would be visiting.

This was the first inspection of the service since it had re-registered because of a change of provider in March 2017.

Northlands is a care home. People in care homes receive accommodation and 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.

Northlands accommodates a maximum of 35 people who require nursing care or personal care, some whom may live with dementia or a dementia related condition. At the time of inspection 32 people were accommodated at Northlands Care Home.

A registered manager was in place. 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.

People, relatives and staff were very positive about the changes that were taking place to make improvements since the change of ownership of the home. They told us the new providers were very friendly and approachable.

People said they felt safe and they could speak to staff as they were approachable. We considered that staffing levels needed to be reviewed and that staff were appropriately deployed to meet people’s needs in a safe, timely and person-centred way.

Improvements had been made to activities and entertainment but we considered people should have opportunities for stimulation and engagement with staff. Care staff were not always able to take the time required to interact and take an interest in people’s hobbies and activities. Staffing levels meant care was sometimes task-focussed.

The home was being refurbished. However, not all areas of the home were clean and well-maintained for the comfort and safety of people who used the service.

People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

Risk assessments were in place and they identified current risks to the person. Records were in place that reflected people's care and support requirements and they were regularly reviewed to ensure they remained accurate. Staff knew the people they were supporting well.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. Systems were in place for people to receive their medicines in a safe way. However, we have made a recommendation about the management of medicines as records were not in place to demonstrate that people who received medicines covertly (without their knowledge) had this decision taken in their best interests.

Appropriate training was provided and staff were supervised and supported. Staff had an understanding of the Mental Capacity Act 2005 and best interest decision making, when people were unable to make decisions themselves. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice. Improvements were required to the documentation to evidence some best interests decision making.

Care was provided with kindness and compassion and people’s dignity was respected. However, improvements were required to people’s dining experience.

Menus needed to ensure people received a varied and balanced diet to meet their nutritional needs. We have made a recommendation about this.

The home had a quality assurance pro