Northfield is registered to provide accommodation for up to 63 older people who require nursing or personal care. The accommodation is provided over two floors, accessed by a passenger lift. One floor provides some intermediate care where people are supported to move back to permanent accommodation. Rehabilitation and enablement support is provided from Sheffield Teaching Hospitals physiotherapists and occupational therapists. The further floor provides permanent accommodation. The home is purpose built and situated in a residential area of Sheffield, close to local amenities and transport links. The home has a garden and car park.

There was a manager at the service who was registered with Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

Our last inspection at Northfield took place on 9 May 2016. We found two breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in regard to Regulation 18: Staffing and Regulation 11: Consent. The registered provider sent an action plan detailing how they were going to make improvements. At this inspection we checked improvements the registered provider had made. We found sufficient improvements had been made to meet the requirements of Regulation 18: Staffing, as staff had been provided with an annual appraisal in line with the registered providers policy. We also found sufficient improvements had been made to Regulation 11: Consent, as records were in place to show the registered provider complied with the requirements of the Mental Capacity Act 2005.

This inspection took place on 31 July 2017 and was unannounced. This meant the people who lived at Northfield and the staff who worked there did not know we were coming. On the day of our inspection there were 57 people living at Northfield.

People spoke positively about their experience of living at Northfield. They told us they felt safe and they liked the staff.

Staff were aware of safeguarding procedures and knew what to do if an allegation was made or they suspected abuse.

We found systems were in place to make sure people received their medicines safely so their health was looked after. Some medicines storage required improvement, which was rectified on the day of our inspection.

We found one area of the home presented a possible falling hazard. This area was made safe on the day of our inspection.

We found two plastic bedrail bumpers were torn which could compromise infection control. Staff had identified this and replaced the bumpers during our inspection.

Staff recruitment procedures ensured people’s safety was promoted.

Sufficient numbers of staff were provided to meet people’s needs.

Staff were provided with relevant training, supervision and appraisal so they had the skills they needed to undertake their role.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered provider’s policies and systems supported this practice.

People had access to a range of health care professionals to help maintain their health. A varied diet was provided, which took into account dietary needs and preferences so people’s health was promoted and choices could be respected.

Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and they were involved in decisions about their care. People’s privacy and dignity was respected and promoted. Staff understood how to support people in a sensitive way.

A programme of activities was in place so people were provided with a range of leisure opportunities.

People said they could speak with staff i

This inspection took place on 9th May 2016 and was unannounced. This meant the people who lived at Northfields and the staff who worked there did not know we were coming. On the day of our inspection there were 57 people living at Northfield

There was a registered manager at the service who was registered 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 and associated Regulations about how the service is run.

Northfield is a care home providing personal and nursing care. Accommodation is provided for 57 people. The home is situated in the residential area of Crookesmoor in Sheffield. It is close to the main bus route and is a short walk away from the local shopping area. The home is purpose built with accommodation provided on two floors, which are accessed, by a lift. The gardens are landscaped and outside patio areas are easily accessible. There is a small car park.

Within Northfield there was the provision of 33 Intermediate Care beds based on a separate floor. People received rehabilitation and enablement support from Sheffield Teaching Hospitals physiotherapists and occupational therapists. Peoples nursing and personal care needs were met by the nurses and care staff of Northfield. The unit had support from a GP, in relation to people's medical needs. Peoples stay varied from 21-35 days before discharge. In addition, Northfields provided permanent accommodation for up to 24 people. At the time of this inspection 22 people were living at the home on a permanent basis.

We spoke with 10 people who used the service and friends or family members, who were visiting at the time. We spoke with the registered manager and seven members staff .We also met a quality assurance manager and the training manager and spoke with three health professionals who were visiting the home during our inspection. We looked at documentation relating to people who used the service, staff and the management of the service. We looked at four people’s written records, including the plans of their care.

People we spoke with told us staff were very nice and easy to talk to. One person told us, “I am delighted with the home.” A relative told us, “I have no worries about this place” another relative told us “There seems to be the right numbers of staff and they seem to be well trained.”

Assessments had not always been completed regarding a person’s capacity to consent to care and treatment, or records to demonstrate that ‘best interest’ decisions made on a person’s behalf were appropriate. Improvements needed to be made in the way the provider complied with the requirements of the Mental Capacity Act 2005.

Robust recruitment procedures were in place and appropriate checks were undertaken before staff started work. This meant people were cared for by suitably qualified staff who had been assessed as safe to work with people

People had individual personal plans that were centred on their needs and preferences and had a good level of information, which explained how to meet each person’s needs.

Staff we spoke with understood what it meant to safeguard vulnerable people from abuse, and they were confident management would take any concerns they had seriously and take appropriate action to safeguard people from abuse.

Staff were aware of people’s nutritional needs and made sure they supported people to have a healthy diet, with choices of a good variety of food and drink.

There were limited activities available. Both the people living at Northfields and relatives told us they would like more activities to be available.

We saw that staff were respectful and made sure people’s privacy and dignity was maintained.

People said they felt comfortable to raise any concerns with staff. The service learned from incidents and from people’

People all spoke very positively about Northfield. They told us they were happy with the care they received at the home. Some people’s comments captured included, “staff are wonderful,” “It’s a nice home,” ”I don’t have any worries, I would recommend this home to anybody” and “staff are very good, conscientious and thoughtful.”

Some people living at the home had complex needs and were not able to verbally communicate their views and experiences with us. Due to this we sat in communal areas of the home, observed care practices and saw how staff interacted with people. We saw that there was clear and respectful communication between staff and people. Staff treated people in a kind, considerate and empathic manner.

Records checked showed that before people received any care, support or treatment they and/or their advocates were asked for their consent and the staff acted in accordance with their wishes.

We found that people's needs were identified in care plans. People told us that they had regular access to healthcare professionals.

We found the home had systems and processes in place to ensure the safe administration of medications.

We found there were effective recruitment and retention processes in place.

We found that a complaints policy and procedure was in place. All of the people and their visitors we spoke with said they had no complaints or concerns about the home.

People told us that they were happy living at the home and that they were satisfied with the care they received. People said, "Staff are smashing." and "It's very nice here the staff are great.”

The majority of people raised concerns about having to wait long periods of time at certain times in the day before they received personal care from staff. People said “The staff work really hard; they are really kind and patient and never get cross when we buzz for help. It’s just we have to wait because I don’t think there are enough of them.”

We spoke with five relatives who were visiting the home and they confirmed that they were very satisfied with the care provided. One told us, “The care and the staff here are excellent.” Another relative said "The care mum receives is very good; the staff are very kind, they are lovely.”

The majority of relatives also expressed concern over staffing numbers. Comments included “The care is really good, the staff are lovely, it’s just residents have to wait for attention because the staff are so busy and there aren’t enough of them.”

We spoke with Sheffield Local Authority, Contracting, Commissioning and Safeguarding and they told us that they had not identified any concerns at the home.

We spoke with healthcare professionals who were visiting Northfield at the time of our inspection. They said they visited the service on a frequent basis. They said they thought the standard of care at Northfield was “excellent.”