Norwood House

Norwood House is a residential care home providing personal care to up to 28 people in 1 adapted building. The service provides support to younger and older people, some of whom are living with dementia. At the time of our inspection there were 24 people using the service.

People’s experience of using this service and what we found

Systems were in place to record, store and receive medicines. However, medicine practices were not always in line with best practice guidelines.

Information about risks and safety was not always comprehensive or up to date. Full information about risks to people's safety was not always recorded.

Quality monitoring systems were in place which helped to check various areas of the home. However, some required improvements, in relation to monitoring records, were identified.

People were supported to have access to healthcare services to monitor and maintain their health and wellbeing. People were encouraged to maintain a healthy diet. Where people had specific dietary requirements, these were catered for.

People had support from safely recruited staff. Staff received training in safeguarding and understood their role and responsibilities to protect people from abuse. The service had enough staff to keep people safe. We observed staff respecting people's privacy and dignity when providing care and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The home was clean and tidy and additional cleaning processes had been implemented to prevent the risk of spread of infection.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 15 June 2022).

Why we inspected

The inspection was prompted in part due to concerns received about governance, medicine management, staffing and risk management. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Norwood House on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation in relation to good governance systems, medicine management and recording systems to help inform decisions about people’s care needs.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Norwood House is a residential care home providing personal care to 26 people at the time of the inspection. The service can support up to 28 younger adults, older people, people living with dementia, a physical disability or sensory impairment.

People’s experience of using this service and what we found

People received safe, effective and well led care.

There was an effective quality monitoring system, which ensured checks and audits were carried out, people's views were obtained and listened to and shortfalls were addressed. Accidents and incidents were analysed so that lessons could be learned. The provider had oversight of the service and completed regular checks.

There were enough staff. Safe recruitment processes had been followed. Staff were trained and their skills and knowledge checked through competency assessments.

People were protected from abuse and avoidable harm. Staff had completed training in how to safeguard people and risk assessments were completed to identify potential hazards. People received their medicine as prescribed.

People and their relatives were involved in the service. Care was planned around people's choices and preferred routines. People and their relatives were supported to receive information in an accessible way to enable them to be involved in their care and support.

People’s relatives were happy with the service people received and felt staff had a clear understanding of their family members needs and preferences.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The culture of the service was open, and people and staff felt able to raise concerns.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.

Rating at last Inspection

The last rating for this service was good (published 06 December 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Norwood House is a residential care home providing personal care to 20 people at the time of the inspection. The service can support up to 27 younger adults, older people, people living with dementia a physical disability or sensory impairment.

People’s experience of using this service and what we found

People told us they were safe and felt staff had a good understanding of their care and support needs. Safeguarding concerns had been referred to the local authority when required. Medicine support was delivered in a safe way. Risks to people were considered and any accidents and incidents were monitored and recorded. Staff were recruited safely.

Support was delivered by a team of staff who had the skills, knowledge and relevant training to support people. Staff communicated with relevant professionals to ensure people received the healthcare support they required. People were provided with a variety of meals which they told us they enjoyed.

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. People were involved in decisions and their choices were respected. Information was presented in a way people could understand.

People were supported by staff who were kind and caring and treated them with dignity and respect and promoted their independence. Staff spent time getting to know people and their life histories. Care plans contained person-centred information.

Staff understood the importance of social interaction. People had opportunities to take part in stimulating and enjoyable activities. Consideration was given to their specific interests and how participation could be encouraged. People knew how to make complaints, and these were dealt with appropriately.

People and staff spoke positively of the management team. The service was well-run by a registered manager who was passionate about ensuring people received the support they required and engaged with the community. Regular feedback on the service provided was requested from people and relatives.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 07 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection we found quality monitoring was not robust in regards to medicine management, auditing of staff files and recruitment. Two breaches of regulation were found regarding; Regulation 17 and 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service was rated requires improvement overall. At this inspection we found the breaches of regulation had been fully addressed and the service was compliant with the regulations.

Norwood House is registered with the Care Quality Commission (CQC) to provide accommodation for up to 26 older people who are elderly or who are living with dementia. Accommodation is provided over two floors; the home is set in private gardens. The service is situated on the main road through Gunness. Local amenities and a bus route into Scunthorpe are accessible. There is a car park for visitors to use. Staff are available twenty four hours a day to support people.

We found the quality monitoring systems were now robust in regards to medicine management and auditing of staff files and recruitment.

This service has a registered manager 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were protected from abuse. Staff had training in how to safeguard people from abuse and knew how to raise concerns. The building was well maintained and equipment was serviced. Effective infection control was in place and medicine management was robust. This helped to maintain people’s safety.

The environment was adapted to help support people living with dementia.

Staff were recruited safely and in sufficient numbers to ensure that people’s needs were met. Training was provided in a variety of subjects to maintain and develop the staff’s skills. Supervision and appraisals occurred, which helped staff to identify any further training needs and allowed discussion regarding their performance.

Staff were caring. People’s privacy and dignity was respected and their personal records were held securely to maintain their confidentiality.

People had their needs assessed and care plans and risk assessments were developed. People’s care was personalised in line with their preferences and needs. People’s nutritional needs were met. Staff contacted health care professionals for advice and guidance to help maintain people’s wellbeing.

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.

The registered manager, registered provider and senior staff were available to speak with at any time. Quality monitoring took place through audits and questionnaires. People were asked for their views and feedback received was acted upon. This helped to maintain or improve the service provided.

There was a complaints procedure in place. People who used the service and their relatives were aware of this. When issues were raised they were dealt with appropriately.

Norwood House is registered with the Care Quality Commission [CQC] to provide care and accommodation for up to 26 older people and who may be living with dementia. Accommodation is provided over two floors and is in private gardens. The service is situated close to local amenities and close to a bus route into Scunthorpe. There is a car park for visitors to use. Staff are available twenty four hours a day to support people.

This service has a registered manager 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found the registered provider was in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that recruitment processes were not thorough. There was a breach of of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that recruitment processes were not thorough. You can see what action we told the provider to take at the back of the full version of the report.

Staff understood people’s preferences for their care. Care plans and risk assessments were in place to help inform staff and keep people safe. People’s nutritional needs were understood by staff. Relevant health professionals were contacted for help and advice to maintain people’s wellbeing.

If people lacked capacity to make their own decisions then the principles of the Mental Capacity Act 2005 and codes of practice were followed to protect people’s rights.

Staffing levels were monitored to make sure there were enough skilled and experienced staff to meet people’s needs. Staff undertook training in a variety of subjects to maintain and develop their skills. Supervision and appraisals were provided for staff to identify any further training needs and allow discussion regarding their performance.

The registered manager and senior staff at the service were available to speak with at any time.

Quality monitoring took place through audits and surveys. However, we found that the quality monitoring in place had been ineffective regarding medicines. People using the service were asked for their views and feedback was acted upon to maintain or improve the service.

A complaints policy was in place, people could raise any issues to be dealt with by the management team.