Background to this inspection
Updated
12 November 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Norwood- 54 Old Church Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager had been promoted to Head of Care services and another manager had been appointed to undertake day to day management of Norwood - 54 Old Church Road.
Notice of inspection
The first day of this inspection was unannounced. The second day of the inspection was announced and we arranged an appropriate time for us to return to the home.
What we did before the inspection
Before the inspection visit, we reviewed information we had received about the service since the last inspection. This included information about incidents the provider must notify us of, such as any allegations of abuse. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
During the inspection
People in the home had learning disabilities and could not always communicate with us and tell us what they thought about the service. Because of this, we spent time at the home observing the experience of the people and their care, how staff interacted with people and how they supported people during the day. We spoke with one person who lived in the home about their experience of the care provided. We also spoke with members of staff, including the acting manager, deputy manager and two support workers.
On the first day of the inspection we reviewed a range of records. This included two people’s care records, medicines records, staff training records, and incident and accidents records. We also reviewed a variety of records relating to the management of the service, including quality assurance audits and checks and records relating to the safety of the premises.
As part of a thematic review, we carried out a survey with the acting manager during this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
As part of the inspection we wanted to look at staff files in relation to recruitment. These records were kept at the provider head office and were therefore not available on the first day of the inspection as the head office was closed. The provider was able to provide these documents to us after the first day of the inspection and we therefore went back to the home for a second day where we viewed four staff files and spoke with a support worker and the manager.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with one relative about their experience of care provided. We also spoke with one support worker.
Updated
12 November 2019
About the service
Norwood- 54 Old Church Road is registered to provide accommodation and personal care to six people. It caters for older people with a learning disability. At the time of our inspection, there were three people living at the home.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People received safe care and were protected against avoidable harm, neglect and discrimination. Risks to people's safety were assessed and strategies were put in place to reduce any risks. Staff understood their responsibility to report any concerns and said they would not hesitate to do so.
There were sufficient numbers of staff who had been safely recruited to meet people's needs. Sufficient staffing levels enabled people’s needs to be met safely and ensured people received consistency in their level of care.
People’s medicines were safely managed, and systems were in place to control and prevent the spread of infection.
Management sought to learn from any accidents or incidents involving people.
Staff received an induction when they first commenced work at the home and ongoing training that enabled them to have the skills and knowledge to provide effective care.
People were supported to eat and drink enough to maintain their health and well-being. A strong emphasis was placed on the dining experience to ensure it was enjoyed by all. The home ensured that only Kosher food was used and prepared as everyone living in the home were Jewish. The home also followed meal preparation according to Jewish law.
Staff supported people to live healthier lives and access healthcare services.
The home had a welcoming atmosphere and was homely. The premises was adapted appropriately to meet the needs of people living in the home.
We saw examples of staff interacting positively with people throughout the inspection. Staff provided care and support in a caring and meaningful way. They knew the people in the home very well and had built up kind and compassionate relationships with them. People and relatives, where appropriate, were involved in the planning of their care and support. People's privacy and dignity was always maintained. Where people had additional or different needs relating to equality and diversity, this was recorded and reflected in the care provided.
Our observations and discussions evidenced a positive, learning culture where people were supported to achieve their aims and desired outcomes. The manager and senior management monitored the provision of care and the environment to further improve people's experience of receiving care.
Care plans were detailed and supported staff to provide personalised care. People were encouraged to take part in a variety of activities and interests of their choice. There was a complaints procedure in place and systems in place to deal with complaints effectively.
The home was well managed. There were systems in place to monitor the quality of the service. Actions were taken, and improvements were made when required. Staff told us they were motivated to work with the manager to ensure people received good quality care.
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 Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Rating at last inspection
The last rating for this service was good (published 5 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.