This inspection took place on 12 and 17 August 2016 and was unannounced. The service met all of the regulations we inspected against at our last inspection in October 2013.‘Norwood – 159a Station Road’ is a care home for up to eight adults. The service is spacious and provides accommodation on the ground and first floor. It specialises in providing services to people who have a learning disability or who are on the autistic spectrum. Autism is a lifelong condition that affects how a person communicates with and relates to other people, and how they experience the world around them.
There was a registered manager in post at the service. A registered manager is a person who has registered with the 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.
The outstanding feature of the service was that staff were exceptional at communicating effectively with people on an individual basis, and used this as a basis for valuing people and developing their autonomy and independence. Staff had received a lot of support to develop skills in these areas, and there was on-going investment at embedding these processes. This had a positive impact on people’s behaviours and the involvement in their care. This helped to demonstrate a very caring service, which matched the highly positive feedback we received from people’s relatives.
We found there to be a positive, inclusive and empowering culture at the service. The registered manager led by example, providing good support to staff and ensuring that appropriate values were upheld towards people using the service.
Attention was paid to people’s safety but in a way that minimised restrictions on their freedoms. For example, whilst many people had positive behaviour support plans in place to help minimise use of any behaviours that challenged the service, there was little reliance on as-needed medicines as part of those plans. Instead, there was an emphasis on recognising and understanding people’s communications, and providing a service that responded to their experiences. There were also effective safeguarding procedures in place.
People were treated with respect and their privacy and dignity was promoted at all times. Attention was paid to keeping the service clean. The service had a number of long-standing staff who knew people well, which helped to enable positive and trusting relationships to be developed with people using the service. There were enough staff working at all times, although there was some reliance on agency staff to address staffing vacancies.
People had opportunities to take part in a variety of activities both in the premises and the community. Good effort was made to match and develop activities that matched people’s abilities and preferences.
People received good support in respect of their individual healthcare and nutritional needs. The service liaised promptly if there were any concerns about anyone’s health, and followed community healthcare professional advice well.
Whilst the provider’s mandatory training was not consistently completed by some staff, staff received a range of additional training that helped to ensure that people using the service received effective and individualised care.
The service took appropriate action if they believed a person needed to be deprived of their liberty for their own safety. However, further work was needed with ensuring that the principles of the Mental Capacity Act 2005 were consistently applied for everyone using the service.
The service listened to feedback and acted on it. There was a formal complaints process in place but it had not been needed recently.
The service audited quality to help ensure good care was provided. Changes were made to the service as a result of any concerns being identified.
However, we found one breach of regulations. Temperature control systems for the safe storage of medicines and refrigerated food were not effective at identifying and addressing risks. This was because records showed that temperatures were consistently too high and that there had not been sufficient action to address risks arising from this. You can see what action we have told the provider to take at the back of the full version of this report.