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Norwood House Requires improvement

We are carrying out a review of quality at Norwood House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 26 January 2019

Norwood House provides accommodation and personal care for up to 71 older people. There were 41 people living in the home when we inspected on 1 November 2018. The home was situated in a rural area of Middleton Moor on the periphery of the village of Saxmundham in Suffolk.

Norwood House 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. This comprehensive inspection took place on 1 November 2018 and was unannounced. Our last inspection at Norwood House in February 2018 was the third comprehensive inspection since 2016 where we had rated the home requires improvement overall. At the inspection in February 2018 we found nine breaches of the regulations. We were concerned that there were insufficient staff deployed on shifts and that people were not always treated with dignity and respect because staff were task focussed and care was hurried. We could not be confident that people always received the care and support they needed because care plans were not all reflective of people's current support needs.

We were also concerned that staff did not have a good understanding of how to safeguard adults from abuse and harm and the provider had not ensured they carried out their responsibilities to comply with the requirements of the Mental Capacity Act (MCA) 2005. In addition, notifications of events and incidents were not always submitted in accordance with statutory regulations. Due to the failure to make and sustain the necessary improvements we rated the key question of 'well-led' inadequate at that inspection.

Following the last inspection, we met with the provider to discuss the necessary actions improvements and seek their assurances that appropriate action would be taken.

You can read the reports from our previous comprehensive inspections, by selecting the 'all reports' link for Norwood House on our website at www.cqc.org.uk

During this inspection, we reviewed actions the provider told us they had taken to gain compliance against the breaches in regulations identified at the previous inspection in February 2018. Shortly after our inspection in February 2018 the registered manager at that time left employment at Norwood House. A new manager commenced in the role of general manager at Norwood House in April 2018. They successfully applied to register with the Care Quality Commission as a registered manager in October 2018. 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.

At this inspection we found improvements had been made. Work had taken place since our last inspection to improve the safety, effectiveness and quality of the service. At this inspection in November 2018 we found two breaches of the regulations of the Health and Social Care Act, 2008 (Regulated Activities) Regulations 2014. This was in relation to the safe recruitment of staff and also the lack of a call bell system which enabled people to seek staff assistance from their bedrooms. We also made a recommendation in respect of the ongoing close monitoring of staffing levels and a recommendation about end of life care. We also found that the work to improve the service was in its early stages but clearly underway and the new management team which consisted of the recently registered manager and a new deputy manager were committed to ensuring the required improvements took place. At this inspection we found further improvements were required to ensure a consistent delivery of safe care and treatment that could be evidenced in the longer term. You can see what action we told the provider

Inspection areas

Safe

Requires improvement

Updated 26 January 2019

The service was not consistently safe.

The provider's recruitment processes were not robust and did

not always ensure the necessary pre-employment checks were completed.

Risks to individuals were not always assessed and measures to mitigate risk

were not always in place and monitored. People did not have access to a call bell system to call for staff assistance.

There were sufficient numbers of suitably qualified staff to meet the needs of people who used the service.

Staff knew how to protect people from the risk of abuse and how to report any concerns.

People received support to take their medicines safely.

Effective

Requires improvement

Updated 26 January 2019

The service was not always effective.

The service was not always compliant with the Mental Capacity Act 2005. People did not have free access to their bedrooms and had to ask staff to unlock their doors.

Staff were provided with supervision and had received relevant training to support them in their roles.

People had been supported to receive on-going healthcare and to eat and drink enough to maintain a balanced diet.

Caring

Good

Updated 26 January 2019

The service was caring.

Staff were kind and compassionate.

People's privacy and dignity were respected.

Responsive

Good

Updated 26 January 2019

The service was responsive.

People were involved in a range of activities according to their preferences and interests.

People's concerns and complaints were listened and responded to in order to improve the quality of care.

Well-led

Requires improvement

Updated 26 January 2019

The service was not always well-led.

Although quality assurance processes had been strengthened, they had not identified the concerns and shortfalls that we identified at this inspection.

The registered manager demonstrated open, transparent and effective leadership.

People, their relatives and staff felt the service had improved since the current registered manager commenced employment.

Some incidents which occurred at the home had been notified to the Care Quality Commission in accordance with the regulations.