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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 23 November 2018

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.

Norwood House is situated in Scarborough. The home accommodates up to 20 older people or people living with dementia in one adapted building. They do not provide nursing care.

Inspection site visits took place on 25 and 27 September 2018. At the time of this inspection, the service was providing support to 9 people.

At the last inspection in January and February 2018 the provider was found to be in breach of six regulations. These were Regulation 12 Safe care and treatment, Regulation 13 Safeguarding service users from abuse and improper treatment, Regulation 15 Premises and equipment, Regulation 17 Good governance, Regulation 18 Staffing and Regulation 19 Fit and proper persons employed.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions: Is the service Safe, is the service Effective, is the service Caring, is the service Responsive and is the service Well-led to at least good.

There was a manager in post but they had not yet registered with CQC. At the time of writing this report, an application for the manager to register had been submitted. 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.

Recruitment processes had still not been established and operated to ensure new staff were recruited safely. One to one supervisions had not taken place in accordance with the providers supervision policy. We have made a recommendation about staff supervisions. A plan was in place to ensure all staff were provided with an annual appraisal.

Risks to people had been assessed and recorded although we found some shortfalls in relation to choking risks. Appropriate checks were in place to ensure the environment and the premises were regularly maintained. Risks in relation to windows, bed safety rails and fire safety were in place and regularly reviewed.

Medicines had been stored and administered safely. Assessments of staffs’ competencies in this area had been conducted to ensure they had the skills and knowledge to manage and administer medicines.

The service was generally clean and tidy although further redecoration was needed in some areas where walls were scuffed or marked. A cleaning schedule was in place to ensure the service followed good infection control practice. Malodours were evident in some bathrooms.

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. Information was not appropriately recorded in relation to best interest decisions. We have made a recommendation about the recording of best interest decisions

People were provided with a variety of meals that they told us they enjoyed. Where people required specialist diets, all staff were not always aware of their needs. Food monitoring charts had not always been completed sufficiently to enable staff to effectively monitor people’s nutritional intake.

People told us staff were kind and caring and treated them with dignity and respect. Where possible, people’s independence was promoted although people were not always presented with information in a format they could understand. We have made a recommendation about accessible information.

Care plans contained person-centred information which focused on the individual. Pre-admission assessments had been completed prior to a person movin

Inspection areas

Safe

Requires improvement

Updated 23 November 2018

The service was not always safe.

Safe recruitment processes were not operated effectively.

Risk assessments were detailed and comprehensive, but the risks around choking had not always been safely managed.

Medicines had been stored and administered safely.

Risks relating to the premises, equipment and environment had been appropriately assessed to reduce the risk of harm.

Effective

Requires improvement

Updated 23 November 2018

The service was not always effective.

Staff had not been provided with sufficient supervision

The principles of the MCA had been followed although records did not always contain sufficient details.

Staff had received training to ensure they had the skills and knowledge to carry out their roles.

Caring

Good

Updated 23 November 2018

The service was caring.

People and relatives told us staff were caring.

Staff supported people to maintain their privacy and dignity.

Staff were familiar with peoples’ likes, dislikes and preferences.

Responsive

Good

Updated 23 November 2018

The service was responsive.

Care plans contained a good level of detail which enabled staff to provide person-centred support.

Activities were provided and adapted to meet people’s needs.

Documents to monitor people’s health and well-being were in place and regularly reviewed. They sometimes lacked detail.

Well-led

Requires improvement

Updated 23 November 2018

The service was not always well-led.

There was no registered manager in post.

The manager had processes in place to monitor and improve the service. However, they had not always been effective in identifying and responding to shortfalls.

Statutory notifications had not been submitted when legally required.