Norwood House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were at risk of receiving care that was not fully tailored to their needs. Electronic care records did not always include an initial assessment of need, and key health information such as dementia, learning disability, or mental health was not consistently recorded. People’s views were sought, but gaps in documentation and planning meant care was not always holistic or person-centred. People were involved in assessments and reviews, but this was not always reflected in their care plans or day-to-day support. There was limited evidence of a trauma-informed approach where this was historically evident for people, and the provider did not consistently check and discuss people’s health, wellbeing, and communication needs in a structured way.

People’s care did not always follow best practice guidelines, because systems for using evidence-based approaches were not consistent. People’s views were listened to, but gaps in planning and follow-through meant care was not always effective or focused on the person. For example, one care plan mentioned difficult behaviours but did not include Positive Behaviour Support (PBS) strategies, even though these are considered best practice. While people talked about what mattered to them, this was not always shown in their care plans or daily support.

People were at risk of experiencing gaps in care because the provider did not always work effectively across teams and services. Information about people’s needs was not consistently recorded or shared when they moved between services. This meant staff did not always have the details required to provide safe and coordinated support. For example, assessments for individuals with learning disabilities or mental health needs were not always clearly recorded or communicated. This led to delays in implementing appropriate care strategies.

People were supported to manage their health and wellbeing in ways that promoted independence, choice, and control. Staff told us that people’s preferences were respected, and reasonable adjustments were made to help them attend appointments and maintain their health. Staff also accompanied people to appointments when needed, ensuring continuity of care and reducing barriers to accessing healthcare services. For example, staff helped people access services such as chiropody, opticians, and GP appointments. One person told us: “Someone comes and cuts my toenails, and we have a hairdresser that comes.” Another person said, “The optician came here, and I got new glasses and reading glasses. If I was in pain or unwell they [staff] would call the doctor.”

People were at risk of receiving care that did not consistently meet their needs. The provider did not always monitor care and treatment to drive improvement. Systems to check that outcomes were positive and aligned with clinical standards and people’s expectations were not always used effectively. While care plans included some information about people’s skills, life experiences, and goals, reviews were not always completed thoroughly and changes in wellbeing were not routinely reviewed. We found care plans had not been updated following significant changes in a person’s presentation. For example, increased anxiety which led to abusive behaviours. This meant staff lacked clear guidance on how to respond. The lack of proactive monitoring limited opportunities to identify and implement improvements in people’s care.

People were confident their rights around consent were understood and respected. Care plans included a space to record consent, but this was not always completed. However, the provider ensured decisions about care and treatment were made in line with the Mental Capacity Act 2005. They involved people fully in discussions about their options when delivering person-centred care and treatment. People told us they felt informed and included in decisions about their care. One person said: “They [staff] have done a care plan with me. When I go to appointments staff come with me. The food’s nice and you get a choice.”