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 requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was in continued breach of legal regulation in relation to governance of the service as improvements had not been consistently sustained since the previous inspection.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always assess and review people’s needs effectively to ensure care and treatment achieved good outcomes.

Assessments of people’s needs were not always consistently completed or fully reflected in care planning. While care plans contained a range of information about people’s health and wellbeing, some key areas were incomplete or lacked sufficient detail, including future planning and aspects of consent.

Information relating to specific needs, such as learning disability and associated risks, was not always clearly recorded across all documentation. For example, key details were not always reflected consistently in summary documents, creating a risk that care may not be informed by a full understanding of people’s needs.

Although people’s preferences and histories were captured in parts of their care plans, this was not always translated into fully developed, holistic assessments to guide care delivery.

The provider did not always plan and deliver care in line with current evidence-based guidance and best practice.

Care plans included relevant information about people’s needs; however, these were not always developed in line with best practice guidance. For example, while behavioural needs were recognised, structured and clearly embedded approaches to support these needs were not consistently evidenced across all care planning.

Some aspects of care lacked clear, outcome-focused guidance for staff, including how to respond to changes in people’s health or wellbeing. End-of-life care planning, while present, did not always include sufficient detail to guide staff in the event of rapid deterioration of health and wellbeing.

This meant that care was not always consistently planned and delivered in a way that reflected current best practice or ensured effective outcomes.

The provider did not always work effectively across teams and services to support people.

Information sharing between services was not always consistent or effective. Key details about people’s needs were not always clearly communicated through documentation such as hospital passports, which lacked important informationto support safe and coordinated care.

Although staff worked with external professionals such as GPs and community health teams, documentation did not always demonstrate a fully coordinated approach to sharing information and planning care.

This created a risk that people may not always receive consistent care when accessing other services or transitioning between them.

The provider supported people to access healthcare and maintain their health and wellbeing.

People were supported to access a range of healthcare services, including GPs, district nurses and other professionals. Records showed that referrals were made appropriately, and advice from healthcare professionals was followed. People told us they were supported to attend health appointments and described receiving good support with their health needs.

Care plans reflected people’s health conditions and included guidance for staff to monitor and respond to changes in health, such as risks related to skin integrity, nutrition and long-term conditions.

The provider did not always monitor care and treatment effectively to improve outcomes for people.

Systems to monitor care were in place; however, these were not always used effectively to ensure consistent improvement. Reviews of care plans were not always completed in a timely way, and some areas of care planning remained incomplete or overdue.

Changes in people’s needs were not always clearly reflected in updated care plans, limiting the provider’s ability to ensure care remained appropriate and responsive to those changes.

Although data such as weight monitoring and daily records were collected, this information was not always consistently used to drive improvements in care planning and outcomes.

The provider did not always ensure people’s rights in relation to consent were fully recorded and reflected in care documentation.

While staff demonstrated an understanding of the need to involve people in decisions about their care, records did not always clearly evidence consent. For example, some care plans did not include completed consent sections, despite evidence that people were involved in discussions.

Mental Capacity Act processes were in place, and some decision-making was appropriately recorded; however, documentation was not always consistent across all areas of care.

This meant it was not always clear from records how people’s consent had been obtained or how their rights were supported in practice.