Archived: Normanton Lodge

Normanton Lodge is a residential care home providing personal care for older people, some of whom were living with dementia. Normanton Lodge is registered to accommodate 26 people, at the time of the inspection 17 people lived at the service.

People's experience of using this service and what we found

People told us they felt safe living at Normanton Lodge. The registered manager and staff knew how to protect people from the risk of harm or abuse. There were enough staff available with the appropriate skills to meet people's needs.

Staff were recruited safely however, some documentation was missing from staff recruitment files, this was acted upon straight away by the registered manager and the missing documentation produced. The registered manager was aware that recruitment files needed to be more robust and was working to embed this in practice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People received their medicines as prescribed and systems were in place to receive, store and manage medicines safely. Staff followed infection control guidance and had access to personal protective equipment (PPE).

The registered manager and staff understood their roles and responsibilities. Staff liaised with health and social care professionals to ensure people's health and care needs were met. There were several quality assurance processes in place and the registered manager had good oversight of the quality of the care provided to people. People and their relatives were given the opportunity to give feedback on the care received, this was used to drive improvement in the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 19 January 2019).

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels, management oversight, risks to people not being managed and infection control. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Normanton Lodge on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

On 29 November 2018 we carried out an unannounced focussed inspection, prompted in part by a notification and a safeguarding concern. The information shared with the CQC indicated potential concerns about the management of risks to people.

Normanton Lodge 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.

Normanton Lodge accommodates up to 26 people in one adapted building. At the time of inspection, there were 25 older people living at the home, some of whom were living with dementia.

The home is situated in Bognor Regis, West Sussex. Accommodation was provided over two floors with a lift for people to use when accessing the upper floor. There were assisted bathrooms on each floor, a dining room and one lounge area on the ground and first floor.

The manager was new in post and registered with the Care Quality Commission in November 2018 and was supported by a deputy manager, who had been the previous registered manager for over 20 years. 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 that Normanton Lodge continued to have effective processes and systems in place to keep people safe and the home was well-led.

The home continued to have robust safeguarding systems, policies and procedures to protect people from abuse. Local safeguarding procedures were followed to respond to safeguarding concerns promptly.

Risks to people continued to be assessed to keep people safe. There were sufficient numbers of staff to support people and meet their needs safely. One person told us, “Yes, there are enough staff and I do get help quickly.”

Risks associated with the environment and equipment had been identified and managed well. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.

Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

Normanton Lodge continued to promote a positive culture that was person-centred, open, inclusive and empowered people to live healthy active lives. One person told us, “They do seem well trained, because they just get on with their jobs. I think it’s just like a family in here and they are very kind to me.”

The registered manager and provider actively involved staff in opportunities to continuously learn and improve the quality of the service, taking on board feedback from people and relatives.

Normanton Lodge is a care home which offers care and support for up to 26 predominantly older people. At the time of this inspection there were 20 people living at the service. Some of these people were living with dementia. Accommodation was on two floors with a lift for people to use when accessing the upper floor.

Comments from people, relatives and healthcare professionals included, “You could not wish for a better place,” “I think they (staff) are all absolutely amazing,” “They (staff) are just wonderful, like a big family, so caring and very thoughtful,” “It's not home but it is the next best thing,” “We have no concerns at all about this place. It is one of the best in the area” and “This is one of the homes that we would consider using for our relatives, and we don’t say that about a lot of services in this area.”

We walked around the service which was comfortable and appeared clear. Bedrooms were personalised to reflect people’s individual tastes. People were treated with kindness, compassion and respect.

Systems for the management and administration of medicines were safe. It was clear that people had received their medicine as prescribed. Regular medicines audits were consistently identifying if errors occurred.

Staff were supported by a system of induction training, supervision and appraisals. People were supported by staff who knew how to recognise abuse and how to respond to concerns. Staff received training relevant for their role and there were good opportunities for on-going training and support and development. More specialised training specific to the needs of people using the service was being provided such as dementia care. Staff meetings were held regularly. These allowed staff to air any concerns or suggestions they had regarding the running of the service.

Risks in relation to people’s daily life were assessed and planned for to minimise the risk of harm.

The service had identified the minimum numbers of staff required to meet people’s needs and these were being met.

People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.

Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Where necessary staff monitored what people ate to help ensure they stayed healthy.

Care plans were well organised and contained accurate and up to date information. Care planning was reviewed regularly and people’s changing needs were recorded. People, and where appropriate relatives, were included in the reviews.

People had access to a wide range of meaningful activities. An activity co-ordinator was in post who arranged regular events for people. These included regular singing and quizzes, also events for firework night and Christmas were planned. People were provided the opportunity to take part in domestic tasks if they wished. One to one activity was provided for people who were being cared for in their bedrooms.

The premises were adequately maintained. The service had some pictorial signage to meet the needs of people living with dementia.

There was effective communication throughout the staff. The staff were happy working for the service and told us they were well supported. The registered manager was supported by a deputy manager, senior care staff and a team of motivated carers, catering and domestic staff. The provider visited regularly to provide support for the registered manager and audit the service provided.

We saw that people's consent was obtained where possible before care and treatment was undertaken. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and preferences were taken into account.

People were protected from abuse and cared for in a safe and inclusive environment. We noted that there were adequate numbers of skilled and experienced staff to deliver safe and appropriate care. We also found that systems were in place for people and relatives to make a complaint about the service if necessary.