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Norton Grange Nursing & Residential Care Home Good

Inspection Summary

Overall summary & rating


Updated 12 February 2019

This inspection visit took place unannounced on 23 January 2019.

Norton Grange Nursing and Residential Care Home is a two-storey residential home which provides care to older people including people who are living with dementia. Norton Grange is registered to provide care for 29 people. At the time of our inspection visit there were 27 people living at the home. Care and support was provided across both floors and each floor had its own communal lounge and dining area. All rooms were en-suite and people had shared use of communal lounges, dining areas and bathroom facilities.

People in care homes receive accommodation and nursing and/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.

There was a registered manager in post. 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 our last inspection we rated the service Requires Improvement overall, and in each key area, except for caring that was rated good. We found people’s choices and decisions about their care were not made in line with the Mental Capacity Act and some people had unnecessary restrictions placed on their freedom. We found the providers audit systems and processes were not thorough so improvements were not always identified and/or actions taken. This meant there was a breach of the Health and Social Care Regulations for safe care and treatment and good governance. The provider sent us an action plan telling us how they would improve in these areas. We completed this inspection visit to check improvements had been made.

At this inspection visit we found improvements had been made and the provider was not in breach of the regulations. Further improvements and time to embed processes and systems of audits was still needed for the registered manager and provider to be confident actions resulted in the quality of service being improved. A range of current audits and checks helped ensure people received safe care that was delivered in a safe environment.

People and relatives were complimentary and satisfied with the quality of care provided at the home. People felt safe living with other people in the home and they were supported by a consistent, kind and caring staff team.

Staff were available at the times people needed and there were enough staff to respond to people’s needs and requests for assistance. Staff were trained but further training was planned to ensure people's care and support needs were met by staff who knew how to support them safely and effectively. Staff understood their responsibility to safeguard people from harm and to report any concerns they had to the management team. Staff were confident actions would be taken.

People's changing needs were responded to by staff and other healthcare providers were contacted when needed. People were treated with respect by staff who addressed them by their preferred names and who supported them in line with their personal preferences and wishes.

No one at the time of our visit received end of life care. The registered manager said care was given so if people wanted, ‘this was a home for life’. Anticipatory and pain relief medicines were arranged so if people’s condition quickly deteriorated, their care could remain as pain free and dignified as possible.

The registered manager worked in partnership with other healthcare professionals to ensure people received effective care that was responsive to their needs. The registered manager had built new relationships with support networks, other healthcare professionals, the local authority, commissioners of services and the local community. This hel

Inspection areas



Updated 12 February 2019

The service was safe.

At the last inspection we found medicines were mostly given as prescribed and risks associated with people's care continued to not always effectively be managed. At this visit, medicines management had improved and people�s risks to their health and wellbeing were assessed and planned for. There were enough staff to keep people safe and people felt safe with staff who understood their safeguarding responsibilities. Accidents and incidents were recorded by staff and learning from such events was encouraged and acted upon.



Updated 12 February 2019

The service was effective.

At the last inspection we found the provider did not work within the Mental Capacity Act. At this visit, staff recognised the importance of seeking people�s permission. Care was provided and considered alongside best interest decisions. Where people�s liberties were restricted, necessary approvals had been requested. Staff supported people to ensure they maintained a balanced diet and people had choice of what they wanted to eat and drink. People received support from other health care professionals.



Updated 12 February 2019

The service was caring.

At the last inspection we found staff time pressures meant staff did not always involve people or had limited time to support people�s health and welfare. At this inspection, staff were kind, considerate and caring in their approach to people. Staff were more attentive to people, especially those who needed more support. Staff promoted equality and diversity to make sure people�s beliefs were supported.



Updated 12 February 2019

The service was responsive.

At the last inspection we found people were not involved in their care decisions and they received limited stimulation through hobbies and interests. This time, people and relatives felt more involved and the registered manager had increased and was planning to improve further, people�s access to pursue their hobbies and interests. People knew how to complain and were confident in approaching the registered manager if concerns were raised.


Requires improvement

Updated 12 February 2019

The service was not always well led.

At the last inspection we found the provider�s audit systems and processes did not identify the concerns we found. At this inspection, the registered manager had implemented a system of audits that had begun to identify and drive improvements, although some improvements were still needed. The registered manager had made a positive difference to the home. People and staff were complimentary of the improvements being made.