Norwood

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People told us that they felt safe. One person said, “I have a pendant alarm which is essential for me. They do come, day or night and I know that they will come.” Relatives said that they were kept up to date with changes in their relative’s needs and any incidents which occurred.

The provider had processes in place for staff to report incidents, near misses and safety events.These were reviewed to identify learning, and we saw that where accidents had occurred, such as falls, steps taken to mitigate further harm. The provider also reviewed incidents across all their services to identify any patterns or changes that were needed. The findings were communicated to all managers as part of ‘learning to improve’.

Clinical risk meetings had stopped temporarily but were due to be reinstated by the leadership team. Staff spoke positively about the provider and, the responsiveness of senior staff. One member of staff told us, “They don’t let things slide here. If I report anything it is never dismissed, it is dealt with always here.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People’s needs were assessed prior to their admission and care plans, and risk assessments were put in place to support their care and transition into the service. Where people were admitted to hospital, information about people’s needs was provided to health care professionals to ensure continuity of care. One person returned from hospital during the inspection, and we noted that the staff were proactive in clarifying changes to the person’s wellbeing and treatment plan to ensure the best outcome for them. Feedback from visiting professionals about how transitions were managed was very positive.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People and relatives told us that Norwood was a safe place to live, and they were very comfortable there. We observed that people were relaxed in the company of staff.

Staff told us that they completed training on safeguarding and told us that they would not hesitate to escalate any concerns to the management team and had confidence that they would be addressed. They spoke positively about the safeguarding training and the importance of protecting people but where less clear about the role of the local authority in undertaking investigations.

Body maps were used to record changes in people’s skin. We saw examples where the registered manager had taken action when concerns had been identified.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People told us they felt safe. One person said they felt reassured by the numbers of staff who were available and liked to leave their bedroom door slightly open, so they knew when staff were nearby. Another person said they were encouraged to use their call bell and that staff responded promptly.

Risk assessments were undertaken and processes were in place to monitor risks related to nutrition, falls and skin integrity. For example, people at risk of pressure damage had access to appropriate equipment, such as specialist mattresses, and staff routinely checked that mattress settings were correct. Where people experienced weight loss, they were weighed more regularly and staff sought advice from healthcare professionals. For those at risk of falls, crash mats and sensor mats were available. We noted that one person did not have a risk assessment for leaving the building but once this was highlighted it was immediately addressed.

We observed that staff were attentive to risks and were clear about the level of support people needed. They carried out regular checks on people in their rooms. Two dining rooms were available, including one designated to support people who required more assistance at mealtimes. Support provided was well paced and people at risk of choking were provided with soft or pureed meals. Fortified drinks and milk shakes were provided where people were at risk of malnourishment.

The provider had systems in place to detect and control potential risks in the care environment. However, these systems could be strengthened further.

Regular checks were carried out on equipment and the environment to reduce the risk to people. For example, water temperatures were monitored and fire safety checks undertaken to ensure that the systems were working effectively. People had personal emergency evacuation (PEEPs) in place and regular fire drills were undertaken to ensure that staff were clear as to the processes to follow in an emergency.

Equipment used to assist people with their mobility was checked and regular health and safety audits were undertaken. Window restrictors were in place, but we asked the provider to review these to ensure that they complied with the guidance and could not be tampered with.

Whilst most risks were well managed, we did identify a small number of potential risks which the provider agreed to immediately review. A door was unlocked to a small balcony and an unlocked gate in the garden leading to an old greenhouse.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People told us that there was enough staff, although some said that they had to wait for support at busy times, but waits were not excessive. Comments included, “If I press the alarm, I know that someone will come,” and “I press the button and I get a response usually 5 minutes, waiting just before meals is longer, but acceptable.”

We observed that staff were visible throughout the service and call bells were answered promptly. Staff told us that they had the time that they needed to support people. One said, “Some days it’s busier than others, sickness does impact sometimes but it is alright mostly.”

The provider used a staffing dependency tool to calculate required staffing based on people’s needs to ensure that they could support people safely. This was reviewed on a regular basis. The service was fully staffed, and sickness cover was provided from within the staff team. Staff told us that they worked well as a team and a number of the staff had complimentary roles, such as housekeeping and care which meant that they were able to work flexibility to cover sickness and holidays.

Staff told us that they were provided with training and induction when they commenced their role. Training included shadowing more experienced staff and completing the mandatory training. One member of staff told us, “We always have staff training ….either eLearning, zoom calls or face to face training, it’s good quality and I have learnt a lot.” Competency checks were completed to evidence understanding in key areas such as medicines. Senior staff completed additional training relevant to their role.

The management team carried out recruitment checks on staff prior to their appointment which included right to work, references and disclosure and barring checks.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The environment and equipment were clean and generally well maintained. Personal protective equipment (PPE) was available to staff who knew when to wear it and how to dispose of it. We observed staff washing their hands and using PPE appropriately.

People told us that they received support to maintain their own personal hygiene in line with their needs and preferences.Cleaning schedules were in place and regular audits were undertaken to check the implementation of infection control procedures.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Records were up to date and showed people received their medicines as prescribed. Running totals were maintained and records tallied with the available medicines. Where irregularities were identified, these were reviewed and incident reports were completed.

Staff stored, managed and administered medicines in a safe way. Controlled drug records were accurately kept and were stored safely in a locked cupboard.Staff followed safe procedures when giving people their medicines and gave people the time they needed. There were regular assessments of staff competence around medicine management.

Medicine audits were completed on a regular basis.