Norwood - 159a Station Road

People’s experience of using this service:

People living in this home were safe. They had good support with their health needs and prescribed medicines. People were fully involved in planning their daily lives and choosing how to spend their time. Staff spent time teaching people skills to support them to be as independent as possible.

Staff knew people’s needs and preferences well and provided a person-centred service. Relatives were very happy with the personalised support that people had in the home. The service worked to the principles and values of registering the right support. The service was exceptionally caring. People had excellent support with their communication.

The service provided people with good support for their religious, cultural, relationship and sexuality needs. Staff were well trained and supported and enjoyed working for Norwood. The provider managed and monitored the service well. The provider organised celebrations of Jewish festivals where people from this service and all their other services could meet up. The provider ensured specialist support was available to people in this home with their religious, cultural, communication and behaviour needs.

The service was well led with a programme of audits carried out by the registered manager and the provider to ensure a high quality person-centred service was provided. There were ongoing improvements to the service. The provider engaged well with relatives of people using the service and worked in partnership with them.

The service met the characteristics of an outstanding service in the way the care was responsive to people's needs and the characteristics of a good service in all other areas. More information is in the full report.

Rating at last inspection: At the last inspection the service was rated Good (last report published 18 March 2017).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated good.

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

We carried out an unannounced comprehensive inspection of this service on 12 and 17 August 2016 at which a breach of legal requirements was found. Specifically the provider had breached Regulation 15 about premises and equipment. We found that temperature control systems for the safe storage of medicines and refrigerated food were not effective at identifying and addressing risks. This was because records showed that temperatures were consistently too high and that there had not been sufficient action to address risks arising from this.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the 'all reports' link for this service on our website at www.cqc.org.uk.

'Norwood – 159a Station Road' is a care home for up to eight adults. The service is spacious and provides accommodation on the ground and first floor. It specialises in providing services to people who have a learning disability or who are on the autistic spectrum. Autism is a lifelong condition that affects how a person communicates with and relates to other people, and how they experience the world around them.

There was a registered manager in post at the service. 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 the provider had followed their plan and legal requirements had been met. Food in fridges and freezers was being stored at safe temperatures. Medicines throughout the service were securely stored at appropriate temperatures. Records showed regular monitoring of temperatures for food and medicines, and that safe temperatures were being maintained.

‘Norwood – 159a Station Road’ is a care home for up to eight adults. The service is spacious and provides accommodation on the ground and first floor. It specialises in providing services to people who have a learning disability or who are on the autistic spectrum. Autism is a lifelong condition that affects how a person communicates with and relates to other people, and how they experience the world around them.

There was a registered manager in post at the service. A registered manager is a person who has registered with the 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.

The outstanding feature of the service was that staff were exceptional at communicating effectively with people on an individual basis, and used this as a basis for valuing people and developing their autonomy and independence. Staff had received a lot of support to develop skills in these areas, and there was on-going investment at embedding these processes. This had a positive impact on people’s behaviours and the involvement in their care. This helped to demonstrate a very caring service, which matched the highly positive feedback we received from people’s relatives.

We found there to be a positive, inclusive and empowering culture at the service. The registered manager led by example, providing good support to staff and ensuring that appropriate values were upheld towards people using the service.

Attention was paid to people’s safety but in a way that minimised restrictions on their freedoms. For example, whilst many people had positive behaviour support plans in place to help minimise use of any behaviours that challenged the service, there was little reliance on as-needed medicines as part of those plans. Instead, there was an emphasis on recognising and understanding people’s communications, and providing a service that responded to their experiences. There were also effective safeguarding procedures in place.

People were treated with respect and their privacy and dignity was promoted at all times. Attention was paid to keeping the service clean. The service had a number of long-standing staff who knew people well, which helped to enable positive and trusting relationships to be developed with people using the service. There were enough staff working at all times, although there was some reliance on agency staff to address staffing vacancies.

People had opportunities to take part in a variety of activities both in the premises and the community. Good effort was made to match and develop activities that matched people’s abilities and preferences.

People received good support in respect of their individual healthcare and nutritional needs. The service liaised promptly if there were any concerns about anyone’s health, and followed community healthcare professional advice well.

Whilst the provider’s mandatory training was not consistently completed by some staff, staff received a range of additional training that helped to ensure that people using the service received effective and individualised care.

The service took appropriate action if they believed a person needed to be deprived of their liberty for their own safety. However, further work was needed with ensuring that the principles of the Mental Capacity Act 2005 were consistently applied for everyone using the service.

The service listened to feedback and acted on it. There was a formal complaints process in place but it had not been needed recently.

The service audited quality to help ensure good care was provided. Changes were made to the service as a result of any concerns being identified.

However, we found one breach of regulations. Temperature control systems for the safe storage of medicines and refrigerated food were not effective at identifying and addressing risks. This was because records showed that temperatures were consistently too high and that there had not been sufficient action to address risks arising from this. You can see what action we have told the provider to take at the back of the full version of this report.

Staff were aware that all people who used the service should be treated with respect and dignity. The home had arrangements for ensuring that the personal needs and preferences of people were respected regardless of their background. Relatives we spoke with provided confirmation that the religious and cultural needs of people had been responded to.

The care needs of people had been carefully assessed. Risk assessments together with guidance to staff on minimising risks to people had been prepared. There was evidence that people and their representatives had been consulted regarding the care plans prepared. However, not all the care plans had been reviewed regularly. People were engaged in a range of activities which they liked.

Staff had been provided with essential training and were knowledgeable regarding their roles and responsibilities. Relatives and some staff informed us that overall, there were sufficient staff to care for people. However, some staff stated that more staff were needed as they were sometimes very busy.

The home had a complaints procedure. Relatives said they knew who to talk to if they were unhappy with the services provided.

The service was homely and comfortable. Staff and people using the service interacted spontaneously and were relaxed with each other. We observed lots of positive interaction and engagement. People were treated with respect and dignity. Care plans contained support plans and risk assessments that were actively reviewed when needed.

People were safe from the risks of abuse as the provider had been alert to potential hazards and had taken steps to ensure staff understood the issues involved and had acted to reduce the risks of neglect or abuse.

Staff were supported and trained. They felt the service was well managed and enjoyed working there.

The provider had a wide range of monitoring and feedback mechanisms in place and used their results to improve the service.