Norlands Nursing Home

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 72 (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 promoted a positive and proactive culture of safety that was underpinned by openness and honesty. Staff listened to concerns about safety, reported incidents appropriately and investigated safety events. The service used learning from incidents to identify improvements and embed good practice.

The service had clear systems for recording accidents, incidents and near misses. Records demonstrated that managers reviewed events, identified learning and implemented actions to reduce the risk of recurrence. Managers shared learning with staff and communicated information effectively through handovers, team meetings and day-to-day discussions. One such example included actions staff should take when a person would move the wet floor signs.

Staff demonstrated a clear understanding of how to identify, report and escalate concerns and incidents, both within the service and to external agencies when required. Staff told us they felt confident raising concerns and were assured that managers would take appropriate action.

The provider worked with people, relatives and healthcare professionals to ensure safe and consistent care. Managers monitored people's needs and worked with partner organisations to maintain continuity of care when people moved between services.

The registered manager completed pre-admission assessments to ensure the service could meet people's needs safely and effectively. They worked with people, families and relevant professionals to support smooth transitions into the service.

The registered manager maintained accurate records and shared relevant information with healthcare professionals and receiving services when people moved from the service. This helped support safe and coordinated care during transfers.

People were protected from abuse, avoidable harm and neglect. The provider worked with people, relatives and healthcare professionals to understand individual risks and support people to live as independently as possible while remaining safe. Managers responded promptly to concerns and shared safeguarding information with relevant agencies when required.

People and relatives told us people were safe living at the service. We observed people appeared calm, relaxed and comfortable around staff. Staff engaged positively with people through conversation, laughter and singing, which helped create a warm and reassuring environment. One relative said, “The staff at Norlands are very kind and helpful, (name) looks comfortable and contented – it’s a good place.”

The provider had effective safeguarding systems in place. Staff received safeguarding training and understood how to recognise, report and escalate concerns. They told us they felt confident raising concerns and were assured managers would respond appropriately.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that the registered manager showed a good understanding of their responsibilities under the MCA. Staff supported people in ways that upheld their rights and showed a good understanding of the Act’s principles. Staff understood the importance of gaining consent and told us ways in which they gained consent for those people who cannot verbalise their wishes.

The provider worked with people to identify and manage risks in a holistic way. Staff delivered care that was safe, responsive to people's needs and supported them to take part in activities and daily routines that were important to them.

Managers completed care plans and risk assessments that provided clear guidance on people's needs and how to reduce identified risks. Managers reviewed these monthly, or sooner if needs changed, to ensure information remained accurate and up to date.

Where people required modified diets, risk assessments outlined the support needed with eating and drinking and reflected professional guidance. We observed staff following this guidance in practice.

The service took a balanced approach to risk management that promoted people's independence, choice and rights while maintaining their safety. Records showed people, relatives and relevant professionals were involved in decisions about managing risks where appropriate.

The provider identified and managed risks within the environment to support people's safety. Regular risk assessments and audits helped ensure the premises, equipment and systems remained safe. Managers acted on findings promptly to reduce risks and improve safety. The provider held the required safety certificates and employed a maintenance person to address maintenance issues.

During the assessment, records showed water temperatures had marginally exceeded recommended limits on a small number of occasions. The registered manager responded promptly by introducing additional monitoring and temperature checks. Subsequent records showed the issue had been resolved.

The provider ensured there were enough skilled and experienced staff to meet people's needs safely. Staff received supervision, training and opportunities for development, which supported them to provide safe, person-centred care.

The provider followed safe recruitment processes and completed pre-employment checks before staff started work. New staff completed an induction, and managers carried out regular competency assessments and observations to monitor practice and support improvement. Staff completed training relevant to their roles, including specialist training where needed. All staff had recently completed National Early Warning Score (NEWS) training, which strengthened their ability to recognise and respond to deterioration in people's health.

The provider maintained staffing levels that met people's assessed needs. Managers reviewed dependency levels regularly to ensure staffing remained appropriate. Staff and relatives consistently told us there were enough staff to provide safe care. One relative said, “Yes, there’s always enough staff and they’re not rushed at all.”

The provider assessed and managed the risk of infection. Staff understood their responsibilities for preventing and controlling infections and took prompt action to identify, monitor and respond to potential risks. Managers shared concerns with relevant agencies when required to help protect people and prevent the spread of infection.

The provider maintained effective infection prevention and control (IPC) systems and processes. Staff received IPC training and, where appropriate, training in safe food handling. Personal protective equipment (PPE) was readily available throughout the service, and we observed staff using it appropriately. The service had designated IPC champions who supported good practice, and managers completed comprehensive IPC audits to monitor standards and identify areas for improvement.

The provider followed clear cleaning and infection control procedures. Staff consistently completed cleaning and deep-cleaning schedules, which clearly identified responsibilities and required tasks. Dedicated housekeeping staff supported these arrangements. During our assessment, we found the environment was exceptionally clean, well maintained and free from unpleasant odours.

Relatives consistently described the home as clean and hygienic. One relative told us, “(Cleaners name) is forever cleaning - she’s just like a busy bee and the home always smells nice. (name) the owner spends money on the home and keeps it lovely.”

Records demonstrated the provider operated safe laundry and cleaning systems. We also reviewed care records that identified a potential illness and documented the actions staff took to monitor the person's condition and reduce the risk of infection spreading.

The provider did not always ensure medicines were administered and recorded safely. However, nurses administered medicines and received appropriate training and competency assessments to support safe practice. During this assessment, we identified some minor medicines errors. There was no evidence people had experienced any harm as a result of these errors.

The registered manager responded promptly to the issues identified. They immediately developed and implemented new daily and weekly medicines monitoring schedules, which were in place by the end of the day. The provider had also already sourced a new electronic medicines system, which would further strengthen oversight and reduce the risk of future errors.

Medicines records were well organised, colour coded and easy to follow. Records for medicines prescribed on an 'as required' basis, such as paracetamol, were completed appropriately. These included the reasons for administration and the outcomes achieved. Staff used body maps to guide the safe application of topical creams and the rotation of transdermal medicines, such as pain patches, helping to promote safe and consistent practice.