Archived: Normanby House

We inspected on 16 and 27 October, day one of the inspection was unannounced.

At the last inspection in December 2015, the service was rated Good. At this inspection, we found the service remained good.

Staff demonstrated a good understanding of safeguarding people who may be vulnerable. They were aware of what to look for and knew how to report incidents. They knew the people they supported well. People we spoke with told us they felt safe, respected and well cared for.

People's medicines were managed safely. Risks to people's health and safety had been identified and risk assessments were in place to guide staff. Regular servicing of equipment and checks of services such as gas took place.

Robust recruitment processes were in place to assist the registered manager in making safe decisions about who they employed. Staff received regular training and they were supported through supervision and appraisal.

Staff worked within the principles of the Mental Capacity Act when providing support to people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Best interest decisions involved people’s representatives when required.

People told us they enjoyed the meals provided and were supported to eat a healthy balanced diet. Where needed, people's nutrition was monitored by staff. People had good access to healthcare professionals to support all of their health needs.

The environment supported people's needs and their personal space reflected their preferences and personalities. People's choices were taken account of when planning their care and they could choose how that care was delivered. Their end of life support needs were considered and planned for with the involvement of the person and their next of kin.

People’s needs were assessed and care plans reflected their care preferences and how they liked to spend their time. People were supported to engage in activities and where they had friends or family they were supported to maintain those relationships in a meaningful way.

Regular checks of all areas of the service were completed by the registered manager. There was good oversight from the provider who completed unannounced quality assurance checks to ensure the safe running and quality of the service.

We received consistently positive feedback from people who used the service, their relatives and friends and visiting professionals.

During the inspection five key questions were answered; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service, their relatives and the staff told us.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

All the people we spoke with told us the care delivered by the staff was of a good standard. One person told us, 'I have been very impressed with the staff. They are very knowledgeable.' We saw the staff had been well trained and supported in their work and they told us it helped them deliver good care.

Relatives told us they were very happy with the home and felt their relatives were kept safe and well looked after. One of them told us, 'My mother was not safe at the last service, we were always worried. Since coming here we no longer worry.'

All the people we spoke with told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported. One person told us, 'I feel very safe here, there are no problems.' Another person told us, 'I can go to the staff at any time.'

We spoke with staff about Deprivation of Liberty Safeguards (DoLS). The registered manager told us there had been one application in the last year and showed us the policy and procedures they followed. We saw this had been appropriately documented. They told us all staff had received relevant training and had access to the policy and procedures. Those staff also told us they had received this training.

Is the service effective?

People explained how their care and welfare needs were met. All the people we spoke with told us they had support with health appointments and felt the service was flexible. One person told us, 'I needed to see a physiotherapist so I asked the staff to arrange this. I have had problems with my mobility. The staff have helped me with my walking and encouraged me. It has really helped.' Another person told us, 'I have not been well and came here from hospital. The staff have been so kind.'

People told us they were involved in their care. They had regular resident meetings. One person told us, 'I sometimes attend the meeting. But I can speak with the staff anytime with any issues.' All the people we spoke with told us they were always asked by staff if they needed help or assistance. The staff told us they always asked people if they were happy and required assistance before providing help.

All the staff told us they felt supported in their work. They told us they received a full training programme. One person told us, 'I received a full induction when I started. I feel well supported. I can go to my manager about anything at any time.'

Is the service caring?

We saw the staff communicated well with people and were able to explain things in a way which could be easily understood. We saw they did not rush people in the home and we saw the interactions were caring. All the relatives we spoke with said they felt the care was very good. One relative told us, 'Our mother has been so well cared for.'

We saw people were treated with respect and dignity by the staff. We saw people were given choices in their care provided and all the relatives we spoke to told us they were very happy with the care. All the people we spoke with told us they were happy with the care and support they received.

Is the service responsive?

The two relatives we spoke with told us the service had been very responsive. One of them told us, 'When we have had any issues we have gone to the manager and she has been very good. She always listens and responds. All the staff are marvellous. We come to regular resident meetings and we can share ideas and things get dealt with.'

All the people we spoke to told us staff would respond to any of their requests for support. One person told us, 'The staff have helped me to stay independent.'

We saw staff responded to people's requests for help in a timely way.

Some of the people we spoke with told us they were involved in decisions about their care. They told us the staff were flexible and responded to their requests promptly. One person told us, 'I like to stay in my room sometimes; I do go out sometimes and the staff encourage me. They always ask me about what I would like to do.'

People's care needs had been reviewed at least every month. We saw how when people's requirements had changed the provider had responded and reviewed their care needs so they could meet their changed support and care needs.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service well-led?

We spoke with the registered manager. They showed us there was an effective system to regularly assess the quality of service people received. We found the views and opinions of people, relatives and staff had been regularly recorded and responded to. The manager showed us they had just recruited a new activities co-ordinator in response to the views and opinions they had received.

We saw the home had systems in place which made sure managers and staff learnt from any accidents, complaints, whistleblowing reports or investigations. This helped reduce the risks to people and helped the service to continually improve.

Staff told us they understood their roles and responsibilities. Staff had a good understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure people received a good quality care service at all times.

We saw that people had individualised care records and risk assessments in place which helped staff to understand and meet people's needs. Everyone we spoke with said they were very happy with the care they received. People who were not able to tell us their views looked well cared for.

People's nutritional needs were assessed and continued to be monitored. Food being served looked appetising. People could eat wherever they preferred. We received the following comments about the food: 'The food is always good I get more than enough to eat." And 'The choice of food is good. I can eat in my bedroom or go to the dining room.'

During our visit we saw that there was enough skilled and experienced staff to meet people's needs in a timely way. This was confirmed by people we spoke with and by staff. One person we spoke with said 'There's enough of them. The staff are all wonderful.'

The quality of the service being provided was being monitored by the manager. Any issues found were being acted upon. This helped to ensure that people remained satisfied with the service they received.