Norton House

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 69 (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.

Incidents, accidents and safeguarding concerns were reported, investigated and reviewed, with learning used to improve practice rather than apportion blame. Safeguarding records showed concerns were escalated appropriately and closed with outcomes and learning points recorded. People and relatives were informed when things went wrong, apologies given.

Staff described using reflective practice through daily meetings, handovers and weekly meetings to discuss incidents and near misses. The registered manager told us, “Reflective practice is in place and there is a reflective practice folder. We have “10:10” meetings every day.” Records showed learning from incidents, including environmental and clinical concerns, was shared with staff and embedded into practice.

Issues identified during the assessment, such as call bell faults and storage concerns, were addressed promptly and monitored. This demonstrated learning was acted on in practice and supported by organisational policies that promoted openness, transparency and duty of candour, reinforcing a culture of continuous improvement.

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.

The provider had systems in place to support safe care pathways and transitions. Staff worked with health and social care professionals to plan and respond when people’s needs changed, helping to maintain continuity and safety of care.

They made timely referrals to district nurses, general practitioners and social workers when required, including for clinical monitoring and changes in care needs. Information about people’s risks, needs and preferences was shared through handovers, meetings and care records, which helped ensure continuity across shifts and during transitions.

Staff understood when to escalate concerns and involve senior colleagues or external professionals. Where people moved between services or attended hospital appointments, staff shared relevant information to support safe transfers of care. This reduced the risk of gaps in care and supported coordinated decision‑making.

This supported safe pathways, continuity and transitions, helping to protect people from avoidable harm when care needs changed.

People and relatives told us transitions were well managed and they had settled well at the service.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that.

The provider had effective safeguarding systems to protect people from abuse and neglect. Safeguarding concerns were recognised, reported and escalated to the local authority when required, with outcomes and learning recorded.

Staff understood safeguarding processes and their responsibilities and managers maintained oversight of safeguarding activity and shared learning with staff to reduce future risk.

The provider applied for Deprivation of Liberty Safeguards (DoLS) authorisations where people lacked capacity to consent to restrictions on their care. Decisions were made in people’s best interests and to keep them safe.

Managers monitored DoLS authorisations and any associated conditions and worked with external professionals to review arrangements when people’s needs or capacity changed. This helped ensure restrictions remained proportionate, lawful and appropriate.

People and their relatives told us they felt safe at the service and knew who to speak with if they had concerns.

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 were involved in decisions about managing risks to their safety and wellbeing, and staff supported positive risk‑taking to promote independence while maintaining safety. Risk assessments were in place for areas such as mobility, skin integrity, nutrition and equipment use, and these were reviewed when needs changed.

Staff demonstrated positive risk‑taking in practice. Where people wanted to remain active or continue familiar routines despite reduced mobility or cognitive impairment, staff supported this safely rather than restricting activity unnecessarily. For people who were at risk when eating and drinking, staff followed professional guidance while promoting choice, dignity and independence.

Care plans reflected this approach, showing how staff encouraged mobility with appropriate support and equipment and adjusted care in response to people’s daily choices and preferences. Measures such as sensor mats, motion sensors and planned checks were used to alert staff rather than restrict movement, supporting people to remain as independent as possible while reducing the risk of harm.

Relatives told us risks were well managed and people were kept safe.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

During the assessment, inspectors identified some environmental issues. A cupboard containing cleaning products was found open and some storage cupboards were cluttered. These issues were escalated immediately, rectified while inspectors were on site, and learning was shared with staff to reduce the risk of recurrence. Evidence of actions taken was shared with inspectors.

Call bell systems were in place to support people to summon assistance. On the day of the assessment, some call bells were not working, which meant staff were not always alerted when people needed help. This was escalated promptly and rectified while inspectors were on site, with leaders monitoring the actions taken.

Overall, the service identified and managed risks in the care environment and ensured equipment, facilities and systems supported safe care. Health and safety arrangements were underpinned by clear expectations for safe premises, equipment and risk reduction. Staff understood how to identify and escalate environmental risks, and leaders maintained oversight through routine checks and audits.

The provider did not always ensure effective oversight of training and competency compliance. Records showed gaps in mandatory training among senior staff, team leaders and care staff, including training in life support, dementia awareness, medicines and safeguarding. These gaps meant staff may not always have had up‑to‑date knowledge and competence to deliver care safely.

Following the assessment, the provider shared evidence of actions taken to address training gaps. This included staff completing overdue training, booking further sessions and putting interim supervision arrangements in place where staff were awaiting training. While this did not change the findings at the time of the assessment, it demonstrated leaders had taken steps to reduce risk and improve compliance

People described staff as caring and attentive, even during busy periods. One person told us, “They are fully stretched at times, but they are very helpful,” and another said, “They are very polite and helpful, and I have never felt neglected.” These views reflected staff prioritising people’s immediate care needs and supporting them respectfully.

There were sufficient staff deployed to meet people’s day‑to‑day needs. Staff worked together effectively and demonstrated good knowledge of people and their care needs. Leaders were visible and provided hands‑on support during busy periods. The registered manager told us, “I go round a lot and stay on the unit. I blend in on the unit and help.” Where pressure points were identified, staffing deployment was adjusted to maintain responsive care.

The provider had systems in place to support safe staff recruitment. Pre‑employment checks were completed, and new staff received induction and training to understand people’s needs and how to deliver safe care. Managers assessed staff competence, and staff received regular updates and supervision.

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 service assessed and managed infection risks and took action to prevent the spread of infection.

The environment was clean and well maintained, and staff followed infection prevention and control procedures to reduce the risk of cross‑contamination and infection.

Staff demonstrated a good understanding of infection prevention and control in practice.

People using the service told us the home was kept clean and they were happy with the laundry service. One person told us, “There is a laundry bin in the bathroom, and my clothes are taken and returned a few days later,” and another said, “I have not had any issues with the laundry.”

Cleaning schedules were in place and completed, and leaders carried out regular checks of cleanliness and hygiene across the service.

Managers maintained oversight of infection prevention and control through audits and routine checks. Where issues were identified, actions were taken and followed up to ensure improvements were embedded. This helped ensure people lived in an environment where infection risks were managed effectively.

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.

Medicines were managed safely, and people received their medicines as prescribed. The provider used an electronic medicines administration record system, and no gaps were identified in the records reviewed. Medicines were stored securely, including controlled drugs, which were double‑signed and kept in secure cupboards.

Staff completed medicines training and competency checks, which helped ensure medicines were administered safely and in line with procedures.

Managers carried out audits to make sure medicines were managed safely.

Stocks of medicines and storage conditions were checked and monitored. Where changes to medicines occurred, staff followed processes to update records and involved health professionals as needed. External professionals confirmed medicines were available and managed reliably. One visiting professional told us, “They keep the stock of insulin, and we have never run out.”

Time‑critical medicines were administered appropriately. Where covert medicines were required, staff followed lawful processes supported by mental capacity assessments, best‑interest decisions and clear care plans. Insulin was administered by district nurses, with clear care planning and professional oversight.

People told us they received their medicines safely and on time.