This was an unannounced inspection that took place on 8 March 2018. Norfolk Road is situated in Denton Holme and is near to all the amenities of the city of Carlisle. It is operated by Community Integrated Care who run similar services nationally.
Norfolk Road is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. When we last inspected this service in September 2016 we rated it as 'requires improvement' and we made recommendations.
The home accommodates six people in a large adapted period property. At the time of our visit there were five people living there.
The home had a suitably qualified and experienced registered manager. 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.
The staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training and could talk to us about how they would identify any issues and how they would report them appropriately. Risk assessments and risk management plans supported people well. Arrangements were in place to ensure that new members of staff had been suitably checked before commencing employment. Any accidents or incidents had been reported to the Care Quality Commission and suitable action taken to lessen the risk of further issues.
The registered manager ensured that there were sufficient staff to support people. Our findings corroborated this. Staff were suitably inducted, trained and developed to give the best support possible. We met experienced and confident team members who understood people's needs as well as new staff who were keen to learn.
Medicines were appropriately managed in the service with people having reviews of their medicines on a regular basis. People in the home saw their GP and health specialists whenever necessary.
We saw that good assessment of need was in place and that the staff team analysed the outcomes of care for effectiveness. People appeared happy with the food provided and we saw well prepared healthy meals that staff supported and encouraged people to eat.
The house itself was warm, clean and comfortable on the day we visited. Suitable equipment was in place to support people with their mobility.
The staff team were aware of their responsibilities under the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
We observed kind, patient and suitable support being provided. Staff knew people and their families very well. They made sure that confidentiality, privacy and dignity were maintained. People were encouraged to be as independent as possible. No one was receiving end of life care when we visited but there were plans in place and training available should the need arise.
Risk assessments and support plans provided detailed and relevant guidance for staff in the home. People in the service were involved in the writing of support plans and were able to influence the content. The management team had ensured the plans reflected the person centred care that was being delivered.
Staff took people out locally and encouraged people to follow their own interests and hobbies. The service was establishing links in the community.
The registered manager demonstrated good vision and values. Staff were able to discuss good practice, issues around equality and diversity and people's rights.
The service had a comprehensive quality monitoring system in place which was used to support future planning.
Complaints and concerns were suitably investigated and dealt with and good records management was in place in the service.