Norden House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People received assessments of their care needs before moving to the service, to establish if they could safely be met. Senior staff were involved and had a good level of knowledge around this area. A person said, “They asked me questions about things I like and the help I need.” Staff provided feedback about changes in people’s needs. A team member said, “The nurses and managers listen when we notice peoples support levels change.” The provider had assessed staff training requirements giving them the skills they needed to fulfil their roles. One staff member said when describing dementia, “It’s a disease that effects the functioning of the brain and impacting on memory and daily life skills.”
 

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.
We saw documents showing people’s care was assessed and delivered using supporting tools, such as the Malnutrition Universal Screening Tool (MUST) which provides staff with information to identify associated risks of malnutrition, undernutrition or obesity. This was used, alongside the Waterlow assessment to evaluate a person’s risk of developing pressure ulcers so care could be tailored to effectively meet their needs.
 

The provider did not always work well across teams and services to support people. For example, staff had not responded to healthcare partners communications about people’s needs, including the GP in a timely way which had the potential to impact on people’s wellbeing.
The interim manager explained there had been issues around communication about people’s healthcare needs between staff and health services, including the GP. A complaint relating to this had been raised with the provider who followed their policy, the interim manager responded holding a meeting with the GP to address their concerns.
Relatives we spoke with explained the support they received during health assessments did not meet their expectations. One relative said, “They have a lot of agency staff at the moment and if the nurse is an agency they wait until the permanent nurse is back to answer general questions.” Another relative said, “A continuing health care meeting I attended for my loved one was quite chaotic, the staff had not prepared and didn’t have any of the documents needed for the assessment. After the meeting I raised my concerns but never heard anything back.” One health professional told us, “Staff now understand that they must access emails from surgeries however, responses are still delayed or sometimes not replied to at all, but this has improved with new management in place.”
Senior staff had completed initial assessments of people’s needs and created care plans which were then reviewed on a regular basis. Staff had access to peoples care plans and associated documents enabling them to provide effective support.
The provider had acknowledged a high amount of agency staff were supporting people at the service and had created a pen profile for each person, alongside full care documents to help agency staff understand people and their support needs.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff were supporting people to monitor and manage their health needs where needed. Care plans contained information around people’s conditions. A relative said, “My [loved one name] was at a previous care home who wasn’t managing [loved ones] condition, Norden House are the opposite completely on top of health and there’s always a nurse available.”
When people’s need’s changed staff made prompt referrals to the appropriate health professionals, for example the Speech and Language Therapy team was contacted when concerns around eating/drinking safely were observed.
People had choices around the food they were offered with a variety of alternatives available to meet dietary requirements such as gluten free and low sugar options.
During our onsite assessment we observed people taking part in chair exercises providing an opportunity to promote their health, people were actively engaging in the activity and with each other.
 

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Systems were in place to monitor and record people’s health outcomes, for example a person was being supported with pressure care who had an improvement in their condition. A person, said, “The nurse comes to check on me and if I need them, they are always there.” Another person said, “I was struggling to get around my house, but I can walk more here which is helping with my independence.”
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff sought the consent of the people they were supporting before providing care. One person said, “Before they help me the staff ask me if its ok, and check what I need because it changes.” Another person said, “They tell me what they’re doing while they’re helping me which I like.”

People had their mental capacity assessed where needed and staff demonstrated a good understanding of the Mental Capacity Act. One staff member said, “It’s about a person’s ability to understand and use information to make a decision.” Care plans informed staff of people’s capacity around daily life choices who had also been supported to make decisions relating to emergency treatment such as DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) and respect forms detailing their wishes ensuring care preferences are known and respected by medical professionals.