Norwood Green Care Home

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 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 75 (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.

Records for people on modified diets who did not engage with meals did not always clearly show what or when people had eaten. In response to our feedback, managers agreed actions to review individual nutrition plans, improve documentation of food and fluid intake, and stated they involved a dietitian for people with complex needs. These actions were added as action points on one of the provider’s monitoring tools.

Some people became distressed and communicated in their first language when upset. Staff used flash cards written in people’s first language including resources, to better support people’s understanding and expression and would ensure staff accurately document this.

Assessments of needs covered health, communication, nutrition, mobility and daily routines.

Staff were able to respond to needs when concerns were raised, such as locating hearing aids when a person could not hear, but this was not always planned. Managers acknowledged this feedback and agreed to strengthen care planning to ensure people’s needs, such as hearing support and personal care preferences, were addressed proactively rather than reactively. Actions were recorded to review care plans and monitoring arrangements to improve consistency.

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.

Inspectors identified gaps in food and fluid recording, with some records completed before meals had finished. Poor nail care was also observed for one person. These issues reduced assurance that care was consistently delivered and monitored in line with best practice.

Managers responded promptly following feedback. Showing us once the gaps had been the relevant care records had been amended. After our site visit, the registered manager sent a shared learning document showing lessons learnt were shared with all staff, who signed to confirm they read and understood. This reinforced expectations to improve consistency, ensuring people’s nutrition, hydration and personal care needs were met and accurately evidenced.

The provider delivered care in line with evidence‑based practice and legislation. Staff used recognised tools, including the Malnutrition Universal Screening Tool and Waterlow assessments, to identify and manage risks. Leaders reviewed assessments and ensured staff had access to specialist training to support people with complex needs.

Policies reflected national guidance, and managers demonstrated openness when inspectors identified gaps between policy and practice.

The provider always worked well across teams and services to support people.

Staff teams worked exceptionally well together and with external services to deliver highly coordinated, person‑centred care. Collaboration was embedded in everyday practice, with staff, families and professionals sharing information, reflecting together and adapting approaches to achieve meaningful outcomes for people.

Staff worked proactively with relatives and external professionals to develop a strong understanding of people’s needs, preferences and behaviours. They held multidisciplinary discussions with families and health professionals to agree how best to support people, which enabled consistent and coordinated care across teams and services.

Staff demonstrated consistency and patience in their joint working. Teams shared learning, adapted care approaches and prioritised trust‑building and reassurance. Staff recognised behaviour and withdrawal as communication and adjusted their responses over time, showing persistence and compassion rather than accepting perceived limitations.

This collaborative approach led to clear improvements in people’s wellbeing. In one example, a person living with a mental health condition was resistant to socialising with other people, which restricted them to their room for several years. Care staff worked patiently getting to know the person’s preferences, history and triggers and for the first time in several years, the person started to spend time in communal areas. We saw photographs of the person celebrating their birthday, enjoying time in the garden and participating in social activities, which demonstrated improved well-being and inclusion.

In another example, staff followed best practice, current guidance and advice from health and social care professionals to deliver personalised care that significantly improved a person’s health, independence and quality of life. The person had been receiving end‑of‑life care due to significant frailty, being underweight and confined to bed. Staff focused on improving their nutritional intake, emotional wellbeing and mobility. As a result, the person gained weight, no longer required end‑of‑life care and was able to mobilise independently using a walking aid. We saw a photograph of the person attending a religious ceremony, which showed they had regained the ability to participate in an activity that was important to them.

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 used a structured ‘is my resident well’ guide to check changes in breathing, hydration, pain, skin condition, mobility and mood. This helped staff identify when people were becoming unwell and seek timely support, which reduced avoidable deterioration.

Staff monitored people’s health consistently and escalated concerns appropriately. The guide supported staff to assess changes using clear green, amber and red indicators and to involve senior staff or health professionals when needed. A staff member said, “It helps us notice small changes early so we can act before things get worse.” This approach improved continuity and confidence in clinical decision‑making.

People and relatives felt involved and reassured by staff responses to health changes. One person said, “They notice when I’m not myself and check on me.” A relative told inspectors, “Staff tell us straight away if there’s a change and explain what they’re doing.” This open communication helped people feel safe and supported to manage their health.

The provider supported healthier outcomes by linking daily monitoring to care plans and external support. Staff used the guide alongside care plans to consider people’s wishes, advance care planning and preferred responses to illness. This enabled timely access to GP, NHS 111 or emergency services when needed and helped people receive the right care at the right time, supporting better health and wellbeing.

The provider monitored people’s care and treatment to improve outcomes, but this was not always reflected consistently in records.

Staff used structured tools to monitor nutrition, skin integrity, mobility, pain, confusion and wellbeing, which helped identify changes and escalate concerns. Care plans described outcomes important to people, such as maintaining mobility or appetite.

The provider’s audits showed staff’s record keeping were not always accurate, including food and fluid charts and wound documentation. In response to the findings from the audits managers introduced actions to improve recording accuracy and follow‑up. Records and examples showed people experienced improved outcomes, including increased strength, nutrition and engagement.

One person told inspectors, “I’m doing more for myself than I used to,” and a relative said, “There’s been a clear improvement since staff started checking things more closely.”

Audit findings showed the provider used monitoring to drive improvement. Where concerns were identified, such as repeated falls or recording gaps, managers strengthened audits, shared learning and increased oversight. A senior staff member said, “We use the audit findings to change how we work, not just to tick boxes.” This supported continuous improvement and better outcomes for people.

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

Staff assessed capacity for specific decisions and adjusted their approach to ensure consent was sought appropriately or best‑interest decisions were made lawfully.

For example, a person lacked capacity to make complex decisions but could make simple choices about daily care, such as where to eat and how to spend their time. Staff respected these choices and obtained consent where the person had capacity. Where decisions were more complex, staff made decisions in the person’s best interest, involving next of kin and relevant health professionals. Consent for medical photography was in place, and a Deprivation of Liberty Safeguards (DoLS) authorisation supported lawful care in a secure dementia unit.

Another person lacked capacity to make complex decisions about care and accommodation. Staff completed Mental Capacity Act (MCA) assessments for significant decisions and made best‑interest decisions in consultation with next of kin and the multidisciplinary team. Staff continued to support the person to make simple day‑to‑day choices wherever possible, promoting involvement and independence.

Where applicable, capacity assessments were completed and recorded, and DoLS authorisations were in place. This showed the provider applied the Mental Capacity Act 2005 appropriately, balanced protection with empowerment, and ensured consent and best‑interest decision‑making were central to care delivery.