Background to this inspection
Updated
2 September 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
This was a focussed inspection to check whether the provider had met the requirements in relation to regulation 11 (Need for consent) and regulation 17 (Good of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Inspection team
This inspection was carried out by two inspectors.
Service and service type
Norton House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection the registered manager was also the nominated individual. The service manager had applied to CQC to take the role of registered manager.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was to allow the provider to make arrangements in line with infection control procedures due to the COVID-19 pandemic
Inspection activity started on 27 July 2020 and ended on 5 August 2020. We visited the location on 29 July 2020.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, the local safeguarding team and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
We requested copies of documentation relevant to the key questions we were to inspect.
We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service about their experience of the care provided. We spoke with the provider who is also the registered manager and the service manager. We also spoke briefly with two members of care staff and a member of housekeeping staff.
As this was a focussed inspection, we only looked at records and documentation relating to the key questions Safe, Effective and Well led. We looked at care records for five people, four people’s medication records and systems for managing medication and various records in relation to monitoring safety and quality.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at a range of records including training data and quality assurance records.
Updated
2 September 2020
About the service
Norton House is a care home which can accommodate up to 23 people. At the time of our inspection there were 21 people living in the home.
We carried out an unannounced comprehensive inspection of this service on 8 May 2019. Two breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve need for consent and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Effective and Well-led which contain those requirements. We also looked at Safe as the evidence gathered at the last inspection under this key question contributed to the breach recorded in Well-led.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
People’s experience of using this service and what we found
Systems for assessing and managing risk had been improved. Care plans included up to date and comprehensive individual risk assessments which gave staff the information they needed to maintain people’s safety. New and emerging risks including the effects of COVID-19 had been assessed.
Improvements had been made to the systems for managing medicines and regular auditing meant these systems remained safe.
Systems were in place to make sure people were safeguarded from the risk of abuse. The provider had liaised with the local authority safeguarding team to revise and improve the safeguarding policy and procedures.
Systems for recruitment of new staff remained safe and people said there were enough staff available to meet their needs in a timely manner.
Clear processes were in place to prevent and control infection within the home. The provider had been proactive in following government and local guidance in relation to managing the COVID-19 pandemic.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The provider had made improvements in systems for assessing people’s capacity to make decisions.
The provider assessed peoples’ needs before they began to use the service and regular reviews took place to make sure care plans reflected people’s current needs.
People’s nutritional needs were assessed, and plans put in place to make sure they were met. People we spoke with said the food they received at the service was very good.
People were supported by a range of health and social care professionals to maintain their overall health and wellbeing.
Staff received the training and support they needed to care for and support people safely and effectively.
Changes in the management structure had been effective in improving quality assurance systems.
Analysis of accidents and incidents enabled the provider to learn lessons from previous events and implement positive change.
Feedback from people who used the service and their relatives had been analysed and produced in a format which gave people an overview of the responses received.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Norton House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.