Norton Lodge

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 inadequate. At this assessment the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 59 (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 did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice. Improvements had been made since our last assessment in the recording and reporting of events which occurred. For example, actions taken in response to individual events which occurred were recorded. However, these improvements were only recently made, and we were unable to establish whether an improved culture of safety had been fully embedded.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Visiting professionals told us this had improved significantly since the new manager had come into post. They told us staff were more prepared for their visits and important information they needed to make decisions about a person’s plan of care was recorded. Nobody had moved into Norton Lodge since our last assessment however, the provider had ensured a successful transition of people who had moved to alternative care services.

The provider had made improvements in how they worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Systems had been improved in terms of reporting concerns and recording actions which had been taken to protect people. However, these improvements were only recently introduced so we could not be assured the improved systems had been fully embedded. Several people were being deprived of their liberty following decisions which had been made in their best interests. This process is known as an authorisation under deprivation of liberty safeguards (DoLS). Following our last assessment, the previous systems to record and monitor DoLS applications and authorisations had not been effective. The manager had recently addressed this however, further work was needed to ensure DoLS information fully reflected peoples current care needs.

People told us they felt safe. One person commented, “I feel safe, it’s the best thing about living here.” Staff were knowledgeable in when and how to raise concerns if they suspected a person had been the victim of abuse. One staff member said, “The residents are looked after.” Staff told us they were encouraged to record when people refused care and support, they offered people assistance who refused support. This enabled them to identify if a person was at risk of self-neglect.

The provider had introduced a new care plan system and the risks to people had been reassessed with improved guidance in place written in care plans for staff to follow. However, we found some care plans needed a further review. For example, there had an ongoing review by professionals of people’s needs with regards to the risk of choking. Staff accurately described people’s needs, and we observed safe care delivered, however some care plans held outdated information. A person required the use of a hoist to safely evacuate the building in an emergency. This was recorded on the staff handover sheet, however, not within the persons care plan. One person had detailed information within a medicines protocol which assisted staff to understand when to offer a particular medicine. The guidance included important hints and tips to de-escalate the persons anxiety however, this was only visible by senior care staff. We discussed our findings with the management team. The manager told us the leadership teams focus had been to update the risk assessments and care plans following the significant failings identified at our last assessment and told us they had already recognised there was a need to now review the quality of the revised care plans. Family members felt more involved and engaged with regards to people’s care. one family member said, “I was lucky to find this place as they have been brilliant. Some management hasn’t been good however, the new manager seems to be on the ball with the residents, and this has made a massive difference.”

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. Significant environment improvements had been made since our last assessment, however, some flooring still needed to be replaced, further attention was needed to the outdoor paving areas which were uneven in places. Some people used the garden without staff support to the designated smoking area. Uneven surfaces placed them at risk of falls. Plans to rectify the shortfalls we identified were immediately put into place. Since our last assessment, the provider had received an inspection from the local authority environmental health department. The food safety rating report was satisfactory but identified areas of improvement. The kitchen staff described the actions they had taken and told us they were waiting for a reinspection to improve the rating. People told us the provider had invested in the building. A family member said, “I have noticed a few positive changes in the building. They have made improvements to the décor, the floors and painting.” A staff member also told us, “The maintenance has improved, things get done straight away.” Routine checks on the environment and equipment were up to date and certificates were in place to demonstrate this.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. We observed staffing levels, and staff were available throughout our assessment in communal areas to respond to people. We did observe one person waiting for a period after they pulled their call bell for staff assistance. We shared this observation with the manager and saw evidence through an existing home improvement plan the effectiveness of the existing system had already been identified and a new system was being sourced. People told us staffing levels had improved. One person said, “It seems we have more staff than we did before.” A family member told us, “There always seem to be staff around when we are here.” Staff worked well together to provide safe care that met people’s individual needs and staff told us how staffing levels and consistency of staff had improved in recent months. One staff member told us they had left Norton Lodge and recently returned having been told positive feedback about the change in leadership arrangements. Staff were recruited safely. Appropriate checks were in place to ensure staff were suitable for their role. Reliance on agency staff had reduced however, when used now received an appropriate induction.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading. Some lounge seating needed to be further cleaned, and, in some bedrooms, people’s bedding needed to be replaced. We raised these issues with the manager who took immediate action to change bedding where needed and told us new sets of bedding were on order. Staff were not always completing the cleaning rota to demonstrate areas had been regularly cleaned. Although we found this, we did receive positive feedback about improvements to the cleanliness of the building. A family member told us, “The building is always clean when you walk in.” A staff member also told us, “Its cleaner and smells a lot fresher when you come in.”

The provider did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice. Improvements had been made since our last assessment in the recording and reporting of events which occurred. For example, actions taken in response to individual events which occurred were recorded. However, these improvements were only recently made, and we were unable to establish whether an improved culture of safety had been fully embedded.