Norcott House

Updated 21 July 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors, a medicines inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Norcott House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Norcott House is a care home without nursing care. 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.

Notice of inspection

This inspection was announced on the first day, and unannounced on the two further visits.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service about their experience of the care provided. We spoke with five members of staff including the registered manager and support workers. We carried out observations of care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included three people’s care records and various medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality audit records. We spoke with five staff on the telephone and with seven people’s relatives and advocates about their experience of the care provided.

Updated 21 July 2022

About the service

Norcott House is a residential care service which can accommodate up to 11 people with learning disabilities or autistic people. 10 people were using the service at the time of the inspection. People who used the service lived in ground floor accommodation with four separate kitchens on each unit, lounges, bedrooms and bathrooms.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support

People were not always kept safe from the risk of infection and the provider took action to put things right following the first day of our inspection. Accidents and incidents were recorded, although it was not always clear what had been done to mitigate risks and reduce incidents.

We have made a recommendation the provider ensures debriefs are detailed after each incident, to help identify possible triggers and prevent a reoccurrence.

Staff were recruited safely to care for people and there were enough staff to meet people’s needs. Medicines were managed safely overall.

People had some involvement in planning their care and future goals, and staff used activity checklists to include in each person’s support plan. Activity planners did not always fully reflect people's choices, although staff supported people with independent living skills and people chose their own activities daily. Staff were kind and patient and said they supported people in the least restrictive way possible and in their best interests. People had their own living areas and they were supported to engage in the community and maintain family relationships.

Right Care

Care promoted people’s dignity, privacy and human rights. People were supported when they wanted to eat and helped to make some choices in their day. Staff spoke with people in a respectful and caring way. Care plans and risk assessments were person centred, although some staff told us they did not always have time to read these. However, the provider showed us a signed list to show staff had stated they read and understood people’s care plans. People were mostly well safeguarded from the risk of abuse and staff understood the procedures to follow if they had any concerns. Some people told us they did not always feel safe living in the service. The management team were aware of this and tried to give reassurance. Risk assessments were in place, but not always reflective of people’s needs or followed by staff.

Right culture

Quality checks were not always robust enough to maintain and improve the quality and safety of the service. There were missed opportunities to identify lessons learnt when things went wrong. People and staff felt supported by the management team and felt they were approachable, although not all staff felt their views were considered.

We have made a recommendation in relation to ensuring quality checks are more robust.

Staff supported people in ways which were appropriate for their needs. However, the complexities of people’s needs, and the dynamic of people living together within the service, meant at times some people did not feel safely supported.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 5 April 2018)

Why we inspected

We undertook a targeted inspection to routinely provide assurance in relation to infection, prevention and control. We inspected and found there was a concern with infection prevention and control, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, responsive and well-led. We undertook this inspection to assess that the service is applying the principles of right support right care right culture.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.