Norwood

Updated 28 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 23 August 2018 and was announced. We gave the service 48 hours' notice that we would be attending as the service. As the service provides special support for young adults who are often at college or out during the day, we wanted to be sure someone would be available to speak to us.

The inspection team consisted of an adult social care inspector.

Before our inspection visit, we reviewed the information we held about Norwood. This included notifications we had received from the provider, about incidents that affect the health, safety and welfare of people who use the service. We viewed the provider information return (PIR). This is information we require providers to send us at least once annually 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 also used this information to populate our planning tool. This helps us plan how the inspection will be carried out.

Due to people’s individual communication needs we were not able to establish their thoughts and feelings with regards to living at the home. However, we did speak with one person who lived at the home. Additionally, we spoke with two relatives and three members of staff and the registered manager. We also contacted two health and social care professionals by email to ask for feedback. We received a response from one person. We looked at the support plans for the four people who lived at the home and the recruitment and training files for four staff. We also looked at other documentation associated to the running of the service.

Updated 28 September 2018

We inspected this service on 23 August 2018.

This was the first inspection of this service since the registered provider had registered with the Care Quality Commission (CQC) in July 2017.

Norwood is a care home. The service is a semi-detached house in Southport, situated close to the town centre and its amenities. 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.

Norwood has links to Arden College which provides specialist further education for young people aged 16-25 years of age with learning disabilities. Norwood currently provides accommodation for four young adults aged over 18 who have completed their education at Arden College. This was referred to as an 'After College Provision.' The support is provided 24 hours a day. The house was split into three self-contained flats and shared communal areas.

The home has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

A registered manager was in post.

A registered manager is a person who has registered with CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the time of our inspection four people were living at the home.

There was a process for analysing incidents, accidents and near misses to determine what could be improved within the home. We saw that when incidents and accidents had occurred, staff were fully debriefed and relevant professionals were updated as and when required.

There was personal protective equipment (PPE) available within the home, such as gloves, aprons and hand sanitiser. These were available for staff to use when they supported people with their personal care or helped people complete cleaning tasks in their flats.

Medication was well managed and only administered by staff who had the correct training. We saw that one person chose to self-medicate and they were supported to do this by staff. This process was reviewed every few months by staff. Medication was stored securely within the home.

There were enough staff to help people with their day to day support needs, such as accessing the community or support with their personal care. There was some agency use, however the same staff were often requested. Staff told us they never felt short staffed and family members did not raise any concerns regarding staffing.

Staff records we saw demonstrated the registered manager had robust systems in place to ensure staff recruited were suitable for working with vulnerable people.

There were systems and processes in place to ensure that people who lived at the home were safeguarded from abuse. This included training for staff which highlighted the different types of abuse and how to raise concerns within the infrastructure of the organisation. Each person had specific instructions in place for staff to follow with regards to keeping them staff.

Risk assessments were detailed and specific, and contained a good descriptive account for staff to follow to enable them to minimise the risk of harm occurring to people who lived at the home. Detailed protocols were in place in relation to people’s challenging behaviour. These protocols were reviewed regularly by the person's keyworker and the registered manager.

The service was operating in accordance with the principles of the Mental Capacity Act (MCA) and consent was sought in line with people’s best interests. People’s mental health needs were assessed appropriately, and they were treated with equality and diversity which was evidenced in the outcomes of their support. Appropriate referrals were made when people were required to be deprived of their liberty. There was information recorded in people's support plans which outlined any best interest decisions and who was involved in them. Consent was also sought and clearly documented in line with legislation and guidance.

Staff had the correct training to enable them to support people safely. Staff also completed additional training to support people who may present additional behaviours. This training was sourced separately.

Staff engaged in regular supervision with their line managers, and had annual appraisals.

Menus were varied, people told us they had input into the menus and often cooked their own meals and this was something they were encouraged and supported with. People were supported by staff to make good choices in accordance with dietary needs and eating plans.

People had access to other medical professionals who often visited the home Regular meetings with external healthcare professionals took place when needed.

People were treated as individuals, and their choices and preferences were respected by staff. This was evident throughout our observations around the home, and the information recorded in people’s support plans. Staff also described how the ensured they protected people’s dignity and choices when providing personal care.

Staff spoke with people and about them with warmth and sensitivity and there was clearly pride in what people had achieved since being at Norwood.

There were examples of accessible information for people who used the service. This was presented in various formats to support people’s understanding and we saw that in most cases, people had been provided with an adapted version of their support plan to help them understand the content.

People’s support plans were person centred and contained a high level of detail about the person, their likes, dislikes, how they wanted to be supported and what successful support looked like for them. This information was reviewed every month and changes were documented within support plans.

We reviewed the complaints policy during the inspection. There were no on-going complaints and there had been no complaints since the service had been registered.

Staff undertook training to enable them to respectfully care for someone who was at the end of their life, however most people who lived at Norwood were younger adults. The registered manager informed us that if someone's health declined their wishes would be respected and provisions would be made to support them.

The service worked in partnership with the local community, as well as other professionals such as the Local Authorities, GPs, the college, and the police. The vision of the organisation was person centred and the staff we spoke with told us they liked working for the company.

Quality assurance systems were robust and sampled a wide range of service provision. Where issues had been identified, an action plan was devised, reviewed regularly and updated with the latest action points.

Further information is in the detailed findings below.