We carried out a review of the data available to us about Norton Nurses Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Norton Nurses Limited, you can give feedback on this service.
Norton Nurses Limited is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 29 people using the service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
People received safe care from a regular team of staff who had received the training and support required to carry out their roles. Staff knew how to keep people safe from abuse or harm. Safe recruitment practices were in place. People received their prescribed medicines safely and there were effective practices to protect people from infection.
People’s needs were assessed before they used the service. Risks to people’s health were assessed and plans were in place to reduce any risks identified; these were reviewed regularly to ensure staff knew how to meet their needs.
People’s independence, privacy and dignity were promoted. Staff were kind, friendly and respectful. People and their relatives described knowledgeable staff who were punctual and provided all their planned care.
People knew who to speak with if they had any complaint or concern. There was a complaints procedure in place so any complaint would be dealt with appropriately.
People and staff had confidence in the registered manager to manage the service well and were encouraged to give feedback. The provider and registered manager monitored the service and had implemented new systems to improve the oversight of all areas to gain a clearer understanding in how to improve the service.
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.
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 the service was Requires Improvement, published on 25 Jun 2019.
Why we inspected
This inspection was prompted by a review of the information we held about this service. The overall rating for the service has changed from Requires Improvement to Good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Norton Nurses is registered to provide care to children, younger adults, older people and people with dementia, physical disability, sensory impairment and mental health needs.
People’s experience of using this service:
• The provider displayed CQC’s rating of performance at their business location. However, they failed to display this on their website.
• Staff absence and the management team providing care to people had impacted on the management team’s ability to undertake regular reviews of risk assessments and care plans, and to undertake staff supervisions and co-ordinate team meetings.
• People were supported by staff that were kind and caring, their privacy and dignity was respected.
• People felt safe receiving care from Norton Nurses. People were supported by staff that had been safely recruited and had adequate training to meet their needs.
• People received their medicines on time.
• Risks associated with people falling, skin damage or eating and drinking had been identified and plans updated as and when people’s needs changed. Staff understood risks associated with people’s healthcare conditions.
• People were supported to eat and drink enough and to attend healthcare appointments when needed.
• People’s choices were respected and they were in control of their care.
• People’s independence was promoted and they received individualised support from staff that knew them well.
• Concerns and complaints were promptly responded to and people knew the management team by name.
• The service met the characteristics for a rating of ‘requires improvement’’ in two of the five key questions we inspected and a rating of ‘good’ in three. Therefore, our overall rating for the service after this inspection was ‘requires improvement’.
Rating at last inspection: Good (Report published 27 July 2016).
Why we inspected: This was a scheduled inspection based on the previous rating.
Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated Good.
Enforcement:
At this inspection we found the service to be in Breach of Regulation 20A Requirement as to display of performance assessments of the Health and Social Care Act 2008 (Regulated Activity) Regulations 2014. Full information about CQC’s regulatory response to the more serious concerns found in inspections and appeals is added to reports after any representations and appeals have been concluded.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission 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.
The registered manager and the provider had values and a clear vision that were person centred and focussed on enabling people to live at home. All staff and the manager demonstrated a commitment to providing a service for people that met their individual needs. People had positive relationships with staff.
People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005. Staff provided people with information to enable them to make an informed decision and encouraged people to make their own choices.
People received safe care and support. Staff understood their role in safeguarding people and they knew how to report concerns. There were enough staff with the right skills and attitudes to meet people’s needs.
People benefited from staff that had received training that specifically met their needs. Staff had a full understanding of people’s support needs and had the skills and knowledge to meet them. Training records were up to date and staff received regular supervisions and appraisals. Staff were clear about their roles and responsibilities in caring for people and received regular support from the provider.
Care records contained risk assessments and risk management plans to protect people from identified risks. They gave information for staff on the identified risk and informed staff on the measures required to minimise any risks. Staff were vigilant regarding people’s changing health needs and sought guidance from relevant healthcare professionals.
Staff were aware of the importance of managing complaints promptly and in line with the provider’s policy. Staff and people were confident that if they had any concerns they would be listened to and any concerns would be addressed.
The provider monitored the quality and safety of the service and staff regularly monitored the support people received. People and staff were encouraged to provide feedback about the service and it was used to drive continuous improvement.