135 Norman Road

About the service

135 Norman Road is a residential 'care home' providing personal care and support for people living with learning disabilities, autistic spectrum disorder and mental health. The service accommodates a maximum of 3 people. At the time of our inspection, there were 3 people living in the home. People using the service had been living at the home for many years. The staff team had been working at the home for some time and everyone knew each other well.

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

Right Support:

Staff assisted people to take part in activities and hobbies in their local area. The service ensured that there were suitable amount of trained and skilled staff working at the service to meet people's individual needs. The provider carried out employment checks to ensure that staff were recruited safely and had the right skill mix to support people who lived at the home.

People told us that they had a choice about their living environment and were able to personalise their rooms. The service made reasonable adjustments for people so they could be involved in making discussions about how they received their everyday support.

The provider ensured that measures were in place to help prevent the spread of infections. We found that medicines were managed in a person centred and safe way and staff ensured that people received regular medicines reviews by their health professionals.

People who used the service 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.

Right Care:

People told us that they felt staff treated them with kindness and their privacy was respected by staff. Staff were able to demonstrate how they protect people from poor care and abuse. The service was clear on their responsibility to work with other agencies to ensure people were safe. Staff received the appropriate training on how to recognise and report abuse.

People communication needs were being met and staff understood each person’s communication style. People’s care and support was recorded in their support plans, which reflected their support needs and promoted their wellbeing and quality of life.

The service assisted people to complete their risk assessments, which helped to ensure people were safe. Staff encouraged and enabled people to take positive risks.

We identified that the communal areas were in needs of some decoration. We made a recommendation in this area.

Right Culture:

We found that people received good care and support as staff were trained to ensure that the service could meet their needs and wishes.

The service carried out a range of audits to ensure a good quality service was provided. Staff understood people's needs well. This enabled people to receive a good service, which empowered people and the care was tailored to their individual support needs.

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

Rating at last inspection

We last inspected this service on 16 December 2019, where it was rated 'good' overall.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for 135 Norman Road on our website at www.cqc.org.uk.

Follow up

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

135 Norman Road is a residential care home providing personal care and support for people living with learning disabilities, autistic spectrum disorder, mental health, younger adults, physical disabilities and older people. The care home is registered for three people. At the time of the inspection they were providing personal care and support to three people with learning disabilities.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them

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

People were supported by kind and caring staff who treated people as individuals and with dignity and respect. The provider had recruitment systems to ensure staff were safely recruited. Staff spoke knowledgeably about the systems in place to safeguard people from abuse. People were supported by staff who were inducted, trained and supervised.

People told us they felt safe. Risks to them were identified and managed. Where required people were safely supported with their medicines needs. The support required by people with health and nutritional needs was identified and provided. Infection control measures were in place to prevent cross infection. However, we found the home needed modernising with the décor.

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.

People’s privacy and independence were promoted. Systems were in place to deal with concerns and complaints. This enabled people to raise concerns about their care if they needed to.

People had person centred support plans in place. People were actively involved in their care and contributed to the development of care plans and reviews. People’s communication needs were identified, and their end of life care wishes were explored and recorded. People were supported with activities.

Staff told us they felt supported by the registered manager. People liked the registered manager. The provider had effective quality assurance systems to monitor the quality and safety of the care provided.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 12 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

On 6 April 2016 we carried out an announced inspection of the service. We found concerns that new staff did not always have the appropriate support and training to enable them to carry out their duties. We issued one requirement action. At this inspection we found improvements had been made.

135 Norman Road is a care home providing personal care and support for people with learning disabilities. The home is registered for three people. At the time of the inspection they were providing personal care and support to three people.

There was a registered manager in post. 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 experiences of people who lived at the service were positive. People told us they felt the service was safe, staff were kind and the care they received was good. We found staff had a good understanding of their responsibility with regard to safeguarding adults.

Risk assessments were in place which provided guidance on how to support people safely. There was enough staff to meet people’s needs. Medicines were managed in a safe manner. There were sufficient numbers of suitable staff employed by the service. Staff had been recruited safely with appropriate checks on their backgrounds completed.

Staff undertook training and received regular supervision to help support them to provide effective care. Staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS is law protecting people who are unable to make decisions for themselves or whom the state has decided their liberty needs to be deprived in their own best interests. We saw people were able to choose what they ate and drank.

Person centred support plans were in place and people and their relatives were involved in planning the care and support the received.

People’s cultural and religious needs were respected when planning and delivering care. Discussions with staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service.

People had access to a wide variety of activities within the community. The provider had a complaint procedure in place. People knew how to make a complaint.

Staff told us the registered manager was approachable and open. The service had various quality assurance and monitoring mechanisms in place. These included surveys, audits and staff and resident meetings.

The service provides accommodation and support with personal care for up to three adults with learning disabilities. At the time of our inspection three people were using the service.

There was a registered manager at the service 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.

At this inspection we found new staff did not always have the appropriate support and training to enable them to carry out their duties. The induction was not robust and not all training had been completed for one new staff member.

The experiences of people who lived at the home were positive. People told us they felt safe living at the home, staff were kind and compassionate and the care they received was good. We found staff had a good understanding of their responsibility with regard to safeguarding adults.

People’s needs were assessed and their preferences identified as much as possible across all aspects of their care. Risks were identified and plans in place to monitor and reduce risks. Medicines were stored and administered safely.

Staff who were not new to the service undertook training and received regular supervision to help support them to provide effective care. People were cared for by sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

The registered manager and staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS is law protecting people who are unable to make decisions for themselves or whom the state has decided their liberty needs to be deprived in their own best interests.

People told us they liked the food provided and we saw people were able to choose what they ate and drank. People had access to health care professionals as appropriate.

People’s needs were met in a personalised manner. We found that care plans were in place which included information about how to meet a person’s individual and assessed needs. The service had a complaints procedure in place.

The service had a registered manager in place and a management structure with clear lines of accountability. Staff told us the service had an open and inclusive atmosphere and the registered manager was approachable and accessible. The service had various quality assurance and monitoring mechanisms in place. These included surveys, audits and staff and resident meetings.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

Is the service safe?

Risk assessments were in place which included information about how to support people in a safe manner. The service carried out various health and safety audits, for example in relation to fire checks and medication audits. We found that medication was stored and administered safely. Staff received appropriate professional development.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People's needs were assessed and care was planned and delivered in line with their individual care plan. We spoke with one person who used the service. They told us they were happy with the care and support provided. The person told us 'it's good here. The staff are friendly." Staff we spoke with had a good understanding of the individual needs of people.

Is the service caring?

People's views and experiences were taking into account and this informed how their care was delivered. The person told us that they were involved and consulted about decisions affecting their care. Care records showed that people had been involved and consulted about their care.

Is the service responsive?

People's needs were assessed and support was delivered to meet their individual needs. We looked at the care file for the one person living at the service. This provided information about the person's needs. Care plans gave guidance for staff about how they should meet people's needs.

Is the service well-led?

The service had a registered manager in place and a clear management structure. Staff we spoke with said they found management staff to be approachable. Quality assurance and monitoring processes were in place.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. One person we spoke with told us they felt "safe". One staff member we spoke with told us they knew how to respond to safeguarding adults concerns and they would report concerns to the manager.

We found there was an initial assessment and a support plan which set out how the person would be supported by staff to their outcomes. People were risk assessed to ensure they were not at risk of harm. One person told us they received "good" care from the service and staff.

The provider has taken steps to provide care in an environment that is suitably designed and adequately maintained. We found the layout and design of rooms to be suitable to meet people's needs.

There were effective recruitment and selection processes in place. We found staff files we reviewed contained application forms which staff had completed which included their skills and experience for the roles they would be undertaking and the interview forms.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. There was documentary evidence the views and opinions of the person who used the service were recorded and acted on.