Normanhurst Residential Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service registered under the current legal provider. This key question has been rated good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (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 assess and review people’s health, care, wellbeing and communication needs effectively with them. People received an initial assessment when they moved into the service, and records showed the use of recognised tools to identify risks relating to falls, pressure damage, nutrition and weight. Care plans included information about health conditions such as dementia, epilepsy and visual impairment.

However, assessments and care plans were not always kept up to date and information was inconsistent across different parts of the care plan. For example, one person did not have a clearly documented seizure care plan. While some information relating to this was recorded on a separate system, this was not fully integrated into their care plan.Following the inspection, the provider took action to ensure documentation was consistent across systems.

Some people told us they were not routinely involved in discussions about their care or shown their care plans, which limited their understanding of how their needs were being met. While a few people felt involvement improved over time, this was not consistent for everyone.Following the inspection, the provider took action to review care plans and involved people in reviews to discuss how they wished to receive care and support.

The provider planned and delivered people’s care and treatment in line with legislation and current evidence-based good practice and standards.

The provider used nationally recognised assessment tools and sought advice from healthcare professionals, including GPs, dietitians and specialist nurses. They carried out appropriate assessments to identify risks of skin breakdown, nutritional risk and regularly monitored people’s weight. Outcomes from these assessments were reflected in care plans and guided staff in delivering appropriate care and support.

Care plans reflected people’s dietary needs, including when modified diets such as soft or texture modified foods were required. We found appropriate equipment was available for some people, such as specialist cutlery and plate guards during mealtimes.

The provider worked well with other teams and services to support people and shared information effectively. Staff communicated changes through handovers and communication books. When people returned from hospital or experienced changes in their health or mobility, professional guidance was recorded and shared with staff. This helped ensure people received coordinated care and reduced the risk of gaps in support.

Relatives spoke positively about staffing levels, teamwork and communication, and told us staff responded appropriately when people became unwell by contacting health professionals and keeping families informed. Observations showed staff supporting one another and adapting communication methods.

The provider supported people to live healthier lives in a way that maximised choice, independence and understanding.

Care plans contained information about people's dietary needs, including allergies, intolerances and food preferences linked to their religious and cultural beliefs. This helped ensure people received care and support that met their individual needs and preferences.

The provider used recognised assessment tools to identify people at risk of poor nutrition and determine when additional monitoring was required. Where appropriate, food and fluid charts were implemented to monitor intake and support positive health outcomes.

We found that guidance from dietitians was incorporated into care plans and staff were provided with clear information about how to support people's nutritional needs. This helped people maintain their health and wellbeing while promoting choice, independence and positive outcomes.

The provider did not always monitor people’s care and treatment effectively to improve outcomes. Systems were in place to record daily care, risks and health concerns, and staff monitored areas such as mobility, nutrition and bowel health.

Initiatives such as regular care plan reviews were in place. However, care plans did not consistently identify clear outcomes or show how monitoring led to improvements in people’s quality of life. We found gaps in records for 2 people where night checks had been planned but not completed. The provider assured us that people did not require the level of monitoring identified, however this rationale was not clearly documented or supported through risk assessments. This meant monitoring was not always carried out in line with assessed needs, increasing the risk that changes in people’s health or safety may not be identified promptly. This limited the provider’s ability to demonstrate continuous improvement in outcomes and reduced assurance that care was consistently responsive to people’s needs.

Systems were in place to support consent to care and treatment. However, these were not always consistently effective. Records did not always demonstrate that people had been fully supported to understand their care and treatment options, including associated risks and benefits, to make informed decisions. For example, where a person had capacity to make decisions, there was not always clear evidence to show how they had been meaningfully involved in decisions about their care, such as the use of discreet monitoring during the night.

Care records included information about capacity, advanced decisions and family involvement, and staff described seeking consent during daily interactions. However, the lack of consistent recording meant the provider could not always demonstrate how people were supported to make informed decisions or how their preferences were reflected in care delivery.