Background to this inspection
Updated
24 October 2019
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.
Inspection team
The inspection team consisted of three inspectors and one 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
Norfolk House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. 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 unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with 16 people who used the service and eight relatives about their experience of the care provided. We spoke with 10 members of staff including the registered manager, nurses, senior carers, and care assistants.
We reviewed a range of records. This included 11 people’s care records and multiple medication records. We looked at 3 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.
Updated
24 October 2019
Norfolk House is a care home providing personal and nursing care to people aged 65 and over.
The home accommodates up to 76 people in one purpose-built building. Care is provided across three floors which each have their own communal facilities and dining areas. One floor provided residential support to people living with dementia. Two floors provided nursing care to people with a variety of long-term conditions and disabilities. At the time of our inspection there were 61 people living at the service.
People’s experience of using this service and what we found
People told us they were happy living at Norfolk House and described feeling safe and well cared for. One person said, “I can’t tell you how good the staff are.” A relative told us, “I have total reassurance that my relation is safe and well cared for.”
There were enough staff to care for people safely. Risks to people were identified, assessed and managed and staff understood how to support people’s specific needs. There were safe systems in place to ensure that people received their medicines as prescribed. Staff understood how to safeguard people from harm and how to protect them with the prevention and control of infection.
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. Staff had received the training and support they needed to care for people’s needs. One relative told us, “I cannot fault anything, the staff have been fantastic.” Staff training reflected people’s diverse and complex needs, staff told us they felt confident in their roles. One staff member told us, “Working here has made me a better nurse.”
People were receiving enough to eat and drink and they told us they enjoyed the food. Risks associated with eating and drinking were assessed and managed effectively. Staff were proactive in supporting people to access health and social care services. Communication systems supported staff to deliver effective care. One staff member said, “I love the way we can share ideas here and with other services.”
Staff knew people well and supported them and, when appropriate, their relatives to be involved in making decisions about their care. People told us staff were caring, kind and treated people with respect. Staff supported people to remain independent and protected their dignity.
People were receiving personalised care. Staff were familiar with people’s needs, their routines and preferences. Relatives described the positive impact of having consistent staff who knew people well. Records included details of people’s personal history, their likes and dislikes and the things and people that were important to them. Staff recognised when people’s needs changed, care was flexible and responsive. People were occupied with activities that were appropriate for their needs and interests and people were supported to maintain relationships and connections that were important to them. Staff supported people to plan for end of life care. One relative told us, “The staff support me too, they understand and help me as well. Nothing is too much trouble.”
Systems and processes supported the registered manager to retain oversight of quality at the home. Staff spoke highly of the management of the service and described a positive atmosphere where they felt able to raise concerns and to make suggestions. People and their relatives said they felt comfortable to raise any complaints and were confident that appropriate actions would be taken. People described the registered manager as approachable and one person said, “He has a real interest in the people here”. A visitor told us, “The manager is first class and the atmosphere amongst the staff is excellent.”
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 requires improvement (published 15 August 2018) and there were three breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
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.