Norway Lodge Nursing Home

We found the following examples of good practice.

People told us that they felt safe and well supported at Norway Lodge during the COVID-19 pandemic; one person told us, “I can’t fault the place.” Staff told us that they had been well supported in their roles; staff members had received additional training and support during the COVID-19 pandemic.

Staff members made effective use of PPE when supporting people. There were good stocks of PPE and PPE stations at convenient locations around the home. The home was clean; we saw records of frequent cleaning that took place.

The service had made effective use of testing to help prevent the spread of COVID-19; clear records had been kept of all tests taken by staff and people living at Norway Lodge. Any visits to the home took place safely.

We found the following examples of good practice.

• Safe procedures were followed for admitting people to the service. Adapted assessment processes were completed, and people were only admitted following evidence of a negative COVID-19 test.

• Visitors were able to spend time seeing and speaking with loved ones in a suitable safe space by arranged appointments. The provider had purpose built a ‘visiting pod’ in the homes grounds that was made to feel homely and welcoming. Personal protective equipment (PPE) such as gloves, masks, aprons and face shields were available for visitors. Additionally full screens were in place to ensure social distancing.

• Following the visits the pod was then fogged/disinfected following visits and there was an hour between each use.

• Visitors had their temperature taken on entering the service. Telephone calls and virtual methods were used to communicate with friends and family keeping them up to date with any changes and informing them of the current IPC visiting guidance.

• There were safe measures in place to facilitate visits for people receiving end of life care and where it had been assessed as being in the persons best interest due to their wellbeing.

• Regular home testing was in place. Stocks of the right standard of personal protective equipment (PPE) were well maintained and staff used and disposed of it correctly.

• Staff had been trained in infection control practices and refresher training had been arranged. The provider regularly checked staff practice and knowledge.

• The home had a designated cleaning and laundry staff team who used recommended chemicals and audits on cleanliness and infection prevention and control were completed.

• The staff changed their clothes on site before and at the end of their shifts and their uniforms were all laundered on site to minimise the risk of cross infection.

• People had been supported to access GP’s and other health professionals to receive care and treatment as they required.

Norway Lodge Nursing Home is a residential care home providing personal and nursing care to a maximum of 29 people aged 65 and over. At the time of the inspection the service was supporting 26 people. Some rooms were shared. Care was provided over three floors for people with complex healthcare needs and those living with dementia.

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

People had no concerns about their safety at the service. Risk was effectively managed. People’s records contained information about risks to their health, safety and wellbeing. Staff understood the risks posed to people and how they should support people to keep them safe. Staff were safely recruited and deployed in sufficient numbers to meet people’s needs. Staff followed a safe process for the storage and administration of medicines. People told us they received their medicines regularly. The service was noticeably clean and free from obvious odours. The service had a clear process in place to record and analyse incidents and accidents. Information was used to improve safety and quality.

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 understood the principles, of the Mental capacity Act 2005 (MCA) and people were supported wherever possible to make their own decisions.

Staff were aware of the relevant standards and guidance and used this effectively to assess people’s needs and plan their care. Staff were appropriately trained and supported to provide effective care. People were given a good choice of nutritious food and drinks. Staff and managers worked effectively with healthcare professionals to ensure that people received the care they needed; such as involving GPs and other healthcare professionals in making important decisions.

People and their relatives spoke positively about the way care was provided and the attitude of staff. We saw and heard examples of staff treating people with kindness, compassion and respect. Staff knew people and their needs well and used personal information to engage and encourage people.

People’s individual needs and preferences were met by the service. Care records contained detailed information about people’s histories, likes and dislikes. Staff used this information effectively to provide individualised care and support. People were supported and encouraged to take part in a range of activities and to build relationships. Complaints were addressed in accordance with the provider’s policy and best-practice guidance. Norway Lodge provided end of life care in accordance with a recognised standard.

There a positive learning culture where people were supported to reflect on performance and improve practice. The registered manager and provider monitored the provision of care and the environment to further improve people’s experience of receiving care.

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 April 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.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People living at the home told us they were happy, well cared for and felt safe. Relatives visiting the home said that they were very happy with the care provided.

We saw that staff had been recruited safely with appropriate checks, including appropriate registration checks for nursing staff. We saw that staff were appropriately trained to support people with their needs. Staffing levels were observed to be sufficient to meet the needs of people who lived at the home.

We found on speaking to staff that they were knowledgeable about support needs of people in their care. We observed staff interacting with people throughout our inspection visit and saw that people looked relaxed and comfortable in the care of staff supporting them.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We found that the appropriate Deprivation of Liberty Safeguard (DoLS) applications had been submitted to the Local Authority in relation to people’s care.

We found the home to be a clean and safe. We found equipment had been serviced and maintained as required.

We saw that medication procedures at the home were safe and staff responsible for the administration of medicines had received training to ensure they had the competency and skills required.

The home had personalised care plans and risk assessments for people living at the home, these had been regularly reviewed and updated. We found people had access to healthcare professionals when health needs were identified.

People who used the service and their relatives knew how to raise a concern or to make a complaint, there were no complaints at the time of inspection. People and their relatives knew who the registered manager was and felt comfortable if they had to raise any issues.

People told us they were happy with the variety and choice of food available to them and we saw that the food looked tasty and appetising at mealtimes.

Further information is in the detailed findings below

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. There were arrangements in place to deal with foreseeable emergencies.

The environment was suitably, safe and adequately maintained. Risk assessments and safety checks were undertaken. However we found that risk assessments were in need of review and update.

Staff employed at the home were suitable, appropriately qualified and experienced. We found that appropriate checks were undertaken before staff began work and there were effective recruitment and selection processes in place.

We saw evidence of suitable quality monitoring systems in place and there was evidence that learning from incidents/events took place and appropriate changes were implemented.