We inspected Norfolk Road on 21 March 2016. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting the first day or exactly when in the following weeks. Norfolk Road is managed by Together Working for Wellbeing. It is a registered service providing accommodation and support to adults with mental health needs. There are eleven single bedrooms across four separate bungalows. Each bungalow has a shared kitchen, lounge and bathroom.
The registered manager and has been in this role for over four years. A provider 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 the time of the inspection 10 people lived at the service and we met five of the people who used the service. They told us that they were very happy with the service and found it met their needs.
Most of the people we met had lived at the service of a number of years and some had been there for 20 years. We found that the provider and staff consistently ensured people were supported to lead an independent lifestyle. We found that none of the people required support with personal care and all led very independent lifestyles. The registered manager told us they had supported people, until recently, with their personal care needs and expected that they would again in the near future.
Staff readily identified triggers that would lead people to become distressed or that their mental health was deteriorating. We found that the staff’s extensive knowledge of people had enabled them to readily spot changes in people’s presentation and this had led to the staff taking prompt action to contact the persons doctor and community psychiatric nurse. We found this had a very positive impact. Since moving to the service none of the people had required a readmission to hospital.
We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. We found that the registered provider had fully embedded a computerised system for recording care delivered at the service and this was very effective.
We saw that people catered for themselves and staff encouraged them to eat a healthy diet. Where needed, staff assisted people to cook their meals and complete the shopping.
We saw there were systems and processes in place to protect people from the risk of harm. We found that staff understood and appropriately used safeguarding procedures.
People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments.
Staff were aware of how to respect people’s privacy and dignity.
Staff had received a range of training, which covered mandatory courses such as fire safety, infection control and first aid as well as condition specific training such as mental health awareness.
Staff had also received training around the application of the Mental Capacity Act 2005. The staff we spoke with understood the requirements of this this legislation. All of the people had capacity so staff did not need to complete capacity assessments or make best interest decisions.
Staff shared with us a range of information about how they as a team worked very closely with people to make sure the service enabled each person to reach their potential.
People and the staff we spoke with told us that there were enough staff on duty. We found that were sufficient staff on duty to meet people’s needs.
Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work.
We reviewed the systems for the management of medicines and found that people received their medicines safely.
We saw that the provider had an effective system in place for dealing with any complaints. We found that people felt confident that staff would respond and take action to support them.
We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. We found that all relevant infection control procedures were followed by the staff at the service.
The registered provider had developed a range of systems to monitor and improve the quality of the service provided. We saw that the provider had implemented these and used them to critically review the service.