Norton Hall

Updated 18 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection site visit activity started on 12 November 2018 and ended on 19 November 2018 and was unannounced. The inspection team consisted of one inspector and an expert by experience who had experience of residential care settings. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. As part of the inspection we reviewed information we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us by law.

During the inspection of the nursing home, we spoke with 11 people and five visiting friends and relatives. We spoke with four staff, one nurse, the deputy manager, the registered manager and the provider.

We reviewed the risk assessments and plans of care for two people and looked at their medicine records. We also looked at audits for reviewing people’s care, the home environment, safety checks and maintenance checks. We looked at three Deprivation of Liberty authorisations, complaints records, and an overview of the last two months incident and accident audits.

During the inspection of the Domiciliary Care agency we spoke with three relatives. We spoke with two staff, the deputy manager and the registered manager.

We reviewed the risk assessments and plans of care for one person and looked at their medicine records. We also looked at audits for reviewing people’s care, the home environment and staff meeting minutes.

Updated 18 December 2018

We carried out an unannounced comprehensive inspection of this service on 12 November 2018.

Norton Hall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. A maximum of 31 people can live at the home. There were 28 people living at home on the day of the inspection and nursing care is provided. A number of people lived with dementia.

This service also provides a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to 15 older adults.

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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People told us that the care and support they received from staff made them feel safe. . People told us that staff assistance maintained their safety and staff understood how they were able to minimise the risk to people’s safety. We saw staff help people and support them by offering guidance or care that reduced their risks.

Staff understood their responsibilities in reporting any suspected risk of abuse to the management team who would take action. There were enough staff to meet people’s needs in a timely way. People told us their medicines were managed and administered for them by staff. Infection control measures were in place to prevent the spread of infections and where incidents or accidents had happened the provider had reviewed and made changes where needed to ensure that learning from these events took place.

Staff knew the care and support needs of people and people told us staff were knowledgeable about them. Staff told us their training courses and guidance from the registered manger helped to maintain their skills and knowledge. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had a choice of where they ate their meals and enjoyed the meals offered. Where people needed support to eat and drink enough to keep them healthy, staff provided assistance. People had access to other healthcare professionals that provided treatment, advice and guidance to support their health needs.

People were seen talking with staff and spent time relaxing with them. Relatives we spoke with told us staff were kind and friendly. Staff told us they took time to get to know people and their families. Family members were updated about their family member’s well being. People’s privacy and dignity was supported by staff when they needed personal care or assistance. People’s daily preferences were known by staff and those choices and decisions were respected. Staff promoted people’s independence and encouraged people to be involved in their care and support.

People’s care needs had been planned, with their relative’s involvement where agreed. Care plans included people’s care and support needs and were reviewed and updated regularly. People told us activities were offered in the home which were of interest to them.

People and relatives were aware of who they would make a complaint to if needed. People told us they would talk though things with staff if they were not happy with their care.

The registered manager provided leadership for the staff team and people had the opportunity to state their views and opinions. The provider worked in partnership with other local agencies to promote people’s well-being. The provider had a range of audits in place to monitor the quality and safety of people’s care and support. Action plans were developed to maintain the home and care of people. The provider’s planned improvements were followed up to ensure they were implemented.

Further information is in the detailed findings below.