Norwood Drive

Updated 15 March 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of one adult social care inspector.

Service and service type:

Norwood Drive 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.

Norwood Drive accommodates up to six people in one adapted building. At the time of our inspection there were five people living at the home. The service provides personal care and accommodation without nursing care to people with a learning disability.

The service did not have a manager registered with the Care Quality Commission. A registered manager 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 took place on 23 and 31 January 2019. The first day of the inspection was unannounced.

What we did:

Before the inspection we:

• Reviewed statutory notifications sent to us by the provider. Statutory notifications are information providers must send us about certain significant events such as deaths, safeguarding, police incidents and serious injuries.

• Reviewed previous inspection reports.

• Asked for feedback from Trafford Council’s quality and contracts monitoring team; the local authority infection control lead; commissioners of the service, Trafford Healthwatch and professionals the provider told us had recent involvement with the service. We used the feedback received to help plan our inspection.

• Looked at the information sent to us in the provider information return (PIR) the service sent to us in November 2018. Providers are required to send us this key information about their service, which includes what they do well, and improvements they plan to make.

During the inspection we:

• Spoke with one person who was living at the home.

• Observed the care and support people received in communal areas.

• Spoke with the relatives of two people by phone, and received feedback from one relative by email.

• Spoke with five staff members. This included two support workers, an agency care worker, the deputy manager and the area manager.

• Reviewed records relating to the care people were receiving. This included daily records of care, three people’s care files, records of accidents, incidents and complaints, and three people’s medicines administration records (MARs).

• Looked at other records related to the running of a care home, including: Records of servicing and maintenance of the premises and equipment, three staff personnel files and audits and quality assurance records.

Updated 15 March 2019

About the service: Norwood Drive is a residential care home that can accommodate up to six people. The home was providing support with personal care to five people with a learning disability at the time of our inspection.

People’s experience of using this service:

• Staff treated people with care and respect. There was a small, consistent staff team, which helped staff build positive relationships with people living at the home.

• Staff had a good understanding of people’s needs and preferences. Care plans were person-centred and contained a good level of detail about how people preferred to receive their care.

• Whilst the home was adequate to meet people’s needs, the provider and relatives recognised that the premises needed refurbishment. Although the provider did not own the building, they were responsible under their registration for ensuring the premises met relevant requirements.

• We saw evidence that required servicing, checks and risk assessments relating to the premises and equipment had been completed. However, there was evidence that recommendations from the home’s legionella risk assessment had not been acted upon. Legionella is a type of bacteria that can develop in water systems and cause Legionnaire's disease.

• There were some shortfalls in infection control procedures. We found some areas of the home were visibly unclean.

• Staff were aware how to identify and escalate potential safeguarding concerns. However, we were aware of one instance prior to the inspection when concerns had not initially been adequately investigated.

• There were systems in place to help ensure people’s medicines were manged safely. However, staff had not always followed safe practice when giving people their medicines.

• We observed some activities taking place during the inspection, and some people attended day centres. However, activities did not engage everyone living at the home, and reports from relatives and staff indicated perceived barriers such as the weather, finances and transport could prevent people from accessing the community as often as they would like. We have made a recommendation about activities.

• Staff received a range of training relevant to their roles and the needs of the people they supported.

• The registered manager had recently left the service. The deputy manager was receiving support from the area manager to run the home day to day.

• The provider had systems and processes in place to help them monitor the quality and safety of the service. However, these systems had not always ensured the issues we found had been addressed and the service continues to be rated requires improvement overall. We found this to be a breach of the regulations.

• Relatives told us they felt the provider had not always acted openly and honestly in relation to previous incidents at the service. The provider assured us it was not their intention to withhold information from families, and that this had been due to a misunderstanding about which relatives had been informed of previous events.

• The service applied the principles and values of registering the right support and other best practice guidance, although this was not consistent. This guidance aims to ensure that people using services can live as full a life as possible, and achieve the best possible outcomes that include choice, control, inclusion and independence.

For full details about the findings of this inspection, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: We last inspected Norwood Drive on 4 and 5 October 2017 when we rated the service as requires improvement overall (report published 12 December 2017). This is the third consecutive time that the service has been rated requires improvement.

Why we inspected: This was a routine scheduled inspection. However, we were unable to inspect the service when we had originally planned in December 2018 due to an incident that raised concerns about the safety of people if they remained at the home. Whilst this incident was not directly related to the care people were receiving, there were concerns that people could be at risk of harm if they remained at the home. People were therefore supported to move to alternative accommodation for 12 nights whilst the provider worked with other agencies to assess potential risks to people’s safety, and put in place measures to reduce these risks as far as possible.

At our last inspection of the service in October 2017, we identified a breach of regulations in relation to staff training. We found the provider had addressed this issue and the service was now meeting the requirements of this regulation.

Enforcement / Improvement action: You can see what action we have told the provider to take at the end section of the full version of this report.

Follow up:

We will:

• Continue to monitor the home.

• Ask the provider to send us a plan to tell us how they intend to improve the rating of the service from requires improvement to good or outstanding overall.

• Ask the provider and commissioners of the service to take part in a meeting to discuss how the service can be supported to improve.