Normanton Lodge Care Home

Normanton Lodge Care Home is a residential care home providing. personal care to up to 67 people. The service provides support to older people, people living with Dementia and people who have a sensory impairment. At the time of our inspection there were 47 people using the service.

Normanton Lodge Care Home accommodates people in 2 adapted buildings, one part of the building is called the Glen Care Village and comprises of 24 individual apartments each with their own bathroom and kitchen. Normanton Lodge comprises of 43 individual bedrooms with communal living areas and bathrooms.

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

The provider’s system and processes for managing people’s finances were not robust. The providers procedure for managing people’s finances had not been followed by staff, this left people at risk of financial abuse.

Systems and processes to identify risks to people needed strengthening as we found risks had not been consistently identified or mitigated. We also found that the system in place to analyse accidents and incidents did not include those that had occurred in the Glen Care Village. We raised this with the management team who told us the actions they would immediately put in place to ensure this was rectified.

Medicines were safely managed. Regular checks of the medication stock were completed and associated records, we reviewed these records and we found people had their medication administered safely and in line with the prescribing instructions. We also found the service to work in partnership with other professionals to ensure people received their prescribed medicines as required. There was clear detailed guidance for staff for safe administration of 'as and when required medicines' (PRN).

Care plans included detailed individual information about people’s choices and preferences the information had been regularly reviewed and reflected people's changing needs. Care plans detailed people’s specific dietary preferences, staff were knowledgeable of this and we could see people’s preferences were being met.

The registered manager carried out regular quality audits of the service and had created an action plan to address any areas for improvement. We reviewed this action plan and could see that actions had been completed or were in progress.

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.

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 22 May 2019)

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.

We received concerns in relation to the systems in place to support people in managing their finances. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Normanton Lodge Care Home on our website at www.cqc.org.uk

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to protecting people from the risk of abuse and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Processes were in place for testing people and staff regularly for COVID-19. Appropriate action was taken following any positive test results with people being supported to isolate in their bedrooms.

Government guidance was being followed by the provider to prevent visitors from catching the virus and spreading the infection to others.

People were being admitted safely into the service with guidance being followed.

The providers infection prevention and control policy was up to date and contained appropriate guidance for staff to follow.

Following the inspection the provider made appropriate improvements to the environment to ensure it followed best practise.

People’s experience of using this service: People were protected from the risk of abuse. Staff knew how to recognise, and report abuse if required. Risks associated with people’s care were identified and actions taken to minimise risks occurring. Accidents and incidents were monitored to ensure any trends and patterns were identified and addressed. The service had sufficient staff available to meet people’s needs. There was a safe recruitment process in place. We completed a tour of the home with the registered manager and identified some areas which required attention. These areas were immediately attended to.

People were supported to have maximum 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.

Staff received training and support to carry out their role. Healthcare professionals were involved in people’s care where appropriate and their advice was adhered to. People had access to an outside space, although this was restricted at the time of our inspection, due to building works taking place in the grounds of the home.

During our inspection we spent time observing staff interacting with people. We found staff were kind and caring and supported people in line with their individual needs.

People received person centred care which met their needs and took in to consideration their preferences. The provider employed an activity co-ordinator and people enjoyed participating in social events. The provider had a complaints procedure which was available to people. The registered manager kept a log of concerns and complaints and the procedure was followed when needed.

A management team supported the staff and ensured people received appropriate care. Staff we spoke with felt supported by the management team and felt valued. Audits were in place to identify areas which required attention and action plans were devised as needed. People we spoke with told us the home was managed well and had confidence they could approach staff and management if they needed to.

Rating at last inspection: Good (report published 17 November 2016).

Why we inspected: This was a planned comprehensive inspection based on the rating at the last inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

A registered manager was in place at the time of this inspection. 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.

The service is registered to provide nursing and residential care for up to 43 people, including some people living with dementia. At the time of our inspection 38 people were using the service.

Staff knew and understood people and paid particular attention to people so that they received responsive and personalised care. People were supported to engage in enjoyable interests and activities. The environment was used in a way to help orientate people living with dementia. People were asked for their views and people knew how to raise concerns or make suggestions. The provider had taken steps to ensure suggestions could be made through their website, in addition to, for example, speaking with staff or using the complaints procedure.

People were supported by staff who were friendly, kind and caring. People’s choices and decisions were respected. Care and support was provided in a way that respected people’s privacy and dignity. People’s independence was supported.

The provider had taken steps to make sure people were cared for safely. Sufficient numbers of staff were deployed to meet people’s needs. Any risks to people were identified and assessed and monitored. Medicines were safely stored and administered safely.

Staff checked with people that they consented to their care and support before this was provided. Policies and procedures were in place to ensure the principles of the Mental Capacity Act (MCA) 2005 were followed. Applications for assessments using the Deprivation of Liberty Safeguards (DoLS) had been made when required. Staff understood how the principles of the MCA related to the services delivered.

People were supported to enjoy mealtimes and received sufficient food and drink that met their nutritional needs. Staff were supported through supervision and training and demonstrated knowledge of people’s needs. Staff received training in areas that were relevant to the needs of people using the service. Staff were inspired by the training in dementia care and showed they understood this and applied it to their role. People were supported to access other health care services as required.

The registered manager was viewed as being open and approachable and involved in the day to day management of the service. The registered manager was supported in their leadership by motivated and supportive staff. Records were well maintained and checks on the quality and safety of services were completed.

The bedrooms were personalised to the people who lived at the home, with lots of their personal effects and family photographs on display. The accommodation was appropriately designed and suitable to meet the needs of the people living there and there was an ongoing plan in place for necessary replacements and renovations.

We saw that support plans and risk assessments were informative and up to date. Staff were aware of their contents, which enabled them to deliver appropriate and safe care. The provider had systems in place that ensured the safe receipt, storage, administration and recording of medicines. Staff recruitment and induction systems were robust.

We found that people had access to a number of different activities and outings. There were photographs displayed from a visit to a local garden centre and from a 'sing-a-long' activity with an entertainer who had visited the month prior to our visit.

People's needs were assessed prior to them moving to the home and were reviewed again within 48 hours of moving in to ensure they were safe.

There were effective systems in place to reduce the risk and spread of infection. Appropriate cleaning schedules were in place for all areas of the home. A number of floors throughout the building had recently been replaced, including bathrooms and living / dining rooms.