The inspection took place on 15 and 19 October 2015 and was unannounced.
Norewood Lodge Nursing Home is a care home providing accommodation for up to 48 people who require nursing and personal care. During our inspection there were 39 people living at the home. The home is set out over three floors and provides support to older people, younger people with health conditions and short stay accommodation.
There was a registered manager in post at the service. 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 systems for checking expiry dates and recording medicines were not always effective. Medicines were administered safely and people received their medicines when required.
We found people’s rights were not fully protected as the correct procedures had not always been followed where people lacked capacity to make decisions for themselves.
The registered manager and provider had systems to monitor the quality of the service provided. Audits covered a number of different areas such as care plans, infection control and medicines. We found the audits were not always effective at identifying shortfalls in the service.
Where there were risks to people these were not always identified and measures were not in place to reduce the risk. After discussing this with the registered manager they ensured the risk assessments required were completed.
Staff had a good understanding about the assessed needs of people and how to keep people safe. However; care plans had not always been updated to reflect people’s needs when they had changed or contain enough information on how staff should support people.
People and their relatives told us they felt safe at Norewood Lodge. Systems were in place to protect people from harm and abuse and staff knew how to follow them. We received mixed feedback from people and staff about staffing levels. During our inspection there were enough staff available to meet people’s needs. The registered manager regularly audited call bell response time and investigated where call bells rang for longer than six minutes.
A recruitment procedure was in place and staff received pre-employment checks before starting work with the service. Staff received training to understand their role and they completed training to ensure the care and support provided to people was safe. New members of staff received an induction which included shadowing experienced staff before working independently. Staff received supervision and told us they felt supported.
People were complimentary of the food provided and had access to food and drinks throughout the day. Where people required specialised diets these were prepared appropriately.
People and their relatives told us they were happy with the care they or their relative received at Norewood Lodge. We observed staff were caring in their interactions with people.
People were confident they could raise concerns or complaints with the registered manager and they would be listened to. The provider had systems in place to collate and review feedback from people and their relatives to gauge their satisfaction and make improvements to the service.
The home offered a range of activities to meet people’s individual needs and had strong links with the local community.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.