CQC report explained · a residential care home
What the CQC found at Norbury Crescent
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that medicines, risks, infection control, staffing, recruitment and the care home premises were managed safely. Medicines stock tracking and checks had improved since the previous inspection.
- Effective?
- Good
- Staff received training, induction and supervision, and people were supported with food, drink and healthcare. One professional said staff needed more support to develop their skills and confidence in managing behaviours that challenged the service.
- Caring?
- Good
- People and relatives described staff as kind, friendly and respectful. Inspectors found that staff understood people's communication, supported relationships and maintained privacy, dignity, choice and independence.
- Responsive?
- Good
- People were involved in developing their care plans, which recorded their needs, preferences and background. People were supported with activities they were interested in, and the provider responded appropriately to concerns.
- Well-led?
- Good
- The registered manager and staff understood their responsibilities. The provider had introduced more frequent audits and gathered feedback from people, relatives, staff and professionals.
What inspectors found, November 2018
Norbury Crescent was rated Good; inspectors found safe, kind and responsive care, with staff needing more support to manage some behaviours.
This was a comprehensive inspection carried out on 4 October 2018. The inspection was announced 48 hours beforehand. Inspectors reviewed records, spoke with people, relatives, staff and health and social care professionals, and checked care and staff files.
The home and agency were rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found improvements in medicines management, risk assessments, care planning and quality checks.
At the previous inspection in September 2017, the service was rated Requires Improvement. The report says the provider had addressed the earlier concerns, including medicines stock control, water safety, involving people in care planning and quality assurance.
Safer medicines systems
The provider had introduced a system to track medicine stocks and carried out frequent checks of medicines records. Inspectors found that medicines were given and recorded correctly.
“Our own checks of medicines stocks and medicines records showed people received their medicines appropriately and staff recorded administration in the right way.” from the report
Kind and consistent staff
People and relatives spoke positively about staff. Low staff turnover meant people were supported by staff they knew well.
“People received consistency of care as staff they knew well supported them each day.” from the report
Personalised care planning
Care plans had improved since the previous inspection. They included people's preferences, backgrounds, family and religious beliefs, and staff understood the guidance.
“Care plans were sufficiently detailed and informed staff of their preferences, backgrounds, family and religious beliefs.” from the report
Activities and relationships
People were supported to take part in activities they enjoyed and to keep in touch with family and their community, where this was part of their agreed care.
“People were supported to do activities they were interested in.” from the report
Improved leadership and checks
The provider had improved its quality checks and leadership arrangements since the previous inspection. Audits covered medicines, health and safety, care plans, risk assessments and staff records.
“The provider had improved their quality assurance processes to check the service was meeting the fundamental standards.” from the report
More support with managing behaviours
needs fixingA health and social care professional said staff needed more support to build their skills and confidence in managing behaviours that challenged the service for one person. The registered manager said competency assessments would be introduced.
“However, a professional told us staff required more support from the provider to develop their skills and confidence in managing these behaviours for one person.” from the report
- 01What competency assessments have been introduced to support staff managing behaviours that challenge the service?
- 02How do you check that medicine stocks and medicines administration records remain accurate?
- 03How will my relative and family be involved in writing and reviewing the care plan?
- 04Which staff would normally support my relative, and how do you maintain consistency if someone is absent?
- 05Which activities and healthcare arrangements would be included in my relative's agreed care?
This was a comprehensive inspection of both the care home and domiciliary care agency, covering all five CQC questions; the home had one resident and the agency supported three people at the time. This explanation was written from the published report of 9 November 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2017
Rated Requires Improvement; inspectors found kind and effective care, but safety, care planning and oversight needed fixing.
This was the first inspection since the service registered. It was an announced visit on 7 September 2017, with 24 hours' notice. The inspector observed care, spoke with one person, two care workers and the registered manager, and reviewed care, medicines, staff and management records. A relative and two social workers also gave feedback.
Inspectors found enough staff, suitable recruitment checks and good staff training and support. People were treated kindly and with respect. They received suitable food and drink, support with healthcare, and activities that interested them.
However, medicines records and stock checks were not always complete. Some risks, including diabetes, diet, weight and possible aggression in the homecare service, had not been assessed with plans for staff to follow. Water safety checks and systems to reduce Legionella risks were also not in place.
The overall rating was Requires Improvement. Safe, responsive and well-led were rated Requires Improvement, while effective and caring were rated Good. The provider breached regulations about person-centred care, safe care and treatment, and good governance.
Kind and respectful staff
Inspectors found that staff knew people well, respected their privacy and supported their independence.
“People were cared for by staff who were kind and cared about the people they supported.” from the report
Enough staff
The home had enough staff to meet people's needs, and records and feedback supported this.
“There were enough staff deployed to support people.” from the report
Staff support and training
Staff received induction, relevant training, monthly supervision and support from the provider.
“Staff received monthly supervision with the registered manager where they reviewed the best ways to care for people and staff training needs.” from the report
Activities and independence
People were supported to take part in activities they enjoyed and to build everyday skills.
“The person's care plan showed they had a programme in place to help them learn skills such as cooking, washing up, tidying their room and laundry.” from the report
Medicines records
seriousThe provider did not record medicines received or carried over each month. Some prescriber's instructions and allergy details were also missing from records.
“The provider did not record the quantities of medicines received each month, or quantities of medicines carried over each month to keep track of stocks.” from the report
Unassessed risks
seriousRisks for a person receiving homecare had not been assessed or covered by risk management plans. These included diabetes, diet, weight and possible aggression.
“However, the provider had not assessed the risks relating to the person receiving care in their own home or put risk management plans in place.” from the report
Water safety
seriousThe provider had not checked water temperatures to reduce scalding risks or put suitable systems in place to reduce the risk of Legionella.
“However, the provider had not followed national guidance for care homes to mitigate the risks relating to scalding by hot water and also Legionella.” from the report
Incomplete care planning
seriousA person receiving homecare did not have a provider care plan covering their preferences. Staff also lacked guidance on supporting behaviour that could challenge the service.
“This meant staff did not have any guidance to follow in providing care to the person according to their wishes.” from the report
Weak quality checks
needs fixingAudits had not found the problems identified during the inspection. Medicines audits were not well established or consistently recorded.
“Although the provider had some audits in place, including those relating to medicines management and health and safety, these had not identified the issues we found.” from the report
- 01How do you now check medicines received, carried over and administered, and how are allergies and prescriber's instructions recorded?
- 02Which written risk assessments and care plans are now in place for diabetes, diet, weight management and behaviour that may challenge the service?
- 03What water temperature and Legionella checks are now carried out, how often, and who reviews them?
- 04How are people receiving homecare involved in writing and reviewing care plans about their preferences?
- 05How often are quality and medicines audits completed, and can we see evidence that previous problems have been found and corrected?
This was the first comprehensive inspection since registration and covered the care home and homecare service, with all five key questions rated. This explanation was written from the published report of 11 October 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Norbury Crescent
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- November 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2016
Registered with the Care Quality Commission on 21 September 2016.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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