CQC report explained · a nursing home
What the CQC found at Norewood Lodge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, staff had safeguarding training, and risk assessments and care plans were in place. Some risk records needed more detail, such as the correct sling size for mobility equipment.
- Effective?
- Good
- Staff were trained and supported, and people received help with food, nutrition and healthcare. Some bathrooms contained moving and handling equipment because storage space was limited.
- Caring?
- Good
- People said staff were kind, respectful and caring. Inspectors saw staff support people's dignity, independence and involvement in decisions.
- Responsive?
- Good
- Care plans, activities and a complaints process were in place. Some plans lacked personal detail, the keyworker system was not working well, and care information was not in large print for a person with a visual impairment.
- Well-led?
- Good
- The home had a positive atmosphere and systems to monitor quality, safety and action plans. People and families could attend meetings and managers understood their legal responsibilities.
What inspectors found, September 2019
Rated Good in all five areas; inspectors found safe, kind and personalised care, with some care records needing more detail.
This was an unannounced inspection on 19 August 2019. Inspectors spoke with nine people, two relatives and seven staff. They also spoke with managers and checked care records, complaints, staff records and other documents.
People said they felt safe and were treated with dignity and respect. Staff were trained, medicines records checked were accurate, the home was clean, and people received support with food, health needs and activities.
The inspectors found some areas to improve. Some care plans and risk records lacked specific detail. A keyworker system was not working well, and one care plan was not in a suitable format for a person with a visual impairment.
The home was rated Good overall and Good in Safe, Effective, Caring, Responsive and Well-led. These ratings were unchanged from the previous inspection in February 2017.
Kind and respectful care
People described staff as kind and caring. Inspectors saw staff treating people politely and supporting their privacy, dignity and independence.
“The staff are kind and caring. They respect my privacy and dignity” from the report
People felt safe
People and relatives said they felt safe and had confidence in the care. Staff had safeguarding training and knew how to report concerns.
“People told us they felt safe living in the home.” from the report
Good health and nutrition support
The home worked with health professionals and supported people's nutritional needs. Inspectors found records showing appropriate support for a feeding tube and a diabetic person's heel ulcer.
“We saw that staff had regular contact with other professionals and took action when they were concerned about a person's health.” from the report
Activities and community links
There was a weekly activities programme, including contact with local groups. Activity staff also offered time with people who preferred to stay in their rooms.
“Links with the local community had been built.” from the report
Quality monitoring
Managers carried out regular checks and followed up actions. The quality manager and registered manager discussed quality and progress every week.
“Regular checks took place to ensure the home was running as it should and this also fed in to an action plan.” from the report
Care plans lacked personal detail
needs fixingSome care plans did not give enough specific information about people's preferences and support. One plan said frequent snacks were needed but did not say which snacks the person enjoyed.
“We found that some support plans would benefit from further detail.” from the report
Risk records needed more detail
needs fixingSome records about managing risks were not specific enough. The report gives the example of not recording the sling size needed for mobility equipment.
“We found that in some cases records relating to risk management would benefit from further detail, such as the size of sling required when using mobility equipment.” from the report
Accessible information
needs fixingA person's care plan was in normal-sized print despite their visual impairment. The inspectors recommended producing care plans in line with people's communication needs.
“We recommend that care plans are produced in line with people's assessed communication needs as required by the AIS.” from the report
Keyworker system
needs fixingStaff said the keyworker system was not working well. Senior staff knew about this and said they were looking to develop it further.
“There was a keyworker system in place at the home, however staff feedback was that it wasn't currently working well.” from the report
Limited storage
minorSome bathrooms were cluttered with moving and handling equipment because there was not enough storage space. Managers said equipment was removed when people wanted to use the bathrooms.
“We did note that some of the bathrooms were cluttered with moving and handling equipment and that overall there was a lack of storage space for equipment.” from the report
- 01How have you made care plans more specific to each person's preferences, including their preferred snacks?
- 02How do you now record detailed risk information, such as the correct sling size for mobility equipment?
- 03What changes have you made so information is provided in large print or other formats when people need it?
- 04How has the keyworker system been improved since the inspection?
- 05How do you keep bathrooms clear and store moving and handling equipment safely?
This was an unannounced planned inspection covering all five CQC questions, and all five ratings remained Good from the February 2017 inspection. This explanation was written from the published report of 12 September 2019 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, February 2017
Rated Good; inspectors found safe, kind and responsive care, but some care records were incomplete or needed updating.
The inspection was unannounced and took place on 11 January 2017. Inspectors spoke with people living in the home, a relative, staff, managers and a healthcare professional. They observed care and checked care, decision-making and management records.
The home was rated Good in all five areas: safe, effective, caring, responsive and well-led. Inspectors found people were protected from abuse, medicines were managed safely, staffing was sufficient during the visit, and staff were suitably trained.
People described kind care and said staff knew them well. The home offered personalised care, activities and links with the local community. People and relatives could raise concerns, and the home had systems to listen to their views.
The home had improved since the October 2015 inspection, when it breached rules about safe care and treatment and consent. Those improvements had been made. However, some care plans needed updating, and some records did not fully show that care had been provided.
Previous problems addressed
The home had acted on the concerns found at the previous inspection about safe care and consent.
“During this inspection we found the provider had taken action to address our concerns.” from the report
Safe care arrangements
Inspectors found systems for safeguarding, risk assessment, medicines and recruitment. People and relatives said they felt safe.
“People were supported by a sufficient number of staff to keep them safe.” from the report
Kind and respectful staff
Staff built positive relationships with people and respected privacy, dignity and independence.
“Throughout our inspection we observed staff interacting with people who lived at the home in a kind and caring way.” from the report
Activities and community links
People could choose from varied activities, including one-to-one sessions, and the home had links with local groups and schools.
“There were a good range of activities available for people to participate in.” from the report
Care plans needed updating
needs fixingSome care plans lacked information and some records had gaps. Staff knew people's needs, but the written information might not be available to unfamiliar or replacement staff.
“We found some of the care plans were in need of updating and required additional information.” from the report
Repositioning records had gaps
needs fixingFor two people who needed regular repositioning, records had gaps of up to 15.5 hours. Inspectors could not be sure from the records whether all the required care had been given.
“We found gaps in the records of up to 15.5 hours in between repositioning.” from the report
One consent record was incomplete
needs fixingOne record did not show that the person lacked capacity before others signed consent for access to care documents. The provider was reviewing its paperwork.
“there was no capacity assessment to demonstrate the person lacked capacity to make the decision themselves.” from the report
Medicines rounds could be interrupted
minorA nurse was interrupted several times while giving medicines. The manager agreed to look into this because interruptions could increase the chance of a mistake.
“This meant the nurse may not be able to fully concentrate on administering medicines and could be at risk of making a mistake.” from the report
- 01How have you updated care plans and added the missing information identified by the inspection?
- 02How do you check that repositioning is completed every three hours and recorded without gaps?
- 03What safeguards are now used to prevent interruptions during medicines rounds?
- 04How do you record mental capacity assessments and best-interest decisions?
- 05What happens to staffing levels when staff are off sick and cover cannot be arranged?
This was an unannounced inspection covering all five areas: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 17 February 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 Norewood Lodge Care Home
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2013
Report published without a new overall rating.
- December 2012
Registered with the Care Quality Commission on 7 December 2012.
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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