Norbury Court is a nursing service that provides care for up to 60 people. It is a purpose built care service. At the time of our inspection 56 people were living at the service. The service has three floors; the ground floor is primarily used for people living with dementia who do not require nursing care. The service has five lounges, five dining rooms, a library room, a music room, a hairdressing room, an activities/games room and two enclosed garden areas.

The registered manager had been registered with the Care Quality Commission in May 2017. A registered manager is a person who has registered with CQC 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.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good.

People told us they felt ‘safe’. There was evidence of involvement from other health care professionals where required, and staff made referrals to ensure people’s health needs were met.

Staff had undertaken safeguarding training and were knowledgeable about their roles and responsibilities in keeping people safe from harm.

All the relatives we spoke with made positive comments about the care their family member had received and about the staff working at the service. Some of the relatives we spoke with told us they would recommend the service.

The service had appropriate arrangements in place to manage medicines so people were protected from the risks associated with medicines.

The recruitment systems were designed to make sure new staff were only employed if they were suitable to work at the service.

Staff received induction and refresher training to maintain and update their skills. Staff were supported to deliver care and treatment safely and to an appropriate standard.

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.

A varied diet was provided, which took into account people’s dietary and cultural needs and preferences. This meant people’s health was promoted and choices could be respected.

The registered provider had appointed an additional activities co-ordinator to increase the level of the activities available at the service. They were due to start working at the service in the near future.

People living at the service, and their relatives said they would speak with staff if they had any worries or concerns and felt they would be listened to.

Relatives we spoke with made positive comments about the way the service was managed.

There were effective systems in place to monitor and improve the quality of the service provided.

Further information is in the detailed findings below.

This inspection took place on 27 October 2014.  This was an unannounced inspection which meant the staff and provider did not know we would be visiting.  The service was last inspected on 14 October 2013 and was meeting the requirements of the regulations we checked at this time. 

Norbury Court is a nursing service that provides care for up to sixty people.  It is a purpose built care service.  At the time of our inspection fifty eight people were living at the service.  The service has three floors; the ground floor is primarily used for people living with dementia who do not require nursing care.  The service has five lounges, five dining rooms, a library room, a music room, a hairdressing room, an activities/games room and an enclosed garden. 

There was a registered manager at the service.  A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

There was a calm and friendly atmosphere in the service.  The service was clean and had a pleasant aroma.  During the inspection we heard people and staff singing along to music.  We observed staff encouraging people to get up and dance with them.  One person spoken with told us it was always like this at the service.

Our observations during the inspection told us people’s needs were being met in a timely manner by staff.  People told us staff responded promptly when they called for assistance.  A few people told us they did not use a call buzzer or want one and they preferred to shout for assistance.  One person demonstrated how effectively this worked.  We observed staff giving care and assistance to people throughout the inspection.  They were respectful and treated people in a caring and supportive way.

People told us they felt safe and were treated with dignity and respect.  Our discussions with staff told us they were fully aware of how to raise any safeguarding issues and were confident the senior staff in the service would listen. 

The service had appropriate arrangements in place to manage medicines so people were protected from the risks associated with medicines. 

Robust recruitment procedures were in place and appropriate checks were undertaken before staff started work.  This meant people were cared for by suitably qualified staff who had been assessed as safe to work with people. 

People had personalised their rooms and they reflected their personalities and interests.  There were memory boxes outside some of the rooms.  There was good signage in the service to help people navigate around the building.  People living with dementia may need such signs every time they move around a building.  People spoken with told us they were satisfied with the quality of care they had received and made positive comments about the staff.  Relatives spoken with also made positive comments about the care their family members had received and about the staff working at the service. 

People had a written care plan in place.  People’s records were updated on a daily basis. 

Individual risk assessments were completed for people so that identifiable risks were managed effectively.  People and/or their representatives were included in the completion of these and they were reviewed regularly and in response to changes.  There was evidence of involvement from other professionals such as doctors, optician, tissue viability nurses and speech and language practitioners. 

People’s nutritional needs were monitored and actions taken where required.  People made positive comments about the food and said their preferences and dietary needs were being met. 

Staff told us they enjoyed caring for people living at the service.  Staff were able to describe people’s individual needs, hobbies and interests, life history, likes and dislikes and the name people preferred to be called by.  Staff completed induction, training and received ongoing support.  Staff received specialised training to meet the needs of people they supported. 

We saw the service promoted people’s wellbeing by taking account of their needs including daytime activities.  There was a range of activities available which included: sing alongs, arts and crafts and games.  A group of people had gone on a trip to Cleethorpes earlier in the year.  We looked at the service’s newsletter dated 5 August 2014.  It gave details of the events the service had held earlier in the year, a sports day and a summer fete.  On the morning of the inspection a small group of people were carving pumpkins in the activities room.  The service was in the process of recruiting an additional activities worker to enable more people to participate in activities in a group or on a one to one basis.    

The provider had a complaint’s process in place.  We found the service had responded to people and/or their representative’s concerns, investigated them and had taken action to address their concerns. 

Regular residents and relatives meeting were held at the service.  A copy of the latest relatives meeting minutes was available for people and visitors to the service to read.  In the reception area there was an information board with details of future projects planned for the service.  For example, changes to the garden area.  This meant people and their relatives or representatives were kept informed about information relevant to them.

Accidents and untoward occurrences were monitored by the registered manager to ensure any trends were identified.  There were effective systems in place to monitor and improve the quality of the service provided. 

Norbury Court opened in April 2013. This was the home's first inspection.

We were not able to fully communicate with some people living at Norbury Court. However, people told us they were "Happy" and "Alright". People also commented that staff were "Lovely" and "Kind."

Relatives spoken with said that they were satisfied with the care their loved one received. They told us they had no worries or concerns about Norbury Court. Their comments included, "It is marvellous here and I would recommend this home. [My relative] is well looked after" and "It is brilliant here. The staff really care."

We found that people's care and welfare needs were assessed and each person had a written plan of care that set out their identified needs and the actions required of staff to meet these.

During the inspection we were able to observe people's experiences of living in the home. The interactions between people living at the home and staff were positive. We found that care and support was offered appropriately to people.

We found that suitable arrangements were in place to ensure people were safeguarded against the risk of abuse and their rights were upheld.

We found that sufficient numbers of staff were provided to meet people's needs. Staff were provided with relevant training to maintain and update their skills and knowledge.

We found that procedures were in place to audit and monitor systems within the home.