The inspection took place on 11 January 2017 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 40 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.

We inspected Norewood Lodge in October 2015. At that Inspection we found the provider to be in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The regulations included; Safe care and treatment and Need for consent. The provider wrote to us with an action plan of improvements that would be made. They told us they would make the necessary improvements by February 2016. During this inspection we saw the improvements identified had been made.

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.

Some of people's care plans needed updating and required additional information and care records were not always completed fully by staff, the registered manager had a plan in place to address this. .

People, their relatives and staff said the home was a safe place for people. Systems were in place to protect people from harm and abuse and staff knew how to follow them. The service had systems to ensure medicines were administered and stored correctly and securely.

People were supported by a sufficient number of staff to keep them safe. Risk assessments had been carried out and they contained guidance for staff on protecting people. The provider followed safe recruitment procedures to ensure that staff working with people were suitable for their roles.

People were complimentary about the food provided. Where people required specialised diets these were prepared appropriately.

People’s rights in relation to decision making were upheld.

Staff had enough training to keep people safe and meet their needs. Staff understood people's needs and provided the care and support they needed. People received support from health and social care professionals.

Staff had built trusting relationships with people. People were happy with the care they received. Staff interactions with people were positive and caring.

There were organised activities and people were able to choose to socialise or spend time alone. There were strong links with the local community. People and relatives felt able to raise concerns with staff and the manager.

Staff felt well supported by the registered manager and felt there was an open door policy to raise concerns. People and relatives were complimentary about the registered manager and felt the home was well led.

There were quality assurance processes in place to monitor care and safety and plan on-going improvements. There were systems in place to share information and seek people's views about their care and the running of the home.

At the time of our inspection 39 people were living in Norewood Lodge. During our inspection we spoke with people living in the home, staff, relatives and examined the care records for people living in the home. We also spoke with staff that worked in the home.

Not all people were able to verbally tell us about the care they received and if they were happy. Therefore we observed how staff interacted and supported people in communal areas, to enable us to make a judgement on how their needs were being met.

We observed some people being supported and examined their care plan documentation at different stages of their assessments. This was to ascertain if an appropriate level of care was being provided, in line with their assessed needs.

Overall people we spoke with who used the service and their relatives were happy with the care they received. Comments included; “I'm ever so happy here”, “staff come when I need help”, “nothing is too much for them, the staff are lovely”, “it’s very clean here”.

Visiting relative comments included; “X is very settled here, staff are never in hurry we trust them fully”, “clothes are washed quickly”, “the food is nice and plenty of it”.

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.