This inspection took place on 7 and 15 March 2018. The first day was unannounced and the second announced.

Norton Lodge is a privately owned care home set in large grounds in the Norton Village area of Runcorn. A bus route and train station is nearby and Halton Lea shopping centre and Runcorn old town are within easy travelling distance.

The home provides personal care for people who experience mental health issues, alcohol related problems, learning disability or dementia. The accommodation is provided over two floors and is registered to take up to thirty two people. At the time of our visit there were twenty four people living at the home, on the first day one person was in hospital.

We last inspected the service in January 2017. During that visit we identified breaches of the Health and Social Care Act (Regulated Activity) Regulations 2014 with regard to Regulations 11, 13, and 17 and of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. The service received an overall rating of Requires Improvement. Following that inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of Safe, Effective and Well-led to at least ‘good’. During this inspection we found that the service had made the required improvements and was no longer in breach of those regulations.

The home is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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.

People told us that they felt safe at Norton Lodge. Policies and procedures were in place to protect people from the risk of abuse or neglect.

On the first day of inspection we saw that a bath had been filled and left unattended and staff were initially unclear about systems for temperature checks. The registered manager was able to clarify the process and addressed this with the members of staff involved.

Medication management and administration processes were reviewed. An electronic medicines administration system was used which mitigated the risk of errors. Although information regarding controlled drugs was held on the electronic system, within the paper records staff had sometimes signed in the wrong box and the form of medication was not always noted i.e. tablet etc.

We observed staff carrying out safe moving and handling practice. There was a policy and procedures were in place to prevent and control the spread of infection.

Arrangements were in place for checking the environment at Norton Lodge to ensure it was a safe place for people to live. We spot checked safety certificates and found these were up to date. We were told that improvements had been made to the environment since the new owner took over.

People had a personal emergency evacuation plan (PEEP) detailing the support they would need in the event of any major incidents/emergencies.

Risks to people’s health and wellbeing were assessed and we saw that measures were put in place to support people to remain safe. Safe recruitment procedures were followed.

People said they felt cared for, respected and listened to, that staff were kind to them and that the care they received was effective. We saw that staff interactions were considerate and were not rushed.

The service operated within the principles of the Mental Capacity Act 2005 (MCA). The registered manager maintained records of Deprivation of Liberty Safeguards authorisations and a system was in place to ensure that these were renewed as required. People told us that staff asked for their consent before care was provided.

People were supported to access health care professionals when needed to support their health and wellbeing. The dis

The inspection was unannounced and took place on 6 and 13 December 2016

Norton Lodge is a privately owned care home set in large grounds in the Norton Village area of Runcorn. A bus route and train station is nearby and Halton Lea shopping centre and Runcorn old town are within easy travelling distance. The home provides personal care for people who experience mental health issues, alcohol related problems, learning disability or dementia. The accommodation is provided over two floors and is registered to take up to 30 people. There were 28 people living in the home at the time of our visit.

At the time of the inspection the registered manager had just resigned her post but has not yet submitted an application to cancel her registration with CQC 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.

This was the first inspection of this service since it was purchased by the current providers in December 2015. We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of safeguarding service users from abuse, consent, staff training and supervision and governance. The registered provider and registered manager had also failed to notify the Care Quality Commission about events and incidents at the home in line with the regulations. You can see what action we told the provider to take at the back of the full version of this report.

Although staff had received some training, some refresher training was overdue and staff had not received regular supervision.

Staff had appropriately referred safeguarding incidents to their registered manager but these had not then been dealt with in accordance with the local Safeguarding Adults Interagency policy, therefore they may not have been investigated or addressed correctly.

Although staff worked cooperatively with people living at the home records were not available to show that people without capacity to make their own decisions were protected by the MCA framework.

Quality assurance processes were not sufficiently robust to ensure that risks to people’s health and safety were mitigated or to ensure that the quality of the service improved. People who used the service and their relatives were high in their praise of the staff and services provided. They told us that staff were kind and caring and understood their needs.

We saw that staff had developed effective communication methods with people to meet their individual needs. We saw staff used verbal and non-verbal interactions to ensure people were able to speak their mind and have choices in all aspects of their daily life.

Care plans held some information about the individual’s needs and choices. They also held risk assessments which balanced the potential benefits and risks in order to support people wherever possible to live a life of their choice. However some care plans were very brief and were in need of updating to ensure current needs were recorded. We saw that some care plans were not signed by the individual or their next of kin to evidence their consent to the care and support provided.

Staff records showed that there was a low turnover of staff and staff files indicated that recruitment policies ensured that all relevant checks had been undertaken prior to staff working at the home.

People told us that they were supported by consistent staff who knew the people very well.

We saw the service had good links with community nurses to enable staff to make necessary referrals in areas such as behaviour which challenged which were followed up appropriately.

The service promoted healthy eating. People were also assisted to eat safely and healthily using guidance from Speech and Language Thera