We undertook an unannounced inspection on 4 April 2017 of Norwood - 54 Old Church Lane

Norwood- 54 Old Church Road is registered to provide accommodation and personal care to five people. It caters for older people with a learning disability. At the time of this inspection, there were three people using the service.

There was a registered manager in post. 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.

At the last inspection on 26 November 2014, the service was rated Good.

At this inspection we found the service remained Good.

People's health and social care needs had been appropriately assessed. Care plans were person-centred, and specific to each person and their needs. Care plans were reviewed monthly and were updated when people's needs changed.

Relatives informed us that they were satisfied with the care and services provided and were confident that people were safe in the home.

Staff had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.

Medicines were managed safely. Arrangements were in place for the recording of medicines received into the home and for their storage, administration and disposal.

We found the premises were clean and tidy. There was a record of essential maintenance carried out at the home. Bedrooms had been personalised with people's belongings to assist people to feel at home.

Staff had been carefully recruited and provided with induction and training to enable them to support people effectively. They had the necessary support, supervision and appraisals from management.

Staff we spoke with had an understanding of the principles of the Mental Capacity Act (MCA 2005). Capacity to make specific decisions was recorded in people's care plans.

The home had made necessary applications for (Deprivation of Liberty Safeguards) DoLS as it was recognised that there were areas of people’s care in which their liberties were being deprived. Relevant authorisations had been granted and were in place.

There were suitable arrangements for the provision of food to ensure that people's dietary needs were met.

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

We undertook an unannounced inspection on 26 November 2014 of Norwood – 54 Old Church Lane. This service is registered to provide accommodation and personal care to five people. It caters for older people with a learning disability. The inspection was carried out by one inspector. At the time of our inspection three people were using the service who were all of Jewish faith. Two people were able to understand and communicate verbally. One person was able to understand but could not communicate verbally and would use specific gestures which staff were able to understand and recognise.

At our last inspection on 10 January 2014 the service met the regulations inspected.

There was a registered manager in post. 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 provider had taken steps to help ensure people were protected from abuse or the risk of abuse because there were clear safeguarding and whistleblowing policies and procedures in place to protect people. Care workers were aware of what action to take if they suspected abuse.

People were not restricted from leaving the home and were encouraged to meet their family and relatives. We saw evidence that people went out to various activities and people identified at being of risk when going out in the community had risk assessments in place and we saw that if required, they were supported by staff when they went out.

People were cared for by staff that were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care workers spoke positively about their experiences working at the home.

We saw positive caring relationships had developed between people who used the service and staff and people were treated with kindness and compassion. We observed people were very relaxed, were free to come and go as they pleased, were smiling and were at complete ease.

We saw that people’s care preferences were reflected in their care plans and information such as the person’s habits, daily routine and preferred times they liked to wake up and go to sleep. Care plans showed how people communicated and contained a communication profile for each person which detailed specific body language, gestures, facial expressions and key words a person used to communicate.

The home encouraged people’s independence and care plans provided prompts for staff to enable people to do tasks they were able to do by themselves.

People were consulted and activities reflected people’s individual interests, likes and dislikes and religious and cultural needs were accommodated. People were supported to maintain links with the wider community. People were able to visit family and friends or receive visitors and were supported and encouraged with maintaining relationships with family members.

The home had a clear management structure in place with a team of care workers, assistant manager, registered manager and the provider. Relatives spoke positively about the registered and assistant manager and felt they were approachable and could raise any concerns with them. One relative told us “The manager is very good. They are very helpful and approachable for anything.”

The home had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. There were systems in place for the maintenance of the building and equipment to monitor the safety of the service.

During our inspection we spoke with two people who used the service, the relative of one person who used the service, two members of staff and the manager. Overall, everyone was satisfied with the care provided. One person told us that they were "happy” at the home. This person also told us that they enjoyed the variety of food offered at the home. One relative told us that they were “pleased with the care provided” and had no complaints. This relative also told us that they felt comfortable raising issues with the manager.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care records indicated that the needs of people had been attended to.

Staff we spoke with told us that they enjoyed working at the home and felt supported by the team and the management. One member of staff told us “the manager and assistant manager are very supportive and they look after staff – they are understanding”.

Staff demonstrated that they were aware of what action to take when responding to allegations or incidents of abuse and had received training in safeguarding people.

We observed that there were appropriate arrangements in place to manage medicines and staff were aware of the importance of ensuring that medicines were administered and recorded accurately.

We saw that people’s personal records including medical records were accurate and fit for purpose.

During our inspection on 25 November 2012 we found that the provider was not meeting two of the standards we checked. We judged this to have a minor impact on people living at the home. We asked the provider to make improvements to ensure that people received safe and appropriate care. They sent us an action plan and told us they would address all the shortfalls we identified by 5 January 2013.

During this inspection we found that that the provider had made the necessary improvements to make sure people who use the service received safe and appropriate care.

During the inspection we talked with two people using the service and three members of staff to get their views about the quality of services that were provided in the home.

We observed that all people appeared well cared for. They were appropriately and discreetly supported by staff when this was required. Staff communicated with people according to their individual needs so they were kept informed about what was happening in the home and enabled to make choices in their daily life. Where people needed support with communication, this was addressed in their care plans.

People were supported with their healthcare needs and encouraged to take part in social and recreational activities and to be a part of their community. For example on the day of the inspection two people told us they were going shopping and would have lunch outside the home.

We found that the provider had not always addressed maintenance issues in a timely manner to ensure people were protected against risks associated with unsafe premises. They had also not ensured that incident/accident reports were appropriately completed when people sustained bruises or other injuries and these were not appropriately dealt with to identify a cause and to rule out suspicions of abuse.

People said that they were treated with respect and that they received the personal care they needed. They were satisfied with the vocational and social activities they could do and they liked their meals. People said they felt safe. They were confident that any complaints would be acted upon and that they could have a say on improvements to their care and home.

Not all people that lived at 54 Old Church Lane were able to converse with us due to their individual communication and health needs. People that couldn’t answer our questions in detail gestured, nodded or shook their head in response to our questions. Throughout our visit we looked for signs of people’s ‘well being’.

People told us that staff listened to them. Comments from people about the staff included ‘I like my key worker’ ‘the staff take me out’ and ‘the staff help me to get dressed’.