This inspection took place on 19 November 2018 and was unannounced. This meant no-one at the service knew we were planning to visit.

Norfolk Road is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. Norfolk Road is a registered to provide accommodation and personal care to adults with mental health needs. There are eleven single bedrooms across four separate bungalows. Each bungalow has a shared kitchen, lounge and bathroom. There were ten people living at Norfolk Road at the time of this inspection.

At our last inspection on 21 March 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good, and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There were enough staff available to ensure people’s care and support needs were met. The registered provider had effective recruitment procedures in place to make sure staff had the required skills and were of suitable character and background.

Staff understood what it meant to protect people from abuse. They told us they were confident any concerns they raised would be taken seriously by the registered manager.

Medicines were stored safely and securely. Where people needed support with managing their medicines there were systems in place to ensure people received their medicines as prescribed.

Staff were provided with an effective induction and relevant training to make sure they had the right skills and knowledge for their role. Staff were supported in their jobs through regular supervisions and an annual appraisal.

People were supported to eat and drink to maintain a balanced diet. People were supported to maintain good health and have access to health and social care services.

Staff understood the requirements of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered provider’s policies and systems supported this practice.

People’s privacy and dignity was respected and promoted.

There was a range of activities available to people. People were encouraged and supported to engage in activities that were important to them.

People’s care records reflected the person’s current health and social care needs. Care records contained up to date risk assessments. Care records were regularly reviewed with the person.

There was a complaints procedure in place. People and staff were regularly asked for their views of the service. This promoted a positive culture with a focus on continuous improvement of the service.

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

Safety and maintenance checks for the premises and equipment were in place and up to date.

The service had policies and procedures which reflected current legislation and good practice guidance. Some were due for review.

Further information is in the detailed findings below

We inspected Norfolk Road on 21 March 2016. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting the first day or exactly when in the following weeks.

Norfolk Road is managed by Together Working for Wellbeing. It is a registered service providing accommodation and support to adults with mental health needs. There are eleven single bedrooms across four separate bungalows. Each bungalow has a shared kitchen, lounge and bathroom.

The registered manager and has been in this role for over four years. A provider 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.

At the time of the inspection 10 people lived at the service and we met five of the people who used the service. They told us that they were very happy with the service and found it met their needs.

Most of the people we met had lived at the service of a number of years and some had been there for 20 years. We found that the provider and staff consistently ensured people were supported to lead an independent lifestyle. We found that none of the people required support with personal care and all led very independent lifestyles. The registered manager told us they had supported people, until recently, with their personal care needs and expected that they would again in the near future.

Staff readily identified triggers that would lead people to become distressed or that their mental health was deteriorating. We found that the staff’s extensive knowledge of people had enabled them to readily spot changes in people’s presentation and this had led to the staff taking prompt action to contact the persons doctor and community psychiatric nurse. We found this had a very positive impact. Since moving to the service none of the people had required a readmission to hospital.

We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. We found that the registered provider had fully embedded a computerised system for recording care delivered at the service and this was very effective.

We saw that people catered for themselves and staff encouraged them to eat a healthy diet. Where needed, staff assisted people to cook their meals and complete the shopping.

We saw there were systems and processes in place to protect people from the risk of harm. We found that staff understood and appropriately used safeguarding procedures.

People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments.

Staff were aware of how to respect people’s privacy and dignity.

Staff had received a range of training, which covered mandatory courses such as fire safety, infection control and first aid as well as condition specific training such as mental health awareness.

Staff had also received training around the application of the Mental Capacity Act 2005. The staff we spoke with understood the requirements of this this legislation. All of the people had capacity so staff did not need to complete capacity assessments or make best interest decisions.

Staff shared with us a range of information about how they as a team worked very closely with people to make sure the service enabled each person to reach their potential.

People and the staff we spoke with told us that there were enough staff on duty. We found that were sufficient staff on duty to meet people’s needs.

Effective recruitment and selection procedu

During our inspection, we spoke with eight of the 11 people who lived at the service. We spoke with the registered manager and two senior social care workers.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People’s comments included, “They [staff] sit down with me and ask me questions about my support” and “We can go through our files and change things,”

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People said, “They’re really very good” and “I'm ever so happy here, it’s ideal for me, I’m very much looked after.”

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

The service had an effective recruitment procedure in place to ensure that people were cared for, or supported by, suitably qualified, skilled and experienced staff.

There was an effective complaints system available. People told us, “We’ve got a complaint’s procedure. We discussed it again at our last meeting”, “You can put complaints in, you can get a form from staff, tell your keyworker or the manager”, and “I’ve seen the complaints information on the wall.”

People who we were able to communicate with told us that they were happy living at the home and that they were satisfied with the care they received. People said, "I love it here, the staff are great", "We all get on very well we’re like family", "I've never had any problems here, I’m much happier here than I was at the other place" and "It's amazing, the staff are friendly and I can go to them if I have a problem."

People who used the service told us they were very happy with the support provided. They said their own key workers listened to them and worked with them to address their issues. People said they were very involved in the planning of their care and support and met with their key worker regularly to review and update their personal support plans.

Sheffield Local Authority, Contracting and Commissioning had visited the home and carried out a 'Care Home Quality Framework' audit. We saw a copy of their report. Although there were a number of actions to complete, the home was considered "fully compliant" and the manager confirmed to us that all the actions in the audit had been completed.