This inspection took place on 27 and 28 September 2017 and was unannounced. The service is registered to provide accommodation and personal care for up to 46 people. At the time of our inspection there were 44 people using the service.

At our last inspection of 8 August 2014 we rated the service as ‘Good’. At this inspection we have rated the service as ‘Good’ and the well-led section as ‘Outstanding’.

The service had a registered manager in place at the time of our inspection. 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.

People felt safe in the service. Each person had a risk assessment in place which had been discussed with them and or their families to minimise risks while supporting them to pursue the life of their choice. Staff had received training in safeguarding and there were sufficient staff organised to be on duty to meet peoples assessed needs.

Regular checks of the fire safety systems and equipment used by staff in the service to support people were arranged and carried out.

The service had a robust recruitment policy and people had been supported to be part of the staff recruitment procedure. Each person had a medicines profile which included information about any allergies and why the medicines had been prescribed for them.

All new staff were provided with regular one to one support from experienced staff and given induction training. All staff had received training to enable them to support the people living at the service.

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.

The staff were trained to support people’s capacity to make decisions and choices in their lives. People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly and the team were committed to ensuring that people were supported in the least restrictive way possible.

People were supported as required to eat and drink enough and they were encouraged to make choices about food and drink and provided. The catering staff spoke with people regularly about the food and drinks provided and acted upon the feedback to develop menus.

People were supported by visiting professionals who were contacted by the service staff as necessary to provide treatment for any illnesses and concerns raised and noted by the staff.

People were supported by exceptionally caring staff that knew them well and understood how to support them to maximise their potential and attain their goals. The service had a person centred culture focussed on the promotion of people's rights to make choices and live a fulfilled life as independently as possible and this resulted in people being valued and treated as individuals. People received a personalised service which was responsive to their individual needs.

Each person was visited by a senior member of staff prior to using the service to carry out a detailed assessment to determine if the service could meet their needs. This was an opportunity also for the person to visit the service and ask questions regarding if it was the right service for them.

People were listened to and there were systems in place to obtain people's views about their care. People were encouraged to provide feedback on the service and felt they could raise concerns. Complaints were taken seriously, investigated and responded to compassionately.

The registered manager and their team of staff were inspiring and dedicated to providing care which met the highest of standards. They strived

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This report was written during the testing phase of our new approach to regulating adult social care services. After this testing phase, inspection of consent to care and treatment, restraint, and practice under the Mental Capacity Act 2005 (MCA) was moved from the key question ‘Is the service safe?’ to ‘Is the service effective?’

The ratings for this location were awarded in October 2014. They can be directly compared with any other service we have rated since then, including in relation to consent, restraint, and the MCA under the ‘Effective’ section. Our written findings in relation to these topics, however, can be read in the ‘Is the service safe’ sections of this report.

The inspection was unannounced, which meant the provider did not know that we were coming.

Norwood provides accommodation and personal care for up to 46 people. At the time of our inspection there were 46 people living in the home. There is 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 were systems in place to provide safe care for people who used the service. People told us they felt safe.

The provider ensured staff were supported to develop the skills and knowledge to provide effective care and support for people who used the service. People were complimentary about the care and support they received.

People were supported by staff who were polite and caring. People said staff treated them well and were happy about the way they were treated.

The service was led by an effective management team who were committed to providing a good service.

To enable us to assess people’s wellbeing we talked with five people and spent time sitting with them observing the care they received and the level of staff interaction. We observed that the staff were attentive to people’s needs, that they respected people’s privacy and dignity and sought their agreement before providing any support or assistance. The people we saw were relaxed, engaged with their surroundings and interacted with each other.

People told us that they were comfortable and liked living in the service. One person told us, “I was lucky to be able to come here, the garden is a delight.” Another person told us that staff, “Never mind if I ask for an extra favour.” People told us that staff always asked their consent before they supported them and one person told us, “I have my say about what I want to do when we have our meetings, we asked them to change the menu and they listened to us.”

We looked at four staff files and saw that staff were recruited in a way that protected the people who used the service and that safeguarding checks were done on new staff before they started work.

We saw that the provider had systems in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

We spoke with six people who used the service. They told us that they were treated with respect and that their views and choices were listened to and acted upon. People said that they were consulted about the care and support that they were provided with. This was confirmed by a person's relative who was visiting the service at the time of our inspection.

People told us they enjoyed the food. They said they liked the menu as it provided them with a variety of choices at meal times. One person told us, “It’s very tasty. It’s fresh and home cooked.” Another person said, “We have plenty to choose from and it is appetising.”

People confirmed they could decide where they wanted to eat their meals. One person said, “Sometimes I prefer the peace and quiet and eat in my room. Other times I want company, so eat in the lounge with the other residents. It all depends on what mood I am in. The staff know this about me and ask me what I want to do. This is good as I need their help to come downstairs.”

People were complementary about the staff and manager. They told us their needs were met and they were well looked after. One person said, “The staff here are very kind and accommodating. They have a caring nature and nice way about them.”

People said that staff respected their privacy and dignity and helped them to remain as independent as possible. One person said, “They (staff) are very understanding and patient. They help me do things for myself, but if I press my buzzer (call bell) they come quickly if I need help.”

We saw that staff interacted with the people who used the service in a caring, respectful and professional manner.

We spoke with five people living in Norwood they told us they were involved in decisions, their views were listened to and they were treated with dignity and respect. One person said “I can say what I want and they (care workers) listen to me”. Another person told us “people listen to me and my views and support me to be independent and active”. They also said “everybody is somebody that deserves to be noticed and the staff here know and respect that”. In relation to privacy one person told us the “staff always knock on peoples’ doors and call out before entering.

People using the service told us there was a range of social activities available, they explained that they could choose whether or not to join in or pursue individual interests if they preferred. One person told us “I personally like to go to the keep fit classes here, there is always something going on and plenty to do. The activities coordinator is excellent and doesn’t push people as not everyone likes to get involved but that’s up to them; you can join in if you want too or opt out - but the carers always ask you”. Another person said “some of us are really looking forward to watching the Olympics on the big screen in the main room; cheer everyone on, it will be a good atmosphere”.

People told us they experienced good care and their healthcare needs were met. One person said “staff are very attentive and supportive and take good care of me”.

We received positive comments about the food and drinks provided at the home. One person using the service said “it’s nice to have my food done for me. I appreciate the food that is on offer here; it tastes lovely”. They also told us “the care staff are always popping in to check if you want a drink or something to eat”. Another person said “the food takes into account different likes and dislikes, so can be a hit and miss for some people, but if you don’t like what’s on the menu you can have something else that you prefer and they (kitchen staff) will make it for you”.

People using the service told us there was enough trained staff to support them with their needs. One person said” I feel very safe and comfortable with the staff they are all very nice”. Another person said “staff overall are extremely good and very attentive”

Everyone we spoke with told us they feel safe and secure living at Norwood with their care workers and their privacy and dignity was respected.