We carried out a review of the data available to us about Glendale Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Glendale Lodge, you can give feedback on this service.
Glendale Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Glendale Lodge offers care and support for up to 30 older people, some of whom may be living with dementia. The majority of bedrooms are on the ground floor and have en-suite bathrooms. The service is located on the outskirts of Deal overlooking countryside. At the time of our inspection there were 29 people using the service. Two people received most of their care in bed.
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 service had last been inspected on 15 June 2016 and was rated Good. At this inspection we found the evidence continued to support the rating of Good. We found one area of improvement within the Effective domain. 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.
People were supported to have maximum choice and control of their lives, the policies and systems in the service supported this practice. Staff had not always supported people the least restrictive way possible. This was an area for improvement.
People were supported to eat and drink enough to maintain a balanced diet and were given choice with their meals. Lunchtime meal choices did not always give people a second substantial main meal option. This was an area for improvement.
People’s needs and rights to equality had been assessed and care plans had been kept up to date when people’s needs changed. People and health and social care professionals involved in their care and support told us how their general health and wellbeing had improved since living at the service. Staff had the right induction, training and on-going support to do their job. People accessed the healthcare they needed, and staff worked closely with other organisations to meet their individual needs. People’s needs were met by the facilities.
Risks to people were assessed on an individual basis and there was comprehensive guidance for staff. People were kept safe from avoidable harm and could raise any concerns with the registered manager. There was enough suitably trained and safely recruited staff to meet people’s needs. People were protected from any environmental risks in a clean and well-maintained home. Lessons were learnt from accidents and incidents. People's medicines had been well managed, medicines were administered safely and there was clear guidance for staff on how to support people to take their medicines.
People told us that staff were caring and the management team ensured there was a culture which promoted treating people with kindness, respect and compassion. Staff were attentive to people. The service had received positive feedback and people were involved in their care as much as possible. Staff protected people’s privacy and dignity and people were encouraged to be as independent as possible. Visitors were made welcome.
People received personalised care which met their needs and care plans were person centred and up to date. Where known, people’s wishes around their end of life care were recorded. People were encouraged to take part in activities they liked. There had not been any complaints, but people could raise any concerns they had with the registered manager. The provider sought feedback from people and their relatives which was recorded and reviewed.
People were happy with the management of the service and staff understood the vision and values of the service promoted by the owners and management team. There was a positive, person centred and professional culture. The registered manager had good oversight of the quality and safety of the service, and risks were clearly understood and managed. This was supported by good record keeping, good communication and working in partnership with other health professionals. The management team promoted continuous learning by reviewing audits, feedback and incidents and making changes as a result.
Further information is in the detailed findings below.
Glendale Lodge offers care and support for up to 30 older people, some of whom may be living with dementia. The majority of bedrooms are on the ground floor and have en-suite bathrooms. The service is located on the outskirts of Deal overlooking countryside. At the time of our inspection there were 30 people using the service.
The service is run by the registered manager with a deputy manager. Both were present on the day 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.
At the previous unannounced comprehensive inspection of this service on 28 and 29 April 2015, four breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements. At the time of this inspection the provider has complied with the breaches and had met their legal requirements.
People, relatives and staff told us they were very satisfied with the service. People said they felt safe and trusted the staff.
Risks to people had been assessed and there were measures in place to reduce risks to keep people as safe as possible. Staff told us how they moved people safely but further detail was required in moving and handling risk assessments to make sure they were personalised to people’s mobility needs. This was an area for improvement.
People told us they received their medicines regularly. Medicines were stored, administered, recorded and disposed of safely. Further detail was required to ensure ‘as and when’ medicines were given in line with people’s needs. This was an area for improvement.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS applications were made for anyone who had their liberties restricted. Policies and procedures were in place relating to the Mental Capacity Act 2005 (MCA) and the DoLS. When people lacked the mental capacity to make decisions the staff were guided by the principles of the MCA to ensure any specific decisions were made in the person’s best interests. Some people living at the service had DoLs authorisations in place and others had been applied for.
Staff had received safeguarding training to protect people and they knew the action to take in the event of any suspicion of abuse. They told us they would not hesitate to report staff bad practice and understood the whistle blowing policy. They were confident the registered manager would take action if they raised concerns and outside agencies would be contacted if required.
Accidents and incidents were summarised to reduce the risk of further occurrence and plans to keep people safe in an emergency were in place. Checks were carried out to ensure the premises were safe and well maintained. Procedures were in place to protect people in the event of an emergency.
There was enough staff on duty to meet people’s needs. People received care from trained staff who had the right skills to ensure their needs were fully met. Staff were recruited safely. All of the relevant checks had been made to ensure they were suitable to work at the service. Staff were supported in their role by the registered manager. They received one to one supervision with their line manager to discuss their development, training and performance. Staff had an annual appraisal to ensure their training and development needs were identified.
People told us the food was good and they enjoyed their meals. The menu offered a variety of meals and people said there was lots of choice. The service had a ‘café area’ where people, visitors and staff could make tea or coffee. There was a cake stand with fruit and cold drinks available nearby.
People and relatives were confident their health care needs were fully met. Referrals were made to health care professionals, such as district nurses or dieticians when required and people told us the doctor was called when they felt unwell.
People and relatives told us that they were treated with dignity and staff were polite and respectful. They said staff were very professional in their manner. Staff had received special training to promote communication and consistency of care to make sure people felt valued and they were involved in the running of the service. Staff respected people’s decisions when they choose what they wanted to do, where they wanted to go or spend time.
Friends and relatives were made welcome and visited during the inspection. They told us they were very satisfied with the service. One relative told us how the staff always made visitors welcome and they were able to make tea whenever they wanted especially since the ‘cafe area’ had been installed.
Before people came to live at the service, they were involved in the assessment of the care they needed so they were aware of what to expect from the service. In some cases relatives were also involved to support people to express their needs.
People’s care plans were reviewed and updated regularly to ensure staff were aware of people’s current needs. Records had been improved; they had also been checked by the registered manager to ensure they were completed accurately and were accurate and up to date.
People’s individual hobbies and pastimes were recorded in their care plan and tailored to meet their needs. People were observed doing things they liked to do, such as art, having their nails painted or doing household tasks. People were enjoying a reminiscing session at the time of the inspection. People told us they enjoyed the sessions very much and looked forward to them every week.
People and relatives knew how to complain but did not have any concerns about the service. Information on how to complain was clearly displayed to ensure people, relatives and visitors knew the procedures to raise a complaint. A new complaints procedure had been implemented and complaints had been managed and resolved in line with this policy.
The registered manager had oversight and scrutiny of the service due to a robust and effective quality assurance system. Staff told us there were supported by the registered manager and deputy manager to develop their skills and knowledge. They understood their roles and responsibilities and were motivated to provide good quality care.
There were robust systems in place for monitoring the quality of the service provided and actions were taken to address any shortfalls. Since the previous inspection the registered manager had undertaken additional training and put this into practice to continuously improve the service. They had implemented new person centred care plans, monitoring systems and networked with other organisations to improve care practice. They were passionate and motivated to provide good quality care and put people at the front of the service. It was clear that advice and guidance had been sought and put into practice to promote and improve the culture and values of the service.
This was an unannounced inspection that took place on 28 and 29 April 2015.
Glendale Lodge offers care and support for up to 30 older people, some of whom may be living with dementia. The majority of bedrooms are on the ground floor and have en-suite bathrooms. The service is located on the outskirts of Deal overlooking countryside. At the time of our inspection there were 30 people using the service.
The service is run by the registered manager with a deputy manager. Both were present on the days 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 and most relatives had confidence in the staff and how they cared for and supported people. However staff were sometimes over familiar with people and this had led to a lack of understanding by some staff about where the boundaries were between a professional caring relationship and over familiarity. This resulted in staff sometimes making decisions for people, because they felt they knew what people wanted. Some people felt that staff could sometimes ‘moan’ at them rather than encourage them and staff did not always speak with people in a respectful manner.
Risks to people were not always assessed and planned for to make sure people were consistently safe from harm. People’s care plans were not all kept up to date to ensure that people were receiving care in accordance with their individual needs. Records were not always kept up to date and accurately maintained.
There was a complaints procedure and people and their relatives knew who they could raise any concerns with. Complaints had not been managed consistently and the service’s policy and procedures had not been followed.
The process used to recruit staff was not robust and did not ensure that all the information as required by Schedule three of the regulations was in place. Staff had not received regular supervision, but were given support when any improvements in practices were needed. There were plans in place to address the shortfalls in the systems for supervising staff. There was a training programme in place to make sure staff had the skills and knowledge to carry out their roles. There was sufficient staff with the appropriate mix of skills, experience and knowledge allocated on duty. People told us they thought there was enough staff on duty, although they commented that staff were busy. People did not feel they had to wait ‘a long time for help’.
People talked about their safety and said, ‘Oh, definitely safe. I’ve never really thought about it”. “There’s nothing to be concerned about here” and “It is absolutely safe. You can go to bed and feel comfortable”. Staff understood how to keep people safe and protect them from abuse. Staff had been trained in safeguarding people and understood the importance of reporting any concerns.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS applications were made for anyone who had their liberties restricted. Policies and procedures were in place relating to the Mental Capacity Act 2005 (MCA) and the DoLS. When people lacked the mental capacity to make decisions the home was guided by the principles of the MCA to ensure any specific decisions were made in the person’s best interests.
People felt staff were kind and caring and told us, “They are always polite and very caring indeed”. “It’s nice to be in a place like this. You get looked after and get lots of attention”.
People had a choice of activities and people told us they liked the different things that were on offer. Some people felt they would like to ‘Help out’ more by doing ‘little jobs’ for staff. People felt they were treated with dignity and respect and said staff knew how they liked to be supported. Friends and relatives were able to visit at any time and most relatives said they were made welcome.
People were offered and received a healthy and balanced diet. People enjoyed their meals and told us, “The food is good” and “The food is very good and well balanced here”. One person thought the meals were not like ‘home cooking’, but told us they were happy with the food. Drinks and snacks were available at regular times and when people requested them.
People received appropriate health care support. People’s health needs were monitored and referrals made to health care professionals if any concerns were identified. People told us they saw the GP as soon as they needed to. People confirmed that they were visited by district nurses when they needed additional support. Most relatives said they were confident that people’s health care needs were met. People were supported safely with their medicines.
Staff felt well supported by the registered manager and were encouraged to discuss any concerns. The registered provider was contactable if staff felt they needed to talk to them rather than the registered manager. The registered manager acted appropriately if staff were not carrying out their duties in the best interests of people using the service.
The environment was maintained safely and checks were carried out on equipment. Procedures were in place to protect people in the event of an emergency.
There were systems in place for monitoring the quality of the service provided and actions were taken to address any shortfalls. Plans were in place to address the shortfalls in the care plans. Systems were in place to make sure that the registered manager and staff learned from events such as accidents and incidents.
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.
We have made a recommendation for the provider to consider improving the service.
We recommend that the registered provider seeks advice and guidance from a recognised source about supporting staff to understand how to promote the culture and values of the service.
People chose how to occupy themselves in the service. We observed that people were spending time in the communal areas singing with staff and interacting with each other. During our inspection we observed people spending time in their bedrooms listening to music, talking to family members and playing with the cat.
People told us they were very happy with the care and support provided at the service. One person told us "I am very happy here and think very highly of the staff - they are genuine and extremely caring. We are well looked after here and I consider myself to be very lucky. I would not want to live any where else".
People's choices and consent to care and support were observed to be respected at all times during our visit. We observed staff supporting people with day to day activities, and the interaction was observed to be sincere, respectful and responsive to individual support needs.
A district nurse told us "in my opinion this is the best home in the area - they are welcoming, offer individualised care and nothing is too small to deal with. They engage with the families and that is invaluable".
They considered their dignity and privacy had been respected. They thought that staff were respectful, polite and caring.
People and relatives said: "We are well looked after here". "The staff are wonderful". "You will have to go a long way to beat this place". "The home is always clean, comfortable and warm".
The staff we spoke with understood people's needs and knew about their routines and how they liked to be supported.
People told us they did not have any complaints but would not hesitate to speak to the staff if they had any concerns. They said they had been asked if they were satisfied with the service and had the opportunity to voice their opinions on the service being provided.