Archived: The Glen Private Nursing Home

The Glen 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. The Glen is registered to provide accommodation for up to 19 people who require nursing and personal care, some of whom may be living with dementia. The home is a converted house with a purpose built extension. The home is situated within its own grounds within a residential area of Sheffield.

There was a manager at the service who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

Our last inspection at The Glen took place on 11 January 2017. We found a breach in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in Regulation 19, Fit and proper persons employed.

The registered provider sent an action plan detailing how they were going to make improvements. At this inspection, we checked improvements the registered provider had made. We found sufficient improvements had been made to meet the requirements of Regulation 19: Fit and proper persons employed, as the registered manager had obtained all of the required information prior to people working at the home.

This inspection took place on 9 April 2018 and was unannounced. This meant the people who lived at The Glen and the staff who worked there did not know we were coming. On the day of our inspection, there were 14 people living at The Glen.

People spoken with were very positive about their experience of living at The Glen. They told us they felt safe and they liked the staff.

Staff were aware of safeguarding procedures and knew what to do if an allegation was made or they suspected abuse.

We found systems were in place to make sure people received their medicines safely so their health was looked after.

Staff recruitment procedures were robust and ensured people’s safety was promoted.

Sufficient numbers of staff were provided to meet people’s needs.

Staff were provided with relevant training, supervision and appraisal so they had the skills they needed to undertake their role.

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 had access to a range of health care professionals to help maintain their health. A varied diet was provided, which took into account dietary needs and preferences so people’s health was promoted and choices could be respected.

Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and they were involved in decisions about their care. People’s privacy and dignity was respected and promoted. Staff understood how to support people in a sensitive way.

A programme of activities was in place so people were provided with a range of leisure opportunities.

People said they could speak with staff if they had any worries or concerns and they would be listened to.

There were systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to.

The Glen Private Nursing home is a small nursing service that provides care for up to 19 people. At the time of our inspection 17 people were living at the service. One person was receiving respite care.

There was a registered manager at the service. 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.

We found the registered manager had not followed the registered provider’s recruitment policy. We found appropriate checks for two members of staff working at the service had not been completed before being employed by the registered provider. The registered manager assured us that immediate action would be taken to obtain appropriate checks. This was a breach in Regulation 19 of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Fit and proper persons employed.

We found the service had appropriate arrangements in place to manage medicines so people were protected from the risks associated with medicines.

People we spoke with told us they felt “safe” and had no worries or concerns. Relatives we spoke with felt their family member was in a safe place.

Staff had undertaken safeguarding training and were knowledgeable about their roles and responsibilities in keeping people safe from harm.

We did not receive any concerns from relatives or people regarding the staffing levels at the service. Our observations during the inspection told us people’s needs were being met in a timely manner by staff.

People had individual risk assessments in place so that staff could identify and manage any risks appropriately. Care plans were detailed and person centred. Care plans were reviewed regularly and changed to reflect current needs.

There was evidence of involvement from other health care professionals where required, and staff made referrals to ensure people’s health needs were met.

Staff had undertaken training which was regularly updated to ensure they had the skills and knowledge to support people effectively.

Staff had received appropriate supervision and appraisal as is necessary to enable them to carry out the duties they were employed to perform.

We saw the service promoted people’s wellbeing by taking account of their needs including activities within the service and in the community.

People made positive comments about the quality of food provided and told us their preferences and dietary needs were accommodated.

People and relatives made very positive comments about the staff working at the service.

We saw that people responded well to staff and they looked at ease and were confident with staff. Staff were respectful and treated people in a caring and supportive way.

People and relatives told us they would speak with the registered manager or assistant matron if they had any concerns or complaints. They felt their concerns would be taken seriously and responded to in good time.

Resident meetings took place so people had opportunities to feedback about the service and suggest improvements.

Accidents and untoward occurrences were monitored by the registered manager and assistant matron to ensure any trends were identified.

We saw the system in place to ensure policies were reviewed so they reflected key legislation and guidance needed to be more robust.

There were quality assurance systems in place to monitor the quality and the safety of the service provided.

You can see what action we told the provider to take at the back of the full version of the report. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

The examples they gave included: choosing when to get up and go to bed, what to wear and choice of meals at breakfast, lunch and dinner. We spoke with three people about the care they received. They told us that they felt cared for. Comments included," I'm not treated as if I don't know anything" "It's warm and friendly, lots of fun and a caring with a big C".

We spoke to a visiting health care professional. They told us that "patient care is centred on their personal needs". Another staff member said "we work around the patients".

We spoke to two relatives about the care that their relatives were receiving .Comments included 'Staff go above and beyond what I would expect'. 'Everybody is very friendly".

We found a range of equipment that was place to support the independence and meet the needs of people and that it was safe and well maintained.

We observed the transfer of person from a wheelchair to a lounge chair by two members of staff and throughout the transfer the patient was reassured and treated with dignity.

We noted that the four care plans we reviewed contained an assessment of moving and handling on initial admission to the home and this was updated on a monthly basis.

People were made aware of the complaints system. This was provided in a format that met their needs. This took the form of an information booklet which was given to each person when they arrived at the home. This contained information on how to make a complaint.

The two relatives we spoke with told us they were very satisfied with the quality of care at the home. Their comments included: 'The standard of care is very good.' 'When they wake someone for medication they do it gently.' 'The care is responsive to people's needs."

We observed staff giving care and assistance to people throughout the inspection and they were respectful and treated people in a friendly and supportive way. People we spoke with made positive comments about their care and the staff. Their comments included: 'The home is a good one.' 'There is always a qualified nurse about when your need one.'

We saw that people in the home benefited from equipment that was comfortable and met their needs.

The provider had a recruitment and selection procedure in place to ensure that staff were appropriately employed. We found that staff had received training and were supervised but that some staff supervisions were overdue. We saw evidence that staff had the opportunity to develop and improve their skills.

We saw that the home had provided people with information about how to complain but that the procedure needed to be updated. All the people we spoke with told us that if they had a concern they would speak to staff or a relative.