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Inspection carried out on 18 December 2018

During a routine inspection

Glastonbury Care Home provides accommodation and nursing care for up to 64 people. The home specialises in the care of older people including people living with dementia. The home has two floors and is split into four houses. At the time of the inspection there were 52 people living at the home.

At our last inspection 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.


At this inspection we found the service Good.

Why the service is rated Good.

The service promoted a person-centred culture where people felt valued and cared for.

People told us they felt safe and well cared for at the home. There were sufficient numbers of staff and the provider had policies and procedures in place which helped to keep people safe.

People were cared for by staff who were kind and had the skills and experience to meet their needs. One person told us, “Staff are very good, nice and helpful.” Another person said, “Staff are very good, very thorough. They know what they are doing.”

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.

Staff were attentive and promoted people’s comfort and well-being. People’s health was monitored by trained nurses and they had access to other professionals to meet their needs.

People could be confident that at the end of their lives they would receive care that was compassionate and professional.

Staff knew people well and care and support was personalised to each individual. People told us they were able to make choices about their day to lives and staff respected their choices.

There was a management team who were committed to providing high quality care and in a homely environment. One visitor told us, “The home has a nice homely atmosphere despite it’s size.” One person told us, “It’s like being in my own home. Everyone loves everyone else. The staff take a lot of trouble to look after you.”

There were systems in place to monitor standards and drive improvement. Staff felt well supported which created a happy and relaxed atmosphere for people to live in

Further information is in the detailed findings below

Inspection carried out on 19 April 2016

During a routine inspection

Glastonbury Care Home is a large purpose built home which provides accommodation, personal and nursing care for up to 64 older people. The home has two floors both staffed by nurses to support people who need nursing care. It is divided into four distinct areas; Tadham House, Tealham House, Sharpham House and Westhay House (which specialises in caring for people living with dementia). There were 59 people living at the home when we inspected.

The last registered manager left the service in February 2016. 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. A new manager was recruited in February 2016 and has begun the registration process with us.

This inspection took place on 19 and 20 April 2016 and was unannounced.

On both days of our inspection there was a homely atmosphere. Staff interacted with people in a friendly and respectful way. People were encouraged and supported to maintain their independence and to pursue their interests and hobbies. They made choices about their day to day lives which were respected by staff. One person said “I choose what I do and staff respect that. They don’t make you do anything.”

People who lived in the home and their visitors described the caring approach of staff in exceptional terms. One person said “Staff are exceptionally good, wonderful.” Another told us “The girls are all wonderful; they are all so very kind to you”. People were involved in planning and reviewing their own care. Staff respected people’s privacy and were aware of issues of confidentiality. Staff ensured people’s legal rights were protected.

There were regular reviews of people’s health and care needs; staff responded promptly to any changes. People saw health and social care professionals to ensure they received treatment and support for their specific needs. Care records were well kept but some medicine records needed more detail.

People told us staff took the time to really get to know them; staff asked them about their life history, their interests, hobbies and preferred routines. There was a varied programme of activities and outings each month in line with people’s interests. People continued to be involved in the local community. They had a choice of nutritious, home cooked food.

People said the home was a safe place for them to live. One person told us “Yes I do feel safe; it’s nice to know someone is there when you need them.” People had developed friendships with others who lived in the home; they kept in touch with their friends and relations. Friends and relatives could visit at any time.

People preferred being cared for by permanent staff rather than agency staff. Permanent staff had an excellent knowledge of people’s care needs. Staff received a thorough induction and ongoing training and support. One staff member said “I love working at the home because of the difference I can make to people’s lives.”

There was a management structure in the home which provided clear lines of responsibility and accountability. People liked and trusted the manager. All staff worked hard to provide the best level of care possible to people. The aims of the service were well defined and adopted by the staff team.

There were effective quality assurance processes in place to monitor care and safety and plan ongoing improvements. There were systems in place to share information and seek people’s views about their care and the running of the home.

Inspection carried out on 11 September 2014

During a routine inspection

We looked at the personal care or treatment records of people who use the service, carried out a visit on 11 September 2014 , observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and /or family members and talked with staff.

We considered all the evidence we had gathered under the outcomes we inspected. We used information to answer the five questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service effective?

Is the service well-led?

This is the summary of what we found:

On the day of our inspection at Glastonbury Care Home there were 60 people living there. We spoke to 10 people living at the home , three relatives and 14 members of staff.

Is the service safe?

We observed people were cared for in a environment that was safe, clean and hygienic. Ten people were able to tell us they "trusted" the staff and were "well cared" for living at the home. People told us staff were always kind and respectful to them. We noted appropriate safeguarding arrangements were in place in the form of safeguarding and whistleblowing policies. All staff had attended training in the Mental Capacity Act 2005 and Deprivation of Liberties. We saw evidence of this in staff files.

CQC monitors the operation of Deprivation of Liberties which applies to care homes. We noted one application had been submitted by the home in line with the proper policies and procedures. The registered manager was on call in case of emergencies. We noted staff records were accurate and complete. We saw evidence that staff had the experience and skills needed to support people in their care at the home. We observed emergency procedures were in place in the event of a fire. We noted fire evacuation training was up to date and documented in staff files.

Is the service effective?

We found the service was effective in meeting people's needs. We observed staff at Glastonbury Care Home interacted well with people. Staff told us "We know people really well and understand each persons needs and their preferred style of communication. We read all the people's care plans and make sure they have the care and support they need". We were told the home had recently received Beacon Status, a top national award for outstanding care to people nearing the end of their lives. One person told us "The home is really good and the staff are so kind. This is my home and we are always treated as individuals here".

Is the service caring?

People told us "It is just wonderful here". One person said "It is the best thing I have ever done coming here. I choose what I want to do and when I want to do it. There are lots of activities and I really like going out in the mini bus". We reviewed five care plans and noted each care plan contained a comprehensive assessment of each person's care and support needs. We spoke to a district nurse who said "The care planning documentation has improved over the last year and I can always find the information I need to complete my assessments". A relative told us "Everyone was so kind and helpful when my family member came to live in the home. The staff have always involved me in the planning of my relatives care and I know I can talk to staff at any time of the day or night". We spoke to another family member who told us "I visit frequently and I am always reassured at how well cared for my family member is".

Is the service responsive?

The registered manager told us it was essential to the care and well being of people living at the home to be responsive to their care and support needs. We noted the home supported people to be as independent as they were able to. We noted there was a wide variety of activities to support people's independence. People's ability to be involved was assessed daily and people were encouraged to choose how they spent their time. One person said "I really enjoy the activities and I ask the staff to remind me each day of what activities are planned so I can decide what I want to do". We observed people were offered choices of what they wanted to eat and drink, where they wanted to sit and if they wanted to participate in activities. We noted staff always respected the choices people made.

Is the service well-led?

The registered manager told us that since the last inspection in December 2013 there had been a number of changes at the home. Nursing care had been provided in three of the four houses, but was now provided across the home from 1st September 2014. The registered manager and the provider had increased the staffing levels and enhanced the nursing skills to meet the changing needs of the service. The additional staff had been appointed and would shortly be taking up post following the completion of their six week induction programme. We observed staff had a good understanding of the ethos of the home. Staff demonstrated throughout the visit that people were encouraged to live full and independent lives within the limitations of their medical condition. We reviewed the feedback from the quality assurance surveys completed by people at the home and their relatives. We noted people had commented favourable on the care and support and management of the service. We noted staff received regular supervision and appraisal and in-service training. This was recorded in staff files and in the central training records held by the registered manager. This demonstrated staff were supported to give quality care to people at the home.

Inspection carried out on 9 December 2013

During a routine inspection

Since the last inspection in March 2012 the organisation and staffing in the home had been changed. Nursing care was provided in three of the home�s four units. Additional nursing staff had been employed. The fourth unit was providing specialist care for people with dementia in an adapted environment. We found the atmosphere in the home to be warm and welcoming.

We spoke with 10 people, who used the service, in their own rooms and observed others in the communal dining rooms and sitting rooms. We spoke with ten staff and a visiting family member. We observed staff's understanding of the care and support needed. The people who used the service we spoke with said they were "well looked after" and staff were "very kind, quite wonderful.�

We looked at people's individual files which incorporated their personal profile, care plans and risk assessments and found they encompassed the safety and well-being of people who used the service.

People living in the home and staff told us they knew how to raise a concern or complaint and felt confident in doing so. They said if they had any issues or concerns they could "talk to the manager."

We looked at the cleanliness and infection control procedures and found the provider had adequate systems in place to ensure the safety of the people who used the service.

We found the home operated a system of recruitment that was designed to employ staff who were suitable for their post and safe to care for people in the home.

The provider had systems in place to monitor and improve the service and to manage risks to the health and safety of people living and working in the home.

Inspection carried out on 12 March 2013

During a routine inspection

There were opportunities for people to be involved in the agreeing and arranging of their care and being asked about their experience of receiving care. People receiving care or their representative were asked to comment on the quality of the care provided. We observed staff interacting with people in a positive, caring and sensitive way. People told us they felt they were treated with respect.

People we spoke with were all very positive about the care they received. One person described their care as "excellent". There were good arrangements in place for the planning and delivery of care. We observed staff supporting people to make sure their nutritional needs were being met. We found that where people had clinical and nursing needs these were being met effectively and staff had the necessary skills and knowledge.

We found that the home had a robust system for the management and administering of medicines. There were audits available to make sure that medicines were given safely and as prescribed. Staff told us they felt well supported by the management team. There was evidence of staff receiving regular one to one supervision. Staff told us they received the training needed and were supported to undertake professional training.

There were comprehensive and robust systems in place to look at the quality of the service provided. We saw that audits had been completed and action taken to address areas for improvement.

Inspection carried out on 8 March 2012

During a routine inspection

We spoke with several people who lived in the home who told us that staff provided the care and support they needed. They said staff were very patient and kind and they listened to them. One person told us �the staff are all very nice and they know me well. I choose what I want to do and what help I need�.

We observed how staff interacted with people who lived in the home and all of the interactions we saw were kind and respectful, particularly when discussing or assisting people with intimate personal care. One person we spoke with said �the staff are so kind. We are all known by our first names here which I think is an excellent idea�.

There were a wide range of activities provided for people who lived in the home; one member of staff organised and led the activities. People told us they had group activities such as a singing circle and visiting entertainers; trips out of the home were also organised. One person said �we are given a list of activities each week, but staff always remind you what�s on each day so you don�t forget. There are lots of activities so I pick and choose what I like to do. I listened to the jazz band this week, that was lovely�.

People who lived in the home told us they felt well cared for and that staff were available when they needed them. When we asked people if staff helped them to do the things they needed help with, people said that they did. Comments from people included �I feel very well cared for�, �I love it here. The staff are really kind and you can follow your own routine� and �the staff all know the care I need�. All of the relatives we spoke with were very happy with the care that staff provided.

People�s healthcare needs were well catered for. Staff ensured they monitored the healthcare of people who would not be easily able to say if they were unwell. One person told us �staff help me with my medicines four times a day. They always give them to me on time. The GP visits the home every week and staff would always ask them to see you if you want them to. When my breathing was bad and I was worried the staff made sure the GP saw me on the same day. It�s so nice you don�t have to worry about things like that.�

People told us they liked the food served in the home and that they always had a choice of meals and snacks. They chose where they wished to eat their meals; some people preferred to eat in their own room rather than the dining areas and this was respected and catered for. One person said �the food here is very good, you always have a choice�.

People we spoke with said they thought the home was a safe place for them to live. One person said �yes I do feel safe living here. If I had any problems or worries I would tell the staff. Staff are always here to help you�. Relatives also told us they thought people were safe living at the home.

People who lived in the home said staff were available when they needed them. One person said "there are always enough staff around, day and night". People had a call bell which they could use when they needed help. We saw that when people used these they were answered quickly. One person said �they always answer it quickly, you don�t have to wait�.

Reports under our old system of regulation (including those from before CQC was created)