Glebelands

About the service

Glebelands is an 'extra care' housing scheme that provides personal care and support to people living in their own flats in a single multi-occupancy building.

The single adapted building comprises of 32 self-contained flats which are managed by the London Borough of Merton. At the time of our inspection, 23 people aged 55 and over were receiving personal care and support at the scheme. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service

People told us they were satisfied with the overall quality of the care and support they received at Glebelands. Typical feedback included, “The service I’ve received here since moving in has been great”, “The manager is brilliant and the staff are all very friendly and polite” and “The carers know how to look after me and keep me safe”.

At our last inspection the provider had failed to ensure their governance systems were operated effectively. At this inspection we found the provider had improved how they managed their oversight and scrutiny arrangements. This meant the provider was no longer in breach of regulations. The new manager recognised the importance of learning lessons when things went wrong and were keen to continuously improve the service.

People were cared for and supported by staff who knew how to manage risks they might face. However, we have signposted the provider to guidance developed by a reputable resource to help them improve their fire safety arrangements.

People continued to be kept safe and protected against the risk of avoidable harm and abuse. Staff followed current best practice guidelines regarding the prevention and control of infection including those associated with COVID-19. People received continuity of care from support workers who were familiar with their needs and wishes, and whose fitness to work in an adult social care setting had been thoroughly checked. Medicines were well-organised and people received their prescribed medicines as and when they should.

People were all complimentary about the way the scheme was managed and how approachable the office-based managers were. The provider promoted an open and inclusive culture which sought the views of people living, visiting and working at Glebelands. The provider worked in close partnership with a range of local community health and social care professionals and agencies to plan and deliver people’s agreed packages of care and support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection

The last rating for this service was requires improvement (published 6th April 2020).

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 3 and 5 March 2020. A breach of legal requirements was found at that time. The provider completed an action plan after the last inspection to show what they would do and by when to improve their governance systems.

The Care Quality Commission (CQC) has introduced focused/targeted inspections to follow up on previous breaches and to check specific concerns.

We undertook this announced focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led where we previously identified issues.

As we only looked at part of the Responsive key question, we cannot change the previous good rating. In addition, the ratings from the previous inspection for the key questions Effective and Caring, which were not looked at on this occasion, will also remain unchanged. All these unchanged ratings were used in calculating the new overall rating for the service following this inspection, which has now improved from requires improvement to good.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information, we may inspect sooner.

Glebelands is an ‘extra care’ housing scheme that provides personal care and support to people living in their own flats in a single multi-occupancy building. The adapted building comprises of 32 self-contained flats which are managed by the London Borough of Merton. Anchor/Hanover housing association own the building and as the property’s landlord was responsible for its maintenance.

At the time of our inspection, 28 people aged 55 and over were receiving personal care and support at the scheme. Some people using the service were living with dementia, had a learning disability or autism, mental health problems and/or had complex physical health care needs. Three people currently living at Glebelands did not receive any personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service

Most people we spoke with told us they continued to be happy living at Glebelands and with the quality of the personal care and support they received there.

However, we found the service was not always well-led. This was because the provider’s governance processes were not robust enough to demonstrate the quality and safety of the service people received was always effectively managed. For example, the provider’s governance systems did not include regular audits of training staff had completed, which led to large gaps in staff records been left unnoticed.

In addition, we found the registered manager condition was not being met. Although the service had an acting manager who had been in operational day-to-day charge for the last 12 months, they had not applied to be registered with us. This meant the service had not had a manager registered with the CQC for over a year and still did not have a registered person in charge who could be held legally responsible for how the service was run and for the quality and safety of the care they provided.

We discussed this issue with the manager during our inspection who told us they had now made up their mind to remain as the service’s manager and would be applying to register with us in the next couple of weeks. Progress made by the manager to achieve this stated aim will be closely monitored by the CQC.

We also found, although managers and staff understood the Accessible Information Standard (AIS), they did not always ensure people were given information in a way they could understand. We have made a recommendation about the provider following AIS to make sure people with communication difficulties are always given information in a way they can easily understand.

The service was safe. There were systems and processes to protect people from the risk of abuse. People were cared for by staff who knew how to prevent or manage risk in a person-centred way. This kept people safe, while not restricting their freedom. There were sufficient numbers of staff whose suitability to work with people had been thoroughly checked. People received their medicines as they were prescribed. Staff followed relevant national guidelines regarding infection control and basic food hygiene.

People benefited from being cared for and supported by staff who were well-trained and supported. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People continued to be supported to stay healthy and well and have access to the relevant community health care professionals.

People received care and support from staff who were kind, empathetic and respectful. Staff took the time to get to know people well and understand their preferences and wishes. People were treated equally and had their human rights and diversity respected, including their spiritual and cultural needs and wishes. Staff supported people to express their views and make choices about their personal care and support they received. People were encouraged and supported to develop their independent living skills.

People received person-centred care that focused on what was most important to them and took into account their diverse needs and wishes. People were involved in reviewing care plans regularly to keep them up to date. People had opportunities to take part in a variety of group and community based social activities that were meaningful to them and tailored to their interests and abilities. Staff supported people to maintain relationships that were important to them. The provider dealt with people’s complaints in a thorough, prompt and fair way.

The service had an open, inclusive and person-centred culture. The provider consulted people, their relatives and staff as part of their ongoing programme of assessing the quality of the service and making improvements. When things did go wrong, there were systems in place to learn lessons and prevent similar incidents from reoccurring. The provider worked holistically in close partnership with other health and social care professionals and specialists to plan and deliver positive outcomes for people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection

The last rating for this service was good (published 11 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach of regulation that relates to records not always being appropriately maintained and the provider’s governance systems not being in place or robust enough to demonstrate the quality and safety of the service people received was effectively managed.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last Care Quality Commission (CQC) inspection in July 2014, the overall rating for this service was ‘Good’. At this inspection we found the service remained ‘Good’. The service demonstrated they continued to meet regulations and fundamental standards.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People continued to be safe being supported by staff who worked at Glebelands. There were robust procedures in place to safeguard people from harm and abuse. Staff were familiar with how to recognise and report abuse. The provider assessed and managed risks to people’s safety in a way that considered their individual needs. There were enough staff to keep people safe and recruitment procedures were designed to prevent people from being cared for by unsuitable staff. Medicines were managed safely and people received them as prescribed.

Staff received relevant training and were supported by managers to help them to meet people's needs effectively. Staff knew people well and had a good awareness and understanding of their needs, preferences and wishes. People were supported to eat and drink enough to meet their dietary needs. They also received the support they needed to stay healthy and to access community healthcare services.

Staff were caring and treated people with dignity and respect and ensured people’s privacy was maintained. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People continued to receive personalised support that was responsive to their individual needs. Each person had an up to date, personalised care plan, which set out how their care and support needs should be met by staff. This meant people were supported by staff who knew them well and understood their needs, preferences and interests. Managers reviewed people’s needs regularly to ensure current support arrangements continued to meet these.

The registered manager continued to provide good leadership and the management team led by example. People were satisfied with the support they received from staff. People knew how to make a complaint if they were unhappy about any aspect of the support they received. The provider maintained arrangements to deal with people’s complaints appropriately. Regular checks and reviews of the service continued to be made by managers to ensure people Glebelands experienced good quality safe care and support at all times.

Further information is in the detailed findings below.

We looked at the plans in place to care for and support people using the service. We saw people's specific needs were clearly identified, with guidance for staff about how these would be met. We also saw people's care and support needs were regularly reviewed by appropriate healthcare professionals. People using the service were asked for their views and experiences and these were acted on. People we spoke with felt safe where they lived.

Staff received training to keep their skills and knowledge up to date. Staff carried out regular checks to ensure that people's care and support needs were being met and people were happy with the care and support they received.