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Inspection carried out on 17 October 2019

During a routine inspection

About the service

Gladstone House is a residential care home providing accommodation and personal care for up to 12 younger adults with a mental health condition. At the time of the inspection there were 12 people using the service.

The service has three floors, two of which provide living accommodation for people. There is a communal lounge and dining area, with a smaller quiet room with access to outside space.

People’s experience of using this service and what we found

People told us they felt safe living at this service and had built trusting relationships with staff. Recruitment procedures ensured staff were suitable to work in a care setting. Staff had time to meet people’s needs and engage them in meaningful conversations. People’s medicines were managed safely. The providers quality assurance systems did not always highlight areas requiring improvement in relation to infection control and window safety. We made a recommendation about the governance and quality assurance systems in place.

Staff received training to support them in their role. The provider had scheduled refresher training to ensure staff knowledge and skills were maintained. Staff received informal day to day chats with the management team; supervisions and appraisals were scheduled to support them carry out their role effectively.

People had choice and control of their lives and the staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People accessed the community independently and were supported by a team of staff to engage in activities or explore interests they had chosen. People were encouraged to participate in the running of the home to further develop their life skills.

Care plans were person-centred and reflective of people’s current needs. Staff knew people well and could tell us about their support needs. People told us staff were, “Supportive, friendly and kind.”

The service demonstrated good outcomes for people. Staff told us people were at the heart of everything they considered. People, staff and relatives had opportunities to raise concerns, make suggestions to improve the service.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gladstone House on our website at www.cqc.org.uk

Rating at last inspection

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

Why we inspected

This was a planned inspection based on the previous rating. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 7 March 2017

During a routine inspection

Gladstone House is a care home that provides accommodation and personal care for up to 12 younger adults with mental health conditions. There were nine people living at service on the day we inspected. The building is a converted hotel with a more recent extension. The property has no garden and car parking is on the road outside the service. It is situated close to public gardens.

At the last inspection this service was rated Good. At this inspection we found that the service remained Good.

There was a registered manager at this service who had been registered with the Care Quality Commission since June 2011 .

We found that the service was safe. There were sufficient staff on duty to meet the needs of people who used the service and they were trained in subjects which were reflective of their role and people's needs. They had been trained in safeguarding adults and were aware of reporting procedures.

Risks to people's health and safety had been identified and recorded. Premises safety was maintained through regular checks of services and equipment.

Medicines were managed safely and people who used the service had access to healthcare professionals when needed.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's nutritional needs were met.

People chose what activities they wished to take part in and led their lives as they chose.

Staff were kind and caring and showed respect to people.

Care plans were person centred and were reviewed regularly.

If people had any concerns or complaints there was a policy displayed telling them what action to take. No complaints had been made.

There was a clear management structure within the service. The organisational values reflected the way people were supported.

There was a quality monitoring system in place.

Further information is in the detailed findings below.

Inspection carried out on 13 November 2014

During a routine inspection

This inspection was carried out on 13 November 2014 and was unannounced. At our last visit to Gladstone House on 4 July 2013 we did not ask for any improvements to be made.

Gladstone House provides accommodation and personal care for up to 12  adults with mental health conditions. There were nine people living at service on the day we inspected. The building is a converted hotel with a more recent extension. The property had no garden or car parking space but was situated close to public gardens.

There was a registered manager at this service who had been registered since June 2011 with the Care Quality Commission. 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 and associated Regulations about how the service is run.

Gladstone House is a small family run service which has a friendly and relaxed atmosphere.

We found that the service was safe. There were sufficient staff on duty to meet the needs of people who used the service and they were trained in mandatory subjects as well as specific subjects such as mental health.

People were protected through the use of the Court of Protection when there were any identified risks. The court of protection is able to authorise a named person to make decisions on behalf of someone who is unable to make the decision for themselves.

Medicines were managed safely and people who used the service had access to healthcare professionals when needed.

Staff were kind and caring towards people who used the service and showed respect when speaking with them. People who used the service were encouraged to maintain links with family and friends.

There was a clear management structure within the service and staff understood the culture and values associated with this service

Inspection carried out on 10 July 2013

During a routine inspection

We spoke with several people who lived at Gladstone House. They told us that they were involved in the planning of and decisions made about the support they required. They told us that staff supported them to make their own decisions about any care, treatment and social activities they were involved in.

Care plans included information about mental and where necessary physical health. The care plan format had been improved recently with information being provided in a clear and concise way. This enabled staff to assist the individual in a personal way.

We saw that the environment was suitable for the people who lived there. People were able to lock their own room when they left it and this gave them a sense of safety.

We saw that employment checks were carried out on the staff before they started working at Gladstone House. This meant that staff were suitable to work with vulnerable people.

The manager carried out several audits of records kept, the environment and how people were. This meant that people received a service that met their needs.

Inspection carried out on 27 November 2012

During a routine inspection

We spoke with seven people who used the service and they told us they could follow their own routines during the day. One person told us that they could get up and go to their room when they wanted to. People told us they attended a regular meeting to discuss their lives at the home. We saw records of these meetings. People who used the service told us that the staff were "All nice". They told us that the staff let them do what they wanted to during the day.

Staff kept daily records for each person. These records contained detailed information about incidents people who used the service had been involved in. These incidents were not reflected in the reviews of the care plans. The daily notes also contained judgements rather than factual information.

People who used the service told us they helped with the domestic activities in the home. One person helped wash up, another set the tables and another took round the afternoon drinks. People told us that they took turns to help with these activities.

Staff told us they had mandatory training every year. Staff records also contained records of national vocational training (NVQ) that they had completed. There was no evidence that staff had received training about mental health issues other than challenging behaviour.

Staff told us that they had time to spend with people who used the service but this was not evidenced during the inspection. We saw that staff were busy with household tasks.

Inspection carried out on 5 June 2012

During an inspection in response to concerns

At this review we did not consult with anyone who used this service. Instead we spoke with the provider.

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