Archived: Glebelands

We considered all the evidence we had gathered under the outcomes we inspected, which related to consent to care, people's care and welfare, suitability and safety of premises, staffing, assessing and monitoring the quality of service provision and records. We used the information to answer five key questions; is the service safe, effective, caring, responsive and well-led.

This is a summary of what we found.

Is the service safe?

People and relatives of people who use the service were complimentary of how the provider maintained people's safety. One person told us 'I feel safe here.' Evacuation plans were in place to ensure people's safety in the event of a fire at the service.

There were enough staff on duty to meet people's needs. A member of the management team was available on call in case of emergencies outside usual working hours.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to this type of service. While no applications have needed to be submitted for the people using the service, proper policies and procedures were in place. Relevant staff were trained to understand when an application should be made, and how to submit it.

Since our last inspection on 11 December 2013 we found actions had been taken by the provider to ensure people were protected from the risk of infection. People had been cared for in an environment that was safe, clean and hygienic. People were protected from the risk of infection because protocols based on current Department of Health guidelines were followed.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others in relation to incidents. There was a system for monitoring and learning from incidents. The provider could identify possible trends that may require additional actions, such as risk assessments and the implementation of appropriate actions, to minimise the risk of occurrences to people and others.

Is the service effective?

The service demonstrated effective practices through the assessment of people's health and care needs. People's views about the type of care they wanted had been sought. People confirmed their involvement in the development of their care plan. We found staff had a good understanding of people's care and specific support needs, for example, in relation to pressure sore prevention and medical conditions such as Multiple Sclerosis.

All four people and a relative we spoke with were complimentary about the care received. One person we spoke with said 'Everything the staff do they do very well.'

Since our last inspection on 11 December 2013 we found actions had been taken by the provider to ensure where people did not have the capacity to provide consent, the provider acted in accordance with legal requirements. The provider had suitable arrangements in place for formally obtaining the consent of people regarding their care and treatment. For people assessed as lacking the capacity to make specific decisions for themselves, staff did not approach relatives to consent on their behalf unless they were lawfully able to do so. During our visit we saw people were asked for their consent before they received any care, and staff acted in accordance with their wishes. One person told us 'They (staff) always say what they are going to do and get my agreement.'

Is the service caring?

People were supported by kind and supportive staff. One relative told us 'Staff are caring towards X. The care here is absolutely brilliant. This is how a care home should be.' All interactions we observed between the staff and people were respectful and courteous. We saw that care workers gave encouragement when supporting people. People were able to do things at their own pace and were not rushed.

The compliments folder we looked at recorded responses from people and their relatives. We saw feedback was positive. People rated staff support and care highly.

Is the service responsive?

People's needs were assessed before they were admitted to the service. Records confirmed people's preferences and diverse needs had been recorded. Staff provided examples of care and support being provided in accordance with people's wishes, for example, in relation to meal preferences and personal hygiene.

We found care was not planned and delivered to meet all of the identified needs for four people who used the service to ensure theirs and others' safety and welfare. For example, in relation to the provision of specific guidance for behaviours that challenge the service arising from the provision of personal care. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring care is planned and delivered to meet the needs of all people who use the service.

People knew how to make a complaint if they were unhappy. We looked at how complaints had been dealt with by the provider, and found that the responses had been thorough, and timely. People could therefore be assured that complaints were investigated and action was taken as necessary. A survey to gather feedback from people's relatives was conducted in April 2014 by the provider. This recorded up to 18 responses from 42 people's relatives. We saw feedback was positive. Relatives rated management's ability to resolve people's concerns and complaints highly.

Is the service well-led?

We saw people's and relative's feedback was sought through meetings and surveys. The provider was responsive to comments from people, such as improvements to the supper menu and the implementation of a planned refurbishment of the service to meet people's wishes and suggestions.

Audits and checks ensured people's safety and wellbeing was promoted. Where issues were identified, an action plan was formulated. Progress and completion of this was monitored. We saw issues were identified and actions completed appropriately.

During our inspection we observed the atmosphere was relaxed and welcoming. Relatives of people who use the service were complimentary about the care their relatives received. One relative told us, 'They (staff) are all very caring. I am happy with the care they give to X.' A person who uses the service said, 'They (staff) treat me well, they are the best.'

Care was planned with the involvement of the people who use the service and their relatives. Care plans reflected people's individual needs. We found people were provided with appropriate care to meet their needs.

During our inspection we observed a clean environment throughout the home. Relatives we spoke with told us the home was always kept clean and tidy. However, people were not always protected from the risk of infection because some protocols based on current Department of Health guidelines had not been followed.

People told us staff took time to explain what was happening before doing things. During our visit we saw people were asked their consent before they received any care, and staff acted in accordance with their wishes. However, the provider did not have suitable arrangements in place for formally obtaining the consent of people living at the home regarding their care and treatment.

We found the building was well maintained and suitable for people who use the service. We found corridors and fire exits were free of clutter and easily accessible. Necessary checks were completed to ensure the safety of people who use the service and staff.

People's records were accurate and fit for purpose and could be located promptly when requested.

We spoke with the person managing the service on the day of our inspection. The location did not have a registered manager at the time of our inspection. This is a requirement for registration with the CQC. The care home manager told us they had started the application process for becoming a registered manager with the CQC.

We spoke with relatives of people who use the services. They told us they were happy with the services provided and were kept informed, were listened to and given opportunity to give their view of the services provided.

We found staff were knowledgeable of people's specific health and personal care needs and had received training to update their skill and knowledge. Staff told us they felt supported by the provider and management team.

We looked at people's care plans and supporting documents. We found peoples care plans detailed their needs, and how to meet those needs.

The provider had ensured staff received appropriate professional development and support to safeguard and deliver care and support to the people who live in the home.

We found people and their relatives had opportunities to contribute their views about the quality of the service. The provider had systems for monitoring services provided.