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Inspection carried out on 31 January 2018

During a routine inspection

Glenhurst Manor is a care home that provides residential care for up to 36 older people. The home is a large converted property set in spacious well-maintained grounds. 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. At the time of this inspection there were 22 people living at the home.

There was a registered manager in post who had recently been registered with the Commission. The home had been without a registered manager for many months with senior staff acting up into management roles to cover this vacancy. 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.

The inspection was unannounced and took place on 31 January and 2 February 2018 and was carried out by two inspectors on the first day of the inspection and one inspector on the second. This comprehensive inspection was brought forward because of concerns that had been raised about the management of the home and the care people received. The concerns were not substantiated at this inspection.

The registered manager had system in place to maintain and promote safety in the home. Environmental risks had been identified and action taken where appropriate. The delivery of people’s care had also been risk assessed to make this as safe for people as possible.

Staff were recruited in line with robust policies and all the necessary checks had been carried out by close of the inspection.

Medicines were well-managed and people received their medicines as prescribed by their doctor.

Staff had received training in safeguarding and were aware of their responsibility to report concerns.

Staff were supported through indirect and formal supervision as well as an annual performance review.

The home was working collaboratively with health services so that people’s needs were met.

People’s consent was sought and granted with regards to the way they were cared for and supported. Where people could not make specific decisions because they lacked mental capacity, staff were following The Mental Capacity Act 2005 and any decisions made in people’s best interests.

The home provided a good standard of food with people having choice of what they wanted to eat and their individual needs catered for.

Staff were kind, caring and compassionate in their interactions with people.

Care plans were up to date, reviewed and available to staff.

People were provided with individual and communal activities to keep them occupied, although people felt the levels of activities provided had diminished since there had been a vacancy for the role of activities co-ordinator. This post was in the process of being filled.

Complaints were responded to and the procedure was well-publicised.

People were consulted, or their relatives, about wishes and preferences for end of life needs and staff had received training in this field.

Since the last inspection, the registered manager had ceased working at the home and a new manager had taken over management responsibilities. The new manager had continued to implement the action plan and staff felt there was a more open, supportive culture that had improved the morale of staff to the benefit of people living at the home.

There were auditing and monitoring systems being followed seeking overall improvement.

Inspection carried out on 22 January 2016

During a routine inspection

The inspection took place on 22 and 25 January 2016 and was unannounced. Glenhurst Manor provides care and accommodation for up to 36 older people. On the day of the inspection 26 people lived at the home.

The service did not have 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The acting manager was in the process of applying to be the registered manager during the inspection.

People were encouraged and supported to make their own decisions and choices whenever possible in their day to day lives. People’s privacy and dignity was maintained. We observed the staff supporting people with kindness and patience at all times.

People were protected by safe recruitment procedures. Staff were supported with an induction and ongoing training programme to develop their skills and staff competency was assessed. Most people we spoke with felt there were sufficient staff on duty.

People had access to healthcare professionals to make sure they received appropriate care and treatment to meet their health care needs, such as district nurses and doctors. Professionals said the staff followed the guidance they provided. This ensured people received the care they needed to remain safe and well, for example people had regular visits by district nurses to change dressings.

People’s medicines were managed safely. Medicines were managed, stored and disposed of safely. Senior staff administered medicines had received medicines training and confirmed they understood the importance of safe administration and management of medicines.

The manager and staff had sought and acted upon advice when they thought people’s freedom was being restricted. This helped to ensure people’s rights were protected. Applications were made and advice sought to help safeguard people and respect their human rights. The provider was acting in accordance with the Mental Capacity Act 2005.

Staff had undertaken safeguarding training, they displayed a good knowledge of how to report concerns and were able to describe the action they would take to protect people against harm.

People were supported to maintain a healthy, balanced diet. People told us they enjoyed their meals and we observed mealtimes did not feel rushed.

People’s care records were mostly comprehensive and detailed people’s preferences. Records were regularly updated to reflect people’s changing needs. People and their families were involved in the planning of their care.

People’s risks were considered, managed and reviewed to keep people safe. All the people we spoke with told us they felt safe at Glenhurst Manor. Where possible, people had choice and control over their lives and were supported to engage in activities within the home.

People and staff described the manager as being very supportive and approachable. Staff talked positively about their jobs and took pride in their work. Visiting professionals and staff confirmed the manager made themselves available and staff followed their instructions.

People’s opinions were sought formally and informally. Audits were conducted to ensure any concerns with the quality of care or environmental issues were identified promptly. Accidents were investigated and, where there were areas for improvement, these were shared for learning.

Inspection carried out on 1 October 2013

During a routine inspection

People told us they were happy with the quality of care provided. One person told us "I could not fault the staff if I tried". People said they had daily contact with senior staff who always asked them if they were happy with their care. This meant people had an opportunity to raise issues in an informal way. In addition, they told us they had regular resident's meetings where they could raise any issue about their care and support and the facilities at Glenhurst Manor.

Staff received training, regular supervision and appraisals. They told us this ensured they were competent and skilled to be able to meet people's needs. We saw evidence of the training, supervision and appraisals in their personal files. Staff we spoke with were clear about the process to be followed in the evident a person was risk of abuse or abuse suspected. Their files showed they were up to date with the provider's safeguarding policy and that of the local multidisciplinary safeguarding procedures.

Inspection carried out on 29 November 2012

During a routine inspection

We carried out this inspection of Glenhurst Manor on the 29 November 2012. We spoke with the registered manager, four people living at the home, one relative and four members of the staff team.

We saw that some people were relaxed and engaged in different activities of interest to them. People had the opportunity to walk freely around the home.

People�s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care plans were person centred and regularly reviewed.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

The provider had a well developed quality assurance system in place.

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