Gloscare

Gloscare has been developed and designed in line with the values that underpin the Registering the Right Support, Building the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

This inspection took place on 24 January 2018. At the last comprehensive inspection in October 2015 the service was rated as Good overall.

At this inspection we found the service remained Good.

People received highly individualised care and support which reflected their aspirations, hopes and routines so important to them. Staff understood them really well, anticipating their feelings and emotions, helping them to make the most of each day as calmly as possible. People’s needs had been assessed and they were involved in developing their care and support with staff. If they wanted to change any aspects of this, it was discussed with staff and care records were updated. 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.

People were encouraged to be as independent as possible. They had developed the confidence to do as much as they could for themselves. People felt safe living in the home and accessing their community with staff support. They enjoyed a wide range of activities which reflected their hobbies and lifestyle choices. One person proudly attended a nursery to attend to their allotment without staff support. They attended social clubs, swimming, bowling and a church service. Contact with friends and family was important and being maintained.

People were supported to stay healthy and well. They chose their weekly menus which were served with portions of fresh vegetables and salad. They helped themselves to drinks and fruit. Each person had a health action plan which described their health care needs. They had annual check-ups with their GP and regular reviews with another specialist healthcare professional. People’s medicines were managed safely.

People had access to sufficient staff to meet their needs who had been through a satisfactory recruitment process. Staff felt supported in their roles and had access to refresher training to keep their knowledge and skills up to date. Staff were knowledgeable about people, their backgrounds and individual needs. They treated people with respect and sensitivity, anticipating their moods and emotions. They had worked together well as a team for a number of years and this consistency had benefited the people they supported. Staff understood how to keep people safe and were confident any concerns they raised would be listened to and the appropriate action taken in response.

People’s views and the opinions of their relatives and staff were sought to make improvements to the service provided. People met formally each month to talk about their needs and any concerns they might have. They also talked with staff daily about any issues which were dealt with as they arose. Annual surveys had been completed with evidence of positive feedback from relatives. The provider and registered manager worked as part of the team enabling them to lead by example and to also ensure their values were embedded in people’s experience of their care. People told us, “This is the best home I have ever lived in; it’s excellent” and “This is where we are comfortable.”

There was 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.

We carried out an announced comprehensive inspection of this service on 2 December 2015. A breach of legal requirements was found. After the comprehensive inspection the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook this focused inspection to check that they had followed their plan and to confirm they now met legal requirements in relation to a breach of regulation 13. This report only covers our findings in relation to this requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Gloscare on our website at www.cqc.org.uk”

At the comprehensive inspection of this service on 2 December 2015 a breach of legal requirements was found. After this comprehensive inspection, we asked the provider to take action to:

• ensure that people who had been deprived of their liberty had the appropriate authorisations in place.

At this inspection we found action had been taken to submit the appropriate authorisation to the supervisory body for people who were unable to make decisions about their care and support and whose liberty had been restricted. There was evidence that wherever possible the least restrictive solution was found.

People had a bedroom which they had personalised. They also had access to a shared bathroom as well as living and dining areas.

Gloscare had a registered manager. 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.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

People who had been deprived of their liberty to keep them safe did not have the authorisations in place as required by law.

People’s needs had been assessed and their care records continued to reflect their changing needs. People and those important to them were involved in the review of their care. People had access to easy to read information which used photographs and pictures to illustrate the text. People said they were asked for their opinions about the care and support they received. Their care and their care records reflected their wishes, aspirations and routines which were important to them. People enjoyed a busy lifestyle taking part in activities they chose such as swimming, the gym, social clubs and college. They helped around their home with the chores and gardening. They chose what to eat and drink and helped themselves to drinks and snacks when they wanted them. People were supported to stay well, with staff working closely with health care professionals when people were poorly.

People were supported by staff who had the opportunity to maintain their skills and knowledge. The staff team had few changes and worked well together providing consistency and continuity of care. When new staff were appointed, the necessary checks had been completed to make sure they could safely work with people. Staff had a good understanding of people’s needs, how to keep them safe and protect them from harm.

People had a positive relationship with staff, the registered manager and provider. They were asked for their views about the service provided and changes to their needs were responded to appropriately. The quality of people’s experiences were monitored by the registered manager and the provider and external organisations. A person commented, “It’s the best home I have ever been”.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and looking at records.

Is the service safe?

People were treated with respect and dignity by the staff.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints and concerns. This reduced the risks to people and helped the service to continually improve.

The home had proper policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. The manager understood when an application should be made, and how to submit one. We found the home to be meeting the requirements of the Deprivation of Liberty Safeguards. People's human rights were therefore properly recognised, respected and promoted.

The service was safe, clean and hygienic. Equipment was well maintained and tested regularly therefore not putting people at risk.

Is the service effective?

Each of the people using the service had an advocate; this meant that when required people could access additional support. People's health and care needs were assessed with them; specialist needs had been identified where required.

Hospital assessments and health action plans were in place. We saw that staff had a good rapport with people who use the service and staff told us they would be able to explain any transfer processes to them.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.

People using the service completed monthly questionnaires when they were asked if there was anything they were unhappy about.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People's needs had been assessed before they moved into the home. People had a monthly meeting with their key workers to discuss what was important to them. People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

Is the service well-led?

The service worked with other agencies and services to make sure people received their care in a joined up way.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home.

We saw that support plans were regularly audited. Support plans we saw during our inspection had all been up dated to reflect changes in need and preferences. Staff completed dignity and respect training to ensure that care was provided in a respectful and flexible way.

We observed excellent interactions between staff and people who used the service. One member of staff was observed to remind one person who used the service of appropriate ways of behaving. This was clearly documented in their care plan. It was communicated to the person in a caring and sensitive way.

During our visit we observed the home to be clean and free from offensive odours. We looked at training records for staff. These showed us that all staff had received training on infection control. The home was well staffed. The manager told us they had never received any complaints, but a complaints policy was in place should any arise.

We spoke to one person who used the service and they told us "it's excellent here, the staff help me all the time and I have lots of things to do".

We looked at the care files for the two people use the service. These files were comprehensive and up to date. Both people had individual person centred care plans and risk assessments that were appropriate and reviewed regularly.The staff interaction with the people was excellent and they knew the individual peoples needs very well. Both people were encouraged to do as much for themselves as possible to maintain and improve their independence. Staff supported people in a range of activities and during our inspection people were preparing for a zumba (Latin inspired dance fitness programme) session. Both people were looking forward to this and to the pub lunch afterwards.