Archived: Gleavewood Residential Care Home

The service is located in the town of Weaverham and is registered to provide accommodation for up to 30 people who require personal care. The service is run by a not-for-profit organisation who also own a number of other services throughout the north-west of England.

There was a registered manager in post who had been registered with the CQC since 2010. 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.

Staff had received the training they required to carry out their role effectively, however they were not always aware of their roles and responsibilities in relation to the Mental Capacity Act 2005. We have made a recommendation around staff training in this.

There were sufficient numbers of staff to meet people’s needs. The registered manager had referred to the local authority for support with finding alternative placements for people whose dependency needs had become too high for them to manage. This was because this was impacting upon the time staff had to spend with people using the service. Following the inspection we were informed that alternative placements had been found, which had impacted positively upon pressures on staff.

There were risk assessments in place which provided staff with relevant and up-to-date information around how to keep people safe. Action had been taken to refer people on to relevant health or social care professionals where required, and assistive technology was in place to support with keeping people safe. Environmental checks were completed on a regular basis to ensure the environment was safe.

People were supported to take their medication as prescribed. Medication administration records (MARs) were filled out by staff to demonstrate when medicines had been given. These were stored securely in people rooms.

Care records contained personalised information around people’s likes, dislikes and their preferred daily routine. Information contained within care records was reviewed on a regular basis which ensured that staff had access to relevant and up-to-date information. This helped ensured that people were provided with care and support that was suitable to meet their needs.

People were protected from the risk of malnutrition and dehydration. People were provided with food and drink options that were suitable for them, for example soft foods, or syrup thick fluids. A choice of options was available at meal times, and where people did not like these options they could request something different. Staff provided people with support to eat and drink where required.

People told us that staff were respectful and kind towards them. Staff maintained people’s dignity by ensuring that doors were closed during personal care interventions, and told us that they were mindful of making people feel at ease whilst supporting them. This ensured that people’s dignity and respect were maintained.

No complaints had been received by the service over the past 12 months however people were aware of the complaints process, and told us that they felt confident that the registered manager would respond to any concerns. The registered provider sought feedback from people on an annual basis. The results from the 2015 survey showed that people felt positive about the service being provided.

People and staff spoke positively about the registered manager and described her as “approachable”. The registered manager completed audits of the service being provided, which included care records and night times checks. Information around accidents and incidents was submitted to the registered provider on a monthly basis so that they could ensure appropriate actions had been taken to keep people safe.

During the inspection we spoke with the registered manager, the home services manager, and three staff members. We also spoke with six of the people who lived in the home and two of their relatives.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

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

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff we spoke with had a good understanding of the process they would follow if a safeguarding incident occurred. They were able to describe various types of abuse and each member of the care staff we spoke with showed an understanding of their responsibilities when caring for vulnerable adults. Staff also demonstrated a clear understanding of whistle blowing and what they would do if they had concerns about the conduct of a staff member. Staff told us that they had received training in protecting vulnerable adults. The registered manager showed us records to demonstrate that all staff had received Safeguarding Adults training and also took part in yearly e-learning to ensure that their knowledge and understanding was kept up to date. We saw that this had recently taken place for all of the staff.

We asked the care team leader about the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). They demonstrated that they had a good understanding of the requirements and how to access support for people who had difficulty in making their own complex decisions. They showed us evidence in care files that mental capacity assessments and best interests meetings had been held in conjunction with other professionals and relatives when they had been required.

Is the service effective?

We looked at five care plans. The records we observed were clear and contained all the information required to meet individual needs. The care plans were person centred and written from the perspective of the person. We saw that future life plans had been made by the people who lived in the home and how they wished to be cared for in the future had been recorded. We saw that all the care plans were reviewed every month and that any changes were recorded.

Is the service caring?

During our inspection we spoke to six people who lived in the home. They all told us that they liked living in the home. Comments we received included; "Staff here are lovely. They help me in the way I like" and "The staff are pretty good. One or two are a bit dodgy but I soon tell them and they do things my way." During our visit we saw that staff asked people who lived in the home for their permission prior to carrying out any tasks. We saw that staff were respectful and treated people with dignity. Some people had made the decision to stay in their bedrooms and the staff were making sure that their needs were met and that they were not forgotten about.

We observed that relationships between staff and people who lived in the home were warm and friendly and we saw that people were relaxed in the company of staff. We saw groups of people chatting to staff in a calm and friendly atmosphere and making jokes with each other. We saw that the staff were skilled in supporting people who had dementia whilst encouraging them to maintain their independence. We saw that lots of people were singing along to the music playing in a lounge area and that staff were joining in.

Is the service responsive?

We attended a resident's meeting that was taking place during the morning of our visit. We saw that the meeting was well attended and many people felt comfortable sharing their points of view. The people who lived in the home told us that they had resident's meetings on a regular basis. They said that these were informal but that it gave them the opportunity to raise any concerns or issues and have them dealt with. They also said that they discussed the activities that were due to take place and could make requests for alternative activities. We saw that up and coming events were discussed in the meeting to give people time to decide if they wished to attend. We looked at the minutes for these meetings and saw that issues raised were dealt with and feedback given at the following meeting.

Is the service well led?

We asked about audits and the registered manager showed us the provider's yearly plan for audits that the registered manager completed on a monthly basis. We saw that audits had been completed in health and safety, infection control and medication administration. We saw that issued raised had been dealt with. We also saw that a 'Marvellous Mealtimes' audit was completed every other month. This had focused on the dining experience for people living in the home and focussed on improving standards.

We saw evidence that the registered manager and two other members of staff had recently completed a 'Six Steps to Success End of Life Programme'. The registered manager told us that this was to improve the care that they could offer to people living in the home at all stages of their lives.

We spoke with six people who used the service, two relatives, three staff and two professionals involved in the service. People who used the service said: “The staff are nice here”, “The food is good” and “I am well cared for.”

Relatives commented: “The home is clean and the staff are friendly and helpful”, “Mum is very happy with the staff” and “The staff cater for my relatives needs well.” All the people spoken with said they didn’t have any concerns or complaints.

Staff commented: “The staff work well as a team”, “The training is good”, “The staff help each other out”, “We have regular meetings” and “I get really good support from the management team.”

Other professionals said: “The home is very nice”, “The manager is very approachable”, “It’s a bright, airy home and the bedrooms are nice” and “The staff care about people here.” They both said that they had no issues or concerns with the service.

We looked at the rotas and staffing levels at the home and discussed staffing issues with the manager.

We observed interactions between the people who used the service and staff during the day and found there was a relaxed and friendly atmosphere between them.

During a tour of the building we found it was clean and odour free.

We spoke to five people who used the service. They said they were well looked after and happy with the service received.

Information provided by health and social care professionals indicated that a good service was provided.

A tour of the home indicated that the service was clean and well presented.

Records showed that people had been assessed before they began to use the service and they had a care plan in place detailing the support they needed and how staff were to minimise risks to their well-being.

There were practices in place to ensure that the recruitment of staff appropriately supported the people who used the service.

There were systems in place to monitor the quality of the service. This included having a number of ways in which the people who used the service and their relatives could make their views known about how the service operated.

We asked LINKs* and Cheshire West and Chester Council for information about how the service operated. LINKs had undertaken a recent visit and found the home to be of a good standard. They made some observations of the home environment and were awaiting feedback from the manager regarding their findings. No information of concern was reported by Cheshire West and Chester Council.

* LINKs are an independent body that have an interest in improving health and social care services.