Background to this inspection
Updated
22 December 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. This inspection took place on 27 and 28 September 2016 and was unannounced.
The inspection was undertaken by an adult care inspector, a nurse and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
As part of the inspection we spoke with 11 people living in The Glen, three relatives, two care professionals and nine members of staff. Before the inspection we reviewed all the information we held about the service included incidents and events we had been advised about as part of the provider's notification responsibilities. As part of the inspection we looked at care planning records for nine people, quality assurance monitoring audits, minutes of staff and "residents" meetings and other information about the service. We reviewed previous inspection reports. We looked at the Provider Information Return (PIR) prior to this inspection. The PIR is a form that asks the provider to give some key information about the service, what the service does well and the improvements they plan to make.
Updated
22 December 2016
This inspection took place on 27 and 28 September 2016 and was unannounced. The Glen provides nursing and personal care and accommodation for up to 59 people. At the time of our inspection there were 46 people using the service of whom 28 required nursing care.
There is a registered manager in post. 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 registered manager had, as required, made applications under the Mental Capacity Act 2005 and obtained an authorisation under Deprivation of Liberty Safeguards (DoLS) arrangements. However, there needed to be improvements in the process and recording when making best interests decisions where people lacked capacity to make decisions for themselves. The service protected people's rights by seeking consent for care and use of certain equipment.
People felt safe living in the home. One person saying "I feel comfortable with staff they make me feel safe." A relative told us they felt staff looked after their relative well and always "Leave here knowing they are safe." Staff demonstrated their knowledge of abuse and responsibilities to report any concerns about possible abuse. Importantly staff were confident the registered manager would act to protect people if told of any such concerns.
People told us staffing arrangements were good and how staff were available and responsive to their requests for assistance and support. There were consistent numbers of staff on duty. Recruitment arrangements ensured employees had the necessary experience and were suitable to work in a care home setting.
People told us they felt confident about staff having the necessary skills and training. One person told us "The carers are good and really know what they are doing and I can depend on them for anything."
People had access to community health services and their GPs when this was requested. Healthcare professionals we spoke with were positive about the care provided by the service. There were good relationships with outside professionals and people had access to specialist support and advice.
People told us they enjoyed the varied menu and always had a choice of meals. One person said "The food is good and I always enjoy my meal." The service ensured people's nutritional needs were met and took action to address any concerns about people physical wellbeing and ensure they were able to have a healthy diet suited to their needs.
People spoke of respectful staff who recognised their right to privacy and upheld their dignity. People and relatives spoke of caring, courteous, professional and friendly staff. One person told us "I always feel staff treat me with respect and speak to me how I like to be spoken to." and another person said "They (staff) treat us with respect and dignity." A healthcare professional told us they found staff "All very caring and friendly and welcoming."
People told us they felt able to have control over their daily routines and what they wanted to do each day. One person spoke of how they chose to remain in their room and this was respected by staff. Others told us how they could choose to get up and go to bed when they wished. One person said "It is very good I get to say what I want to do and when." Where people had complex or need for more specialised care plans reflected people's needs so care could be provided in a person centred way. Staff knew people's routines, likes and dislikes and how they liked care to be given.
There was a welcoming environment where people were able to maintain their relationships with family and friends. People and relatives told us there were no restrictions on visiting.
People felt able to voice their views or concerns about the service. There were regular meetings where people living in the home and their relatives were kept informed about the service and people could give feedback about the quality of care provided in the home.
There were a range of quality assurance audits which had identified areas for improvement. A home improvement plan demonstrated how these had been actioned.
People and staff spoke of a registered manager who was approachable and made themselves available to people on a daily basis through walking around the home. This was commented on by people we spoke with. One person told "She is always about which is nice because you can have a chat with her about anything if you want."