We carried out a review of the data available to us about Glenister Gardens on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Glenister Gardens, you can give feedback on this service.
About the service
Glenister Gardens is a supported living service for up to 11 people with learning disabilities and/or autism. At the time of the inspection, 9 people were living at the service. People had their own flats and tenancies. The Guinness Partnership Ltd provided housing support and CCS Homecare Services Limited provided care and support to people using the service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
We found the service was not always able to demonstrate how they were meeting the underpinning principles of right support, right care and right culture.
Right Support
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Medicines were not always managed safely.
We recommended the provider consistently applies the principles of the Mental Capacity Act 2005.
We also recommended the provider considers current guidance on infection prevention and control and take action to update their practice accordingly.
People were supported by staff to take part in activities and pursue their interests in their local area. People had a choice about their living environment and were able to personalise their rooms. Staff enabled people to access specialist health and social care support in the community. Staff communicated with people in ways that met their needs.
Right Care
We found risk assessments were not always in place or followed. Staff understood how to protect people from poor care and abuse and the service worked with other agencies to do so. People received kind care. Staff protected and respected people’s privacy and dignity. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People who had individual ways of communicating, using body language, sounds, pictures and symbols could interact comfortably with staff. People were supported to access healthcare services.
Right Culture
The provider had systems to evaluate the quality of the service being delivered, but these were not always effective as they had not found concerns identified during the inspection. Staff knew and understood people well and were responsive. People and those important to them were involved in planning their care. Staff were supported through supervision and training and told us they felt supported by the registered manager.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 24 October 2017).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We have identified breaches in relation to safe care, including medicines management, need for consent and good governance at this inspection.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Glenister Gardens is a supported living service for adults with learning disabilities. The service supports people with a range of day to day tasks including personal care, medicines administration, meal preparation and accessing the community.
People had their own flats and tenancies. Paradigm Housing provided housing support and CCS Homecare Services Limited provided care and support to people using the service. At the time of the inspection there were 12 people being supported by the service, nine of whom required support with personal care.
The service 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.
Staff we spoke with knew how to respond to safeguarding concerns. They had the relevant training and supervision to develop the necessary skills to support people using the service and there were sufficient numbers of staff on duty to meet people’s needs.
People had risk assessments and management plans in place to minimise risks and any incidents and accidents were recorded appropriately.
Medicines were administered and managed safely.
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’s dietary requirements were met and we saw evidence that relevant health care professionals were involved to maintain people’s health and wellbeing.
People, and their families where appropriate, were involved in their care plans and making day to day decisions. People told us they had developed positive relationships with staff. The service arranged regular activities for people but feedback from relatives indicated they would like more community based activities for people using the service.
People using the service, staff and most relatives said the team leader was accessible and responded to concerns.
The service had a number of systems in place to monitor, manage and improve service delivery. This included a complaints system, service audits and satisfaction surveys.
Glenister Gardens is a supported living service for adults with learning disabilities with a range of needs. The provider offers care and support to people who require help with day to day routines including personal care, meal preparation, housework, accessing the community and companionship. People using the service live in their own flats and each person has a tenancy agreement with the landlord. There is one communal room on the ground floor. The service has care workers on duty at all times. At the time of our inspection there were seven people receiving personal care.
The service is required to have a registered manager. 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 area manager had submitted an application to CQC to register as the manager of the service.
The majority of risks were assessed and action plans put in place to minimise them. However, risk assessments in relation to the environment were not carried out comprehensively to minimise the risk people faced such as the risk of falling from a height.
Staff understood medicines management procedures and provided the support people required to take their medicines safely. However, discrepancies in the medicines stock recording had not been identified so action had not been taken to address this. PRN (as required) procedures were not robust enough to clarify when PRN medicines should be given.
Staff understood and respected people’s rights to make choices about their care and knew to act in their best interests but the service did not fully understand the principle around depriving people of their liberty. We have made a recommendation that the provider review guidance in relation to the Mental Capacity Act (2005) for people living in their own homes.
Although the provider had comprehensive monitoring systems in place, some aspects of the service were not being monitored effectively so shortfalls were not always identified and addressed in a timely way.
Procedures were in place and being followed by staff to safeguard people against the risk of abuse.
Staff recruitment procedures were in place and being followed. There were enough staff to meet the needs of people using the service. Staff received training and supervision so they had the knowledge and skills to provide the care and support people required.
People were supported with eating and drinking to maintain their nutritional intake. Staff recognised changes in people’s healthcare needs and knew the processes to follow so people received the input from healthcare professionals that they needed.
People told us staff were caring and treated them with dignity and respect. Staff shadowing procedures did not always ensure that people’s privacy was adequately maintained.
Care records reflected people’s individual needs and wishes and staff understood these and cared for them in a person-centred way.
People’s care and support was planned and reviewed when any changes were identified so people’s needs continued to be met.
Procedures for raising complaints were in place and were followed. Complaints were recorded and responded to, however relatives did not always feel improvements were consistently maintained.
The majority of people were happy with the way the service was being managed. Staff found the team leader and area manager to be supportive and approachable. Meetings with relatives and people were to take place to improve communication and address any issues raised.
We found breaches of one 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.