Glebe House

Updated 8 February 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was undertaken by one inspector and a specialist advisor. Their specialism was in children's mental health, safeguarding and crisis teams.

Service and service type

This service provides independent healthcare and support for younger people. It provides the regulated activity of treatment of disease, disorder or injury. Accommodation is provided and regulated by OFSTED.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced. This meant the provider did not know when we would be inspecting.

Inspection activity started on 23 January 2020 and ended on 28 January 2020. We visited the office location on 23 January 2020.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included notifications about various incidents the provider must tell us about. We sought feedback from the local authority and professionals who work with the service. The provider sent us their provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people and two relatives of people who used the service about their experience of the care provided. We spoke with a visiting social worker and a member of the youth offender’s team. We spoke with the registered manager who is also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with seven staff including the deputy head of care, the clinical director, a quality manager, recruitment and training coordinators, and three support workers.

We reviewed a range of records. This included two people’s care records and three people's medication records. We looked at one new staff recruitment file and records relating to the training and supervision of staff. A variety of records relating to the management of the service, including complaints, audits, accident and incident records were also reviewed.

Updated 8 February 2020

About the service

Glebe House is an independent healthcare service providing rehabilitation therapies and support to up to 11 younger people. Accommodation and support with eating, drinking and education for all 11 people is provided under OFSTED registration and regulation.

For Glebe House's Care Quality Commission registration, the service supports younger people who may live with a learning disability, autistic spectrum disorder, or mental health needs. At the time of our inspection all 11 people were being supported with rehabilitation and therapies. These included work experience, music and art as well as learning to drive and theatrical performances.

People’s experience of using this service and what we found.

Sufficient staff were recruited safely and deployed in a way which kept people safe. Staff implemented their knowledge of hygiene and safeguarding systems well. Risks were identified and managed. One person told us, "I keep my self clean. Staff wash their hands before giving me my [medicines]." Sufficient staff supported people with their rehabilitation. Lessons were learned when things did not go quite so well.

People's assessed needs were met by staff with appropriate skills and whose induction, supervision and training was kept up-to-date. The provider worked well with professionals involved in people's care, we found people benefitted from this. People prepared their own meals and drank enough. Staff enabled people to access healthcare and support services. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported support this practice.

People's care was kind, dignified and staff were thoughtful about how they did this. Staff respected people's privacy and upheld their confidentiality. People who needed support from an advocate were given this. People had a say in developing their care and how it was provided. People used advocacy support, and this helped them to have actions in relation to their views about their care.

People's care was person centred and based on what mattered and what was important to them. People's lives were transformed to enable them to achieve their dreams, which some relatives and professionals??? did not previously think were possible. One person said that the difference to their life had been, "Tremendous". Relatives praised the service for its achievement which one relative told us had been, “A struggle but [staff never gave up. It is incredible what they have done.” Systems and procedures were in place to support people with end of life care and in an emergency situation.

The registered manager was aware of their responsibilities and made improvements when needed. The registered manager had fostered an open and honest staff team culture, staff felt supported. People, relatives and staff had a say in how the service was run. Quality assurance, audits and governance were effective in identifying and driving improvements. The provider worked well with others to provide people with joined up care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection.

The last rating for this service was requires improvement (published 2 January 2019) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous inspection rating.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.