Glendale Court

We found the following examples of good practice.

¿ Two indoor and three outdoor spaces had been adapted to allow visiting to happen safely. This included the installation of Perspex screens to create visiting ‘booths’ indoors. People were able to book visits at a time that suited them, and choose which space they preferred.

¿Routes of entry and exit to visiting spaces ensured social distancing was maintained.

¿The Registered Manager suspended admissions to the service until they could assure themselves that the risks to people already living in the service were reduced. Admissions only resumed once people were able to be tested for Covid-19 before moving to the service.

¿The Registered Manager and Deputy Manager demonstrated strong leadership and clear expectations of the standards they expected staff to maintain with regards to Personal Protective Equipment and routine testing.

¿The Providers had invested in specialist equipment to sterilise and disinfect the environment.

¿Proactive measures had been taken to prepare for any increase in Covid-19 infections in the local community. This included employing additional staff, moving the laundry to an external building and purchasing specialist equipment.

Further information is in the detailed findings below.

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

People told us they were happy and safe living at Glendale Court. People felt that staff were kind, caring and their needs were met daily.

Staff promoted people’s privacy and dignity and their choices were respected. Care and support were delivered in a personalised way by staff who knew people’s likes, dislikes and preferences.

People were supported to take their medicines safely. However, medicines storage did not meet best practice guidelines. We made a recommendation to the provider about this.

People's needs, and choices were assessed, and their care and support delivered to achieve effective outcomes. Care plans provided staff with information and guidance about how to meet people's needs in the way they preferred. Risk assessments covered areas such as, moving and handling, falls, nutrition and hydration. Not all care plans were as detailed as they could be. We made recommendation to the provider about this.

People lived in a home that kept them safe. Staff had been recruited safely and had received training on how to recognise and report abuse. There were sufficient staff to meet people's needs in a timely manner and ensure that care was person centred.

Staff were supervised, supported and clear about what was expected of them. People's care was provided in line with best practice. People were cared for by staff who received regular training that was tailored to meet the needs of the people living in the service.

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 this practice.

People’s independence was promoted. There were areas in the home where people could meet, socialise and form friendships with each other and staff working in the home. People had the choice to engage in a variety of activities if they wished. People were supported with their dietary needs.

The environment had a homely feel and was clean and welcoming. Staff used effective infection control measures to protect people from the risk of infections.

People, relatives and staff told us the home was well led. The provider had systems and procedures to monitor and assess the quality and safety of the home. People's and relatives' views were sought, and opportunities taken to improve the home. Audits were used to assess standards and drive up improvements. Accidents and incidents were recorded and reviewed, so any problem could be identified and rectified.

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 good (published 1 December 2016).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: 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.

One of the registered providers also held the position of the home’s 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.

The inspection took place on 17 and 20 October 2016 and was unannounced. This was the home’s first inspection since a change of provider registration to Glendale Court (Teignmouth) Limited, although the owners of the service had remained unchanged.

The home was clean and well maintained with no unpleasant odours in any of the bedrooms or communal areas. It was homely and warm throughout with plenty of space for people to use, including lounges, dining rooms and conservatories. The garden area was well maintained and accessible to people using wheelchairs. It included seating areas and raised beds for people to be able to assist with gardening if this was an activity they enjoyed.

People spoke highly of the care they received. They told us the staff were always caring and friendly. Comments included “the staff are excellent” and, “the girls couldn’t be kinder”. One person referred to night staff as “night staff night angels”. The atmosphere in the home was warm and welcoming and we heard pleasant conversations and laughter between people and staff throughout the inspection. Visitors came and went all day and were made welcome by staff. One relative who was visiting said, “It’s a brilliant place. Managers, staff, everything. I cannot fault anything. I feel part of their family, totally involved. It really is gold standard care”.

People told us they felt safe at Glendale: one person said, “It’s absolutely safe. They’ve been marvellous here. I can’t fault them”. Another said the attention of staff made them feel “Very safe, very good”. Staff had received training in safeguarding adults and there was clear information available on what to do in case of a concern. Staff understood about people’s rights to make decisions and felt confident that if they had any concerns these would be acted upon. Robust recruitment procedures were in place to ensure suitable staff were employed.

People said there were always enough staff on duty to meet their needs. We saw staff had the time they needed to provide care in an unhurried manner and had time to spend talking with people. People told us they had confidence in the staff and spoke positively about the care they received. One person said “I’m being very well looked after. It’s wonderful here” and another said “staff are very good. They know me very well”.

Care plans showed each person had been assessed before they moved into the home and any potential risks were identified. Where risks were identified there were detailed measures in place to reduce these where possible. Where necessary staff had consulted with healthcare professionals for guidance on how to support people safely. Care files included a summary of people’s care needs and more detailed information where specific care needs had been identified. Care plans were regularly reviewed to make sure they accurately reflected people’s changing needs and to ensure staff had up to date guidance about how to provide care.

People told us they liked the food and had a good choice available to them. One person said “Yes, there is a good choice of food…I can’t fault it. If you say you don’t like anything they’ll get you something different. They all listen to what you say”. Another commented, “The food is marvellous”. People confirmed they were able to continue with their interests and hobbies and were free to come and go from the home as they pleased. The registered manager told us they encouraged people to try new activities and to have a fulfilling life.

We observed medicines being administered and this was done safely and unhurriedly. Medicines were stored safely and only senior staff and the registered manager and deputy manager had responsibility for checking stocks, reordering and returning medicines to the pharmacy.

Documentation within people’s records did not follow the clear guidance set out in the Mental Capacity Act (MCA) Code of Practice regarding how people’s mental capacity should be assessed. Standard templates were used to assess people’s mental capacity and these were not specific or detailed in relation to the individual person or the decision that was being considered. However, when we spoke with staff and the registered manager we found they had a good understanding of the principles of the MCA and how to make sure people had their legal rights protected. This meant there was no negative impact for people. We spoke with the registered manager about this. They gave assurance they would seek further training and review records to ensure processes used for assessing and recording people’s capacity and best interest decisions were in line with legal guidance. On the second day of the inspection we saw additional training had been booked and work had started on reviewing records.

People benefitted from strong working partnerships between local healthcare professionals and the service. Health and social care professionals were confident that the service cared for people competently and was well led. They said the service had a strong and effective working partnership with the local GP surgery and community nursing service. One community nurse told us people living at Glendale “thrived” and they knew any advice they gave would be closely followed by the manager, deputy and staff.

People, relatives, staff and healthcare professionals all expressed a high level of confidence in the leadership of the home and integrity of the registered manager. Comments included “It’s so well run here. I can’t think of anything I would change or would improve it” and “Everything about the home is excellent” and “They have a good person in charge here”.

Staff confirmed there were clear lines of responsibility within the management structure and they knew who they needed to go to, to get the help and support they required. They described themselves as a happy and motivated team, benefitting from the strong leadership and support of the registered manager. Comments included, “I can’t fault [name of manager]. She’s the best manager I could wish for. She’s very hands on and she’ll help on the floor anytime, morning, noon or night. And she cares about us staff too”.

The registered manager and deputy manager were passionate about providing high quality care for people. The culture of the home was that people were at the heart of the service and their views about how the service was run were regularly sought. There was a policy in place for dealing with any concerns or complaints and this was made available to people and their families. People and relatives were all confident they could speak with the registered manager if they had any concerns or wished to make a complaint. However, they had not needed to as they were very happy with the care and support they received.

There were thorough systems in place for managing information relating to the running of the home. This helped monitor the quality of care and drive improvement. The registered providers undertook regular health and safety audits to ensure people’s safety and that the environment was well maintained and suited to the people living in the home. There was an ongoing programme of improvement and investment in the home. At the time we inspected surveillance cameras were about to be installed to increase security around the outside and grounds of the home.