We looked at the personal care or treatment records of people who use the service, carried out a visit on 11 September 2014 , observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and /or family members and talked with staff.We considered all the evidence we had gathered under the outcomes we inspected. We used information to answer the five questions we always ask:
Is the service safe?
Is the service effective?
Is the service caring?
Is the service effective?
Is the service well-led?
This is the summary of what we found:
On the day of our inspection at Glastonbury Care Home there were 60 people living there. We spoke to 10 people living at the home , three relatives and 14 members of staff.
Is the service safe?
We observed people were cared for in a environment that was safe, clean and hygienic. Ten people were able to tell us they "trusted" the staff and were "well cared" for living at the home. People told us staff were always kind and respectful to them. We noted appropriate safeguarding arrangements were in place in the form of safeguarding and whistleblowing policies. All staff had attended training in the Mental Capacity Act 2005 and Deprivation of Liberties. We saw evidence of this in staff files.
CQC monitors the operation of Deprivation of Liberties which applies to care homes. We noted one application had been submitted by the home in line with the proper policies and procedures. The registered manager was on call in case of emergencies. We noted staff records were accurate and complete. We saw evidence that staff had the experience and skills needed to support people in their care at the home. We observed emergency procedures were in place in the event of a fire. We noted fire evacuation training was up to date and documented in staff files.
Is the service effective?
We found the service was effective in meeting people's needs. We observed staff at Glastonbury Care Home interacted well with people. Staff told us "We know people really well and understand each persons needs and their preferred style of communication. We read all the people's care plans and make sure they have the care and support they need". We were told the home had recently received Beacon Status, a top national award for outstanding care to people nearing the end of their lives. One person told us "The home is really good and the staff are so kind. This is my home and we are always treated as individuals here".
Is the service caring?
People told us "It is just wonderful here". One person said "It is the best thing I have ever done coming here. I choose what I want to do and when I want to do it. There are lots of activities and I really like going out in the mini bus". We reviewed five care plans and noted each care plan contained a comprehensive assessment of each person's care and support needs. We spoke to a district nurse who said "The care planning documentation has improved over the last year and I can always find the information I need to complete my assessments". A relative told us "Everyone was so kind and helpful when my family member came to live in the home. The staff have always involved me in the planning of my relatives care and I know I can talk to staff at any time of the day or night". We spoke to another family member who told us "I visit frequently and I am always reassured at how well cared for my family member is".
Is the service responsive?
The registered manager told us it was essential to the care and well being of people living at the home to be responsive to their care and support needs. We noted the home supported people to be as independent as they were able to. We noted there was a wide variety of activities to support people's independence. People's ability to be involved was assessed daily and people were encouraged to choose how they spent their time. One person said "I really enjoy the activities and I ask the staff to remind me each day of what activities are planned so I can decide what I want to do". We observed people were offered choices of what they wanted to eat and drink, where they wanted to sit and if they wanted to participate in activities. We noted staff always respected the choices people made.
Is the service well-led?
The registered manager told us that since the last inspection in December 2013 there had been a number of changes at the home. Nursing care had been provided in three of the four houses, but was now provided across the home from 1st September 2014. The registered manager and the provider had increased the staffing levels and enhanced the nursing skills to meet the changing needs of the service. The additional staff had been appointed and would shortly be taking up post following the completion of their six week induction programme. We observed staff had a good understanding of the ethos of the home. Staff demonstrated throughout the visit that people were encouraged to live full and independent lives within the limitations of their medical condition. We reviewed the feedback from the quality assurance surveys completed by people at the home and their relatives. We noted people had commented favourable on the care and support and management of the service. We noted staff received regular supervision and appraisal and in-service training. This was recorded in staff files and in the central training records held by the registered manager. This demonstrated staff were supported to give quality care to people at the home.