Background to this inspection
Updated
21 April 2018
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 was 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 31 January 2018 and was unannounced. The inspection was carried out by two inspectors.
Before the inspection we reviewed the evidence we had about the service. This included any notifications of significant events, such as serious injuries or safeguarding referrals. Notifications are information about important events which the provider is required to send us by law. The provider had returned a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR before our inspection to ensure we addressed any areas of concern.
During the inspection we spoke with seven people who lived at the home. We also observed the care and support people received from staff. We spoke with the registered manager, the deputy manager, a registered nurse, three care assistants and the chef. We looked at the care records of three people, including their assessments, care plans and risk assessments. We looked at how medicines were managed and the records relating to this. We looked at four staff recruitment files and other records relating to staff support and training. We also checked records used to monitor the service, including the provider’s quality assurance reports and audits.
After the inspection we received feedback from a relative by email.
Our last inspection of the home was on 18 September 2015 when we identified no concerns.
Updated
21 April 2018
Glebe House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Glebe House accommodates a maximum of 24 older people in one adapted building. There were 22 people living at the home at the time of our inspection. The home is owned and operated by Surrey Rest Homes Ltd. The provider has four registered care homes providing a total of 124 beds.
This inspection was carried out on 31 January 2018 and was unannounced.
The home 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. The registered manager was also responsible for managing another of the provider’s registered care homes, Heath Lodge. At the time of this inspection Heath Lodge Care Home was rated Good.
Rating at last inspection
At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Why the service is rated Good
People were safe because staff understood any risks involved in their care and took action to minimise these risks. There were enough staff on each shift to keep people safe and meet their needs. Staff understood their roles in keeping people safe and protecting them from abuse.
The provider carried out appropriate pre-employment checks before staff started work. There was a business continuity plan to ensure people would continue to receive care in the event of an emergency. Accidents and incidents were recorded and reviewed to ensure any measures that could prevent a recurrence had been implemented. Staff maintained a safe environment, including appropriate standards of fire safety. Medicines were managed safely. People were protected from the risk of infection.
People’s experience of living at the home would be enhanced by improvements to their environment. The home was clean and tidy but the décor in some areas was faded and the environment had not been adapted to meet the needs of people living with dementia. We will monitor progress towards improving the environment at our next inspection or sooner if we receive information that the environment is having a negative effect on people’s care.
People’s needs had been assessed before they moved into the home to ensure staff could provide the care they needed. Staff knew people’s needs well and provided support in a consistent way. Staff had access to the induction, training and support they needed to do their jobs. They met received regular supervision and were supported to achieve relevant qualifications. Language lessons had been provided for staff who spoke English as a second language to ensure they could communicate effectively with the people they cared for.
People’s care was provided in line with the Mental Capacity Act 2005 (MCA). Staff encouraged people to make choices about their care and understood that restrictions should only be imposed upon people where authorised to keep them safe. Where people lacked the capacity to make decisions about their care, appropriate procedures had been followed to ensure decisions were made in their best interests. Where people were subject to restrictions for their own safety, applications for DoLS authorisations had been submitted to the local authority.
People enjoyed the food they ate and could contribute to the menu. The chef knew people’s dietary needs and preferences well and regularly asked for people’s feedback about the food. Any dietary restrictions were recorded and referrals had been made to appropriate professionals if people developed needs in relation to eating and drinking. People’s healthcare needs were monitored and they were supported to obtain treatment if they needed it.
People were supported by caring staff with whom they had established positive relationships. Staff treated people with respect and maintained their privacy and dignity. The registered manager took the lead in promoting dignity in the way staff provided people’s care. People’s religious and cultural needs were met. Staff supported people to be independent where possible.
People received care that was responsive to their individual needs. People’s support plans reflected the care they needed and staff had liaised with relevant healthcare professionals where necessary. People had opportunities to take part in activities they enjoyed. There were appropriate procedures for managing complaints. There had been no complaints about the home since our last inspection.
The registered manager provided good leadership for the home. A relative told us the registered manager made the effort to get to know everyone living at the home and to understand their needs. Staff said the registered manager had supported them to improve the way in which they provided care. The areas we identified for improvement at this inspection had been noted by the registered manager and the registered manager had begun work to address them.
The registered manager had implemented monitoring systems which ensured people received safe and effective care. Staff shared information about people’s needs effectively through handovers and team meetings. The registered manager had formed links with other professionals to ensure they remained up to date with legislation and guidance. The registered manager understood their responsibilities in terms of reporting notifiable events and had notified CQC of incidents when necessary.
Further information is in the detailed findings below.