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. T

Glebe House Care Home provides accommodation, care and support for a maximum of 20 older people, some of whom were living with dementia. There were 18 people using the service at the time of our inspection.

The inspection took place on 18 September 2015 and was unannounced.

There was a registered manager was in post. 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 and associated Regulations about how the service is run.

Risk assessments had been carried out to protect people from avoidable harm. Staff were aware of safeguarding procedures and how to report if they suspected abuse. People were protected by the provider’s recruitment procedures. There were enough staff to keep people safe and meet their needs in a timely way. People’s medicines were managed safely.

Staff had access to the training, supervision and appraisal they needed to do their jobs. Staff knew people’s individual needs well and provided care in a consistent way. Staff communicated information about any changes in people’s needs effectively.

Staff asked people for their consent before providing their care. The service provided care and treatment in line with the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People enjoyed the food provided and were supported to maintain a balanced diet. People were supported to stay well and to obtain treatment when they needed it.

People had positive relationships with the staff who supported them and received their care from staff who were considerate, friendly and helpful. Staff were attentive to people’s needs, treated people with respect and promoted their independence.

People’s needs were assessed before they moved in to ensure that the service could provide the care they needed. Care plans reflected people’s individual needs and preferences and provided guidance for staff about the delivery of care.

People were supported to take part in activities and to maintain relationships with their friends and families. The service listened to people’s views and responded to their feedback. The provider had a written complaints procedure and people were confident that any complaints they made would receive an appropriate response.

The registered manager provided good leadership and encouraged people, their relatives and staff to contribute to the development of the service. Staff were encouraged to develop their skills and to work towards further, relevant qualifications.

Records relating to people’s care and to the safety of the premises were accurate, up to date and stored appropriately. There registered manager had implemented systems of quality checking that ensured standards in key areas of the service were monitored.

During the inspection we spoke with nine residents, two visitors, the manager and four members of staff.

Residents told us that staff were available when they needed them and that they provided good care. They said that staff treated them with respect when talking to them and providing their care. One resident told us, “There’s not a bad one amongst them. I couldn’t wish for better” and another said, “They’re all very good, very caring.”

Relatives told us that staff knew their family members’ needs well and were available in sufficient numbers to meet people’s needs promptly. One relative said of her family member, “She’s very happy here” and another said, “It’s a very homely environment and all the staff are very kind.”

Staff told us that the manager had improved the support provided to staff since her arrival in post, which had had a positive impact on the care provided to residents. They said that the manager had introduced regular team meetings, individual supervisions and improved the access to training.

The staff we spoke with were aware of their responsibilities around recognising and reporting abuse. They were aware of the provider’s whistle-blowing procedures and how to contact relevant agencies if they needed to refer an incident outside the home.

There were effective systems to monitor the quality of service people received. Residents and relatives had opportunities to have their say about the care they received and how the home was run.

We spoke with ten people using the service, a visiting relative, the manager, deputy manager and two members of care staff. People using the service told us that staff were polite and treated them with respect. They said that staff were available when they needed them and provided care and support in the way they preferred. One person told us, “I like it here, I really do” and another said, “The staff are absolutely brilliant – nothing’s too much bother for them.”

The relative we spoke with said that staff knew their family member’s needs well and provided good care. The relative told us “The staff are very caring” and said of their family member, “She’s very happy here.”

We found that staff had not had access to the training and support they needed during the past year. For example, staff had not had regular supervision sessions with their manager or had an annual appraisal. A significant number of staff had not attended recent training in core areas and team meetings had not been held regularly.

We found that the manager had improved the support provided to staff since taking up her post. Staff told us that team meetings now took place regularly and that they were encouraged to voice their opinions and ideas. The manager told us that she planned to arrange training to ensure that all staff had access to the training they needed for their roles and would be encouraged to achieve National Vocational Qualifications (NVQs).

During our discussion with people living at the home, we received many positive comments related to the provision of care and support. Favourable comments were made in respect to the food and staff members. People expressed words of happiness and contentment about the care they received.

On the day of our visit, we spoke with a number of residents and visiting family who attended the home. The residents were able to tell us that the staff generally discussed their care needs and listened to their wishes and likes. We received positive feedback about the level of satisfaction felt by residents and their families. We were told that residents felt that the staff treated them with dignity and respect. The staff were said to be approachable, helpful and caring and that the home felt safe. Visiting family said that they had been involved in discussions of the required care and were able to participate in reviews at meetings held by the home.

Feedback regarding meals was positive, with comments made about the choice and quantity of food provided. Generally, we received positive feedback on the cleanliness of resident rooms and the environment.