We carried out this inspection on 09 July 2018. The inspection was unannounced.

Glenarie Manor Nursing Home 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.

The service 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 home supports people living with complex mental health needs and provides accommodation with nursing care. It can accommodate up to 26 people and at the time of our visit, 26 people lived at the home.

The home is a large victorian house situated in Sefton Park. Local shops and public transport are within walking distance. Accommodation consists of 26 single bedrooms. On the ground floor, there is a communal dining room for people to use and on the first floor there is TV room and games room.

Although the home was clean and well-maintained, improvements to the home’s fire safety arrangements home needed to be made. During our inspection we saw that an action plan of improvements was in place with regards to this and we received assurance from the home’s fire consultant that these improvements were in progress and would be completed in a timely manner.

The home had a smoking room that was in need of improvement. This was because the smoking room lacked adequate ventilation and contained smoking debris that needed to be addressed. We spoke with the manager, area manager and fire consultant about this. They told us that improvements to the safety of the smoking room were planned. Shortly after the inspection we received confirmation from the provider that these improvements were now in progress.

We looked at the way medicines were administered in the home. We found that the time that people’s medicines were administered was not recorded. This meant that staff could not be sure that time specific medicines or medicines that required a set time period between doses (such as Paracetamol) had been given safely. We also saw that the manager’s medication audits had identified a pattern of missing signatures and medication errors. This indicated improvements to the way medicines were managed was required. We saw that the manager had taken action to raise the standards of medication administration. This work was on-going at the time of the inspection. On the day of the inspection people’s medication had been administered appropriately.

We spoke with eleven people who lived in the home. They spoke highly of the home and the staff who supported them. It was clear that the manager and staff team were well thought of. People told us the manager and staff were caring and that the support provided was good.

People’s care records contained information about people’s needs and risks and how to support them effectively. People’s life histories were included and gave staff information about their families, life prior to coming to live at the home and the things that were important to them in their day to day lives. This gave staff an understanding of the people they supported so that positive relationships could be developed.

The manager and the nurse on duty who we spoke with had a good knowledge of people’s needs and spoke with genuine affection about the people they supported. The atmosphere at the home was warm, homely and relaxed. People and staff chatted socially to each other and we saw that these conversations were natural and spontaneous. It was clear staff knew people well and vice versa.

Staff recruitment was safe and there were enough staff on duty to meet people’s needs. Peopl