This inspection took place on 26 June 2018 and was unannounced.

The provider of Glenfield Nursing Home is registered to provide accommodation, nursing and personal care for up to 46 people. At the time of our inspection there were 45 people who lived at the home. The home is split over three floors.

At the time of our inspection there was not a registered manager in post. The deputy manager was acting as manger in their absence. 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 provider had failed to store people's medicines safely. Temperatures had exceeded the safe storage recommendations.

Staffing levels were sufficient to meet the needs of people using the service. Although the provider and deputy manager needed to consider the deployment of the staff on shift, especially on the first and second floor so people are not kept waiting for their meals and personal care.

People told us they enjoyed the food that was available. The provider and deputy manager needed to consider how they could improve the meal time experience for people, so their food was not left out cooling until staff were available to assist them. Snacks and drinks were provided to people throughout the day which helped people maintain a healthy weight and stay well hydrated. Fluid and food intake charts were not always completed promptly, to ensure effective monitoring of people's food and drinks.

Risk assessments were in place with regards to people's care needs to ensure risks to people were mitigated. For example, pressure area, falls and malnutrition risk assessments were in place and appropriate action had been taken to mitigate these risks as much as possible. However, we identified that there were no risk assessments in place around the risk of choking to guide staff practices in meeting people's needs safely.

People's care records contained important and up-to-date information about their care needs. These outlined to staff what level of support needed to be provided. Daily monitoring records were kept up-to-date by staff which outlined the support that had been given. However the provider did not ensure these notes were securely stored to respect people’s right to confidentiality.

Although the provider had systems in place which they used to monitor and check the quality and safety of services provided, they had failed to identify the shortfalls and concerns found at the inspection.

Throughout the inspection we observed staff wearing personal protective equipment such as disposable gloves and aprons. Hand soap and alcohol gel was available at dispensing units within the premises which helped staff maintain hand hygiene.

Recruitment processes were in place to ensure the safe recruitment of staff. Recruitment records showed that prior to employment being confirmed staff had been subject to a criminal background check.

Staff had completed training in safeguarding and were aware of the different types of abuse that could occur.

Staff reported accidents and incidents to the management, however; the management team recorded what action had been taken but did not have a system to analysis patterns so reduce the risk of incidents happening again.

Staff had received the training they needed to carry out their role effectively. This helped ensure people received the care they needed.

Where required, people were supported to access support from health and social care professionals, which helped ensure people's health and wellbeing was maintained.

People and their relatives knew how to make a complaint and action was taken to resolve and drive through improvements.

We found three breaches of the Health and Social Care Act (2008) Regulated Activities 2014 Re

The inspection was unannounced and took place 10 February 2016.

Glenfield Nursing Home is registered to provide accommodation and personal and nursing care for adults who may have a dementia related illness for a maximum of 46 people. There were 41 people living at home on the day of the inspection. The home is over three floors, with the main communal areas on the ground floor.

There was a registered manager in place however they were not working on the day of the inspection. 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.

People told us they felt safe living at the home. Staff knew how to safeguard people and what to do if they suspected abuse. However, nursing staff need to take steps to record the action they had taken in responses to concerns raised. Where care staff had used charts to record the detail of the incidents they were not aware of how these were used to see if improvements could be made to the person’s care.

People received their medicines from nursing staff who looked after their medicines. People received support that met their individual needs and from care staff that were available when they needed them. People’s risks relating to their safe care and treatment had been assessed and all staff knew the detailed plans in place to help minimise those risks.

Staff had training to do their jobs effectively in order to meet people’s care and support needs. All staff were encouraged to continue to develop their skills in health and social care. All staff told us they felt supported by the management team to carry out their roles effectively. People’s nutritional needs were met, choice was offered and special dietary needs were catered for. Nursing staff referred to other health professionals when needed, so people were supported to maintain their health and wellbeing.

People told us they liked living at the home and that staff were friendly and kind. People were cared for as individuals with their preferences and choices supported. Staff treated people with dignity and respect when supporting them and encouraged people to be as independent as possible. Relatives were encouraged to be involved in supporting their family members.

People’s health and social care needs were reviewed regularly and people took part in some organised activities and day trips and told us there was enough for them to do. People knew how to complain if they wished to and complaints were addressed to people’s satisfaction.

People, their relatives and all staff felt involved in how the home was run. The management team responded to people’s feedback in developing the service and making continued improvements. The registered manager and provider regularly checked that people received care that met their needs.

During this inspection we spoke with three people who lived at the home, four staff and with four relatives. We looked at some people’s care plans which provided information on the needs of each person. We also looked at how staff cared for the people who lived at the home.

We found that people were being treated with dignity and respect. One person told us: "They (staff) are very nice and respectful of me".

We saw that people appeared relaxed and comfortable. They were being cared for in a way that they preferred. The people we spoke with were positive about their experiences of living at the home. One person told us: "I think the care here is the best it could be".

People were being cared for by staff who had knowledge of keeping people safe.

We found that medicines were being appropriately stored and administered.

Families and carers views were regularly sought and they were being kept up to date with any changes. Regular meetings ensured that people who lived there were supported to comment, discuss or make a complaint if they were not happy with the service provision. Where concerns had been raised by relatives, carers or people who were used the service they were quickly remedied.