Glenfields Care Home Limited is registered for 28 older people who may be living with dementia. It is set out over two floors and has all single occupancy rooms. There are several lounge areas and a separate dining room.

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.

At this inspection we found the service remained good.

People felt safe and staff had been trained and understood their responsibilities around safeguarding adults and reporting concerns.

Risks to people’s physical and mental health had been identified and guidance was available for staff to manage those risks. The environment and equipment was safely maintained.

Staff recruitment was robust and there were sufficient staff on duty to meet people’s needs. Staff were well trained in basic care and in specialist subjects giving them the knowledge they required to care for people who used the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had access to healthcare professionals from the community such as their GP or community nurses.

Staff maintained positive relationships with people and showed care and compassion in their interactions.

Staff were caring, maintaining positive relationships with people. Feedback was positive from people, their families and professionals.

There was a quality monitoring system in place which identified where improvements were needed. These had been acted upon.

People and staff were invited to share their views and give feedback about the service. They attended regular meetings where they could discuss any issues related to the day to day running of the service.

Further information is in the detailed findings below

This inspection took place on 16 May 2016 and was unannounced. We previously visited the service in April 2014, when we found that the registered provider met the regulations we assessed.

The home is registered to provide accommodation and care for up to 28 older people, including people who are living with dementia. On the day of the inspection there were 23 people living at the home. The home is situated on the outskirts of Driffield, in the East Riding of Yorkshire. There are various communal areas where people can spend the day, a garden and an enclosed courtyard. The second floor of the home is accessed by a stair lift and there are ramps to the premises to enable wheelchair access.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager who was registered with the Care Quality Commission (CQC). 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.

On the day of the inspection we saw that there were sufficient numbers of staff employed to meet people's individual needs. New staff had been employed following robust recruitment and selection policies and this ensured that only people considered suitable to work with vulnerable people worked at Glenfields Care Home.

People told us that they felt safe living at the home. People were protected from the risks of harm or abuse because there were effective systems in place to manage any safeguarding concerns. The registered manager and care staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.

Staff told us that they were well supported by the registered provider and registered manager, and felt that they were valued. They confirmed that they received induction training when they were new in post and told us that they were happy with the training provided for them.

We checked medication systems and saw that medicines were stored, recorded and administered safely. Staff who had responsibility for the administration of medication had received appropriate training.

People who lived at the home and relatives told us that staff were caring and that they respected people’s privacy and dignity. We saw that there were positive relationships between people who lived at the home, relatives and staff.

People told us that they were very happy with the food provided and people's nutritional needs had been assessed. We observed that people’s individual food and drink requirements were met.

We saw that any complaints made to the home had been thoroughly investigated and that people had been provided with details of the investigation and outcome. There were also systems in place to seek feedback from people who lived at the home, relatives and staff.

Staff, people who lived at the home, relatives and health care professionals told us that the home was well managed. Quality audits undertaken by the registered provider and registered manager were designed to identify any areas of improvement to staff practice that would promote people’s safety and well-being. Staff told us that, on occasions, feedback received at the home was used as a learning opportunity and to make improvements to the service provided.

Our inspector visited the service and assessed five essential standards of quality and safety which helped us answer our five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led? We also wanted to check that the provider had taken action to improve an area that we found non-compliant at our last inspection of the service.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that people were safe because they had their care and healthcare needs fully assessed, risk assessed and planned for, so that staff had clear instructions to follow and were able to help meet peoples' needs. People said, "I was happy here right from the start" and "We are well cared for and we want for nothing".

We saw that care plan documentation protected people from inappropriate or unsafe care because they were pertinent to peoples' needs, wishes and preferences and they had been appropriately reviewed each month, or as a person's needs changed. Care was provided for older people that may or may not have had a dementia type condition and this was clearly recorded in their documentation. The manager and staff were aware of their requirements under the Mental Capacity Act 2005.

We saw that the service maintained accurate and up to date records to show how people had been supported, how they presented and how staff had been trained in caring for them. Records enabled safe accountability of the care people had received.

Is the service effective?

We found that care plans were effective at instructing staff on how to best support people with meeting their care needs and they enabled people to have the support they required, reviewed as their needs changed.

From the information people gave us about liking the food and having menu choices, and from observing the mid-day meal we were able to see that the food and drink provision was effective in meeting peoples' nutritional needs. The kitchen was well maintained and the cook effectively managed budgets and cleaning schedules.

We found that people were effectively cared for because staff were experienced workers and had completed training courses to equip them with the skills they required.

Is the service caring?

We observed staff being caring when they provided care and support to people that used the service. Staff gave people time to do things at their own pace, encouraged independence and showed empathy. Staff knew peoples' wishes and preferences and included and encouraged them to make choices throughout the day. People said, "We are quite content here. The staff are very kind" and "I was happy here right from the start".

Is the service responsive?

From the information people gave us about the support they received, observing care provided and looking at care file documentation we found that the service responded well to peoples' care and health care needs.

People were encouraged to be active and to make their own decisions about daily life. They received help and support from health care professionals when required and the service coordinated this. The service also ensured people made their choices about rising, going to bed, what to eat, what to do.

Is the service well led?

We found that the manager led the way with ensuring peoples' care and health care needs were met. The manager spent some of their time involved with the daily support that people received and facilitated and guided the care and cleaning staff in their tasks. The manager ensured people that used the service had up to date care plans in place for staff to follow and ensured peoples' health care needs were met. This was because there were established links with health care professionals.

There had been a lapse in operating the quality assurance and monitoring systems in 2013 and so people had not been asked their views of the service and audits had not been carried out to determine where improvements were needed. The systems had been revised and put into greater use since our last inspection in January 2014 and we found that a wave of audits had been completed and people that used the service and their relatives had been asked to complete satisfaction surveys. This meant that the provider had clearer information about where the service needed to be improved.

We found people that used the service liked living at Glenfields. They told us they were well cared for. They said, "Living here has done me the world of good", "We are really well looked after" and "Truly it is absolutely lovely here, we want for nothing". Other people said, "The girls are nice", "I have made friends here" and "The staff help me how I like to be helped".

We found that peoples' health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

When we looked round the premises we found that the environment was clean, hygienic and well cared for and so people were protected from the risk of infection. Equipment was always available to staff and some of them had completed appropriate training to ensure safe systems of work were followed.

When we looked round the premises we found that the provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. There was evidence of this from the maintenance contracts in place, the certificates of servicing or repair and the insurance cover available.

We found that people were protected from unsafe or unsuitable equipment because the provider had ensured people were assessed for the use of equipment and equipment was appropriately maintained.

We found that the provider had a system to regularly assess and monitor the quality of service that people received, but it had not been used effectively since 2012 and so the provider had no way of knowing how the service needed to be improved.

We found that there was an effective complaints system available and people were able to make their 'niggles' known before they became complaints.

We spoke with seven people that used the service, two staff and the manager and we looked at systems for providing care and support. We looked at documentation and records held in the home.

We found that people were included in deciding their care needs and encouraged to make decisions whenever possible. We found that the provider and staff obtained peoples' consent to support before they received it, that their needs were well planned for and met using good care plan systems and documentation, and that people received their medication safely.

We found that staff working in the service had been appropriately recruited, vetted and supervised to carry out their roles and we saw that there were effective quality monitoring systems and audits in operation to assess for shortfalls in the performance of service delivery. One person that used the service told us, "You would find no better place than this."

We spoke with three people in the home about the service they received and the opportunities for activities and outings. They told us they had been satisfied with the service at Glenfields and went out or joined in with pastimes when they could.

People told us they liked the staff, found them to be helpful when needed and that they had no concerns for their safety. They liked the food available and thought the home was well maintained.