About the service: Glengariff is a residential care home which provides accommodation and personal care for up to 55 people aged 65 and over. There were 45 people using the service at the time of the inspection.

People’s experience of using this service:

People told us and we observed that they were safe and well cared for and their independence was encouraged and maintained.

The service had made improvements since our last inspection. People who used the service and staff told us that the changes made had improved the service.

Maintenance work had been undertaken on the premises to ensure it was safe. Extensive refurbishment, internally and externally, was planned for 2019. We made a recommendation that further involvement of people in the redecoration of the service and good practice guidance about environments for people with dementia be explored.

The premises were clean and practices for the prevention of infection were in place. Medicines were managed and administered safely.

There were sufficient staff with the right skills and knowledge to carry out their roles and care for people effectively.

Assessments of people’s capacity to make their own decisions had been carried out with the involvement and agreement of their legal representatives. Applications to deprive people of their liberty had been completed appropriately and the relevant authorities informed.

People had a good meal time experience with food which was home made and provided a balanced diet.

Staff were kind and friendly and provided a warm and caring atmosphere in the service.

Care plans were person centred and comprehensive. There was sufficient detail in the documentation that enabled staff to provide responsive care. The service worked alongside professionals to provide joined up care.

Processes were in place to measure, document, improve and evaluate the quality of care. Management had clear oversight of the service. People's complaints were dealt with appropriately.

Rating for this inspection: The service met the characteristics for a rating of ‘Good’ in all key questions.

More information about our inspection findings is in the full report.

Rating at last inspection: The service was rated as ‘Requires improvement’ in all key questions and was in breach of Regulations 9 person centred care, 11 consent, 12 safe care and treatment and 17 good governance. The report was published on 5 February 2018.

Why we inspected: All services rated as ‘Requires improvement’ are re-inspected within one year of our prior inspection. This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received and the improvements made.

Follow up: We will continue to monitor the service through the information we receive.

This inspection took place on 27 November 2017, and also incorporated additional evidence collection days where the registered manager was able to provide us with information following concerns found at the inspection.

Glengarrif residential 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.

Glengarrif residential care home accommodates up to 54 people in one adapted building over three floors. On the day of inspection 47 people were living at the home, some of whom were living with dementia.

A long standing registered manager was in place at the home. ‘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.’

We found that the service required improvement across all domains. All staff observed at this service knew the people living there well. Responses to people receiving care were kind. However, staff did not always demonstrate that engagements with people was meaningful, nor did they demonstrate how people’s independence was promoted. We found that care for people living with frailty and older age was good, however, for those living with dementia or receiving end of life care, care needed to be more person centred and based on current best practice.

Systems in place to monitor the safety and quality of the service and the oversight of all these systems was poor. However, the registered manager took actions to address some of the concerns found during the inspection, and consequently we have made recommendations for improvements needed at the service, and we have also breached the provider in four areas. You can see the actions we took at the end of the report.

Following the inspection the registered manager immediately began to address some of the concerns found during the inspection. In addition the registered manager had set up, and was providing good support networks and links with other care managers in the area in order to share good practice and future learning. This should support the service to continue to develop and improve.

We will inspect the service again within 12 months of this reports publication, to assure ourselves that initial improvements made have been sustained.

The inspection took place on 5 May 2015 and was unannounced.

Glengariff Residential Home provides accommodation and personal care for up to 55 older people who may also have physical disabilities, sensory impairment or who may be living with dementia. The service does not provide nursing care. At the time of our inspection there were 41 people using the service.

A registered manager was in post at the service. 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 were safe because staff understood their responsibilities in managing risk and identifying abuse. People received safe care that met their assessed needs.

There were enough staff who had been recruited safely and who had the skills and knowledge to provide care and support in ways that people preferred.

The provider had systems in place to manage medicines and people were supported to take their prescribed medicines safely.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) which apply to care homes. We found the provider was following the MCA code of practice.

People’s health needs were managed appropriately with input from relevant health care professionals. Staff supported people to have sufficient food and drink that met their individual needs.

People were treated with kindness and respect by staff who knew them well.

People were supported to maintain relationships with friends and family so that they were not socially isolated.

There was an open culture and the registered manager encouraged and supported staff to provide care that was centred on the individual.

The provider had systems in place to check the quality of the service and take the views and concerns of people and their relatives into account to make improvements to the service.

We gathered evidence of people’s experiences of the service by talking with people living in the home and with visitors. We observed how people spent their time and noted how they interacted with other people living in the home and with staff.

During our inspection we spoke with people who told us they liked living in Glengariff Residential Home Residential Home. A relative told us they were happy with the standard of care. We saw that people were comfortable with staff and others living in the home and there was a relaxed atmosphere.

People enjoyed the lifestyle in the home and people made positive comments about the food, the social activities and the support they received from staff. People felt safe in the home and were confident that any concerns would be listened to and something would be done.

We saw that staff understood the needs of people living in the home, treated them with respect and provided care in ways that people preferred and that met their needs.

At the time of our inspection there were 33 people living in Glengariff and we spoke with two people about their care and the lifestyle in the home. We also spoke with four relatives and a visiting healthcare professional. We gathered evidence of people’s experiences of the service by observing how they spent their time and noting how they interacted with other people living in the home and with staff.

Our observations confirmed that people received good quality care and support and people enjoyed the lifestyle in Glengariff.

A health care professional told us they visited the home regularly and professional advice was very well received. They also said, “The home has coped so well [with the project the professional was involved in]” and “Staff are really on the ball at Glengariff.”

One person living in Glengariff told us the home was, “lovely” and a relative spoken with told us, “The care is excellent.”

We spoke with four people who use the service. They all said they were happy at Glengariff and that they enjoyed the outings that the service arranged for them. All of the people with whom we spoke were very complimentary about the staff working at Glengariff.

People with whom we spoke said they were very happy at Glengariff. They were very complimentary about the food and choice of food available. One person said they were feeling very low until they came into the home and said they now wished they had moved there much earlier, as it had had such as positive effect on their life and health. All the people with whom we spoke said they enjoyed the outings that the provider organised and that staff were very good and considerate. They had not experienced any problems with their medication and said that they received these on time.