The unannounced inspection took place on 31 January 2017.

Glenhomes Care Home is a care home providing personal care for up to 21 older people. It is situated close to the centre of Bolton, the motorway network and public transport. The home is a large converted, semi-detached building, in a residential area, built on four floors (the fourth floor is not used by residents), with a passenger lift provided. There is a garden with both a lawned and patio area which is fenced off for safety.

There was a registered manager 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.

People told us they felt safe. Staffing levels at the home were good and staff recruitment and induction procedures were robust. Training was ongoing and staff had regular supervisions and appraisals to ensure their development and training needs were continually reviewed.

There was an up to date safeguarding policy and staff demonstrated a good knowledge of the procedures. There was also a whistle blowing policy which staff were aware of. Health and safety measures were in place.

Medication systems were appropriate and medicines were stored, administered and disposed of safely at the service. Infection control procedures were in place and the home was clean and free from malodours.

The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS).

People’s nutritional needs were recorded and met appropriately. There was a good choice of food and the mealtime experience was pleasant and unhurried.

People told us staff were kind and we saw respectful and friendly interactions within the home throughout the day. Visitors told us they were made welcome and people and their relatives were involved in all aspects of care planning. People’s dignity and privacy was respected at all times.

Some staff had undertaken training in end of life care and others were booked on further training courses. This helped support people at the end of life, according to their expressed wishes.

Care plans were person-centred and included a range of health and personal information, including likes, dislikes and background history. This helped staff care for people in a more individual way.

There were a number of activities and outings on offer and people told us they enjoyed them. Special occasions were celebrated and people were supported to pursue their interests and hobbies.

The service had an appropriate complaints policy which was displayed prominently in the home. No recent complaints had been received but the service had received a number of compliments.

People who used the service, relatives and professionals felt the management were approachable.

Staff were supported via supervision sessions, meetings and informal chats.

Questionnaires were used regularly to seek opinions of people who used the service. The results were used to continually improve the service.

A number of audits were regularly carried out to help ensure quality of service delivery. The management were involved in a number of local groups to enable them to keep up to date with best practice and current guidance.

We undertook the unannounced inspection on 28 July 2015. The service had not been inspected before under the current registration. Glenhomes Care Home is a home providing personal care for up to 21 older people. It is situated close to the centre of Bolton, the motorway network and public transport. The home is a large converted, semi-detached building, in a residential area, with a passenger lift provided. There is a garden with both a lawned and patio area which is fenced off for safety.

There was a registered manager 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.

People who used the service and their relatives told us they felt safe within the home. Safety equipment was in place and regularly maintained and serviced.

We saw that the service had appropriate risk assessments in place for people who used the service. The risk assessments determined the level of risk and the control measures required to manage that risk.

Appropriate safeguarding policies were in place and staff we spoke with had an understanding of the issues and procedures. The service followed safeguarding procedures when required, although no safeguarding issues had been raised within the last 12 months.

Recruitment of staff was robust and the policy was followed appropriately. Potential staff were required to produce proof of identification and references and all were subject to satisfactory disclosure and barring service (DBS) checks, to help ensure they were suitable to work with vulnerable people. There were sufficient staff to attend to people’s needs.

Medicines were administered, stored, ordered and disposed of safely. Medicines management policy and procedures, which were robust and comprehensive and included information on controlled drugs, medication errors, homely medicines and covert medication.

People’s nutrition and hydration needs were met appropriately and they were given a choice of food at meal times. However, the meal time experience could be improved to ensure that people were supported into the dining room in a more organised way.

The service considered the requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS). However, the records in respect of consent and capacity were inconsistent.

The induction process was thorough and included mandatory training and shadowing. Supervisions and appraisals took place regularly and were documented appropriately. Training for staff was on-going.

People who used the service and their relatives felt the staff were kind, respectful and polite. . One person who used the service told us, “The staff are lovely here, they really look after me”. Throughout the day we observed staff interacting with people who used the service in a kind and considerate manner, ensuring people’s dignity and privacy were respected.

Some staff had undertaken training in end of life care and others were booked on further training courses. The service endeavoured to support people at the end of life according to their wishes.

Care plans were not easy to follow and did not demonstrate person centred care planning. There was an inconsistent approach to how information was recorded. Five of the six care files contained information sheets that were loose and could easily have fallen out or been misplaced. The registered manager agreed to review and change the care plans to ensure they were more reflective of person centred care.

There was an activities coordinator and a number of activities were on offer to people on a regular basis. These included exercises, church services, pet therapy, visits from a local befrienders’ group, crafts, trips out and entertainment. Seasonal festivities were also arranged.

An appropriate complaints policy was in place and people were aware of how to complain. The complaints process was outlined within the service user guide. No recent complaints had been received by the service.

People who used the service, relatives and professionals felt the management were approachable.

One professional told us, “Overall I feel Glenhomes is a lovely little independent care home always working towards improving the residents’ quality of life”.

Regular staff supervisions were undertaken, including themed supervisions, general supervisions and tailored sessions to address particular learning needs. Appraisals were undertaken annually and staff meetings took place regularly to help ensure good communication between staff and management.

Feedback was sought from people who used the service on a monthly basis and issues identified and addressed. A number of audits were regularly undertaken and the results analysed to help drive improvement of service delivery.