About the service: Glenroyd House is a 'care home'. People in care homes receive accommodation and personal care under a contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Glenroyd House accommodates up to eight people who may have a learning disability, in one adapted building. At the time of our inspection, seven people were using the service.

People’s experience of using this service:

¿ The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice, and independence.

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

¿ People felt safe using the service and under the new management team reported various improvements.

¿ People felt listened to and found the new registered manager approachable and friendly.

¿The safe recruitment of new staff meant improvements had been made in how people could spend their time. There were now more drivers available to support people to access the community when they chose and enjoy a range of activities.

¿ Previously concerns had been raised about how people’s finances were managed but this issue had been addressed and a robust system for monitoring people’s money was in place.

¿ There were systems in place to safeguard people from the risk of harm. Risks to people were very well managed with one exception which placed a person at risk of harm.

We made a recommendation about risk recording.

¿ The local authority had previously found that the service was not pro-active in supporting people to manage their own medicines. This had been addressed and the service was actively supporting people to take on these responsibilities if they chose and were able. We did find several errors relating to administration of medicines which were addressed at the time of inspection.

We made a recommendation about medicine management.

¿ Staff had training in food hygiene and infection control and followed good practice to prevent contamination and the spread of infection.

¿ People had choice around mealtimes and were involved in shopping and meal preparation.

¿ Staff received training and monitoring to ensure they were competent in their role.

¿ Staff enjoyed working at the company and felt well supported.

¿ A new registered manager and deputy had recently been recruited. Both were valued by people and staff.

¿ People were supported to be independent and exercise choice and control in their daily lives and could access a range of activities and interests of their choosing.

¿ Information was provided to people in easy read formats to help people’s understanding, including how to make a complaint or raise concerns.

¿ Systems and processes were in place to monitor safety and quality and drive improvements.

¿Peoples information was protected and confidentiality maintained.

¿ People and staff were included in the running of the service and were provided with opportunities to share their ideas and give feedback.

Rating at last inspection: Requires improvement. (Last report published 12 June 2018). At the last inspection people were not always receiving care which responded to their needs and preferences in relation to accessing the community and following their interests. Improvements were also needed to the management of the service. Some systems had not been reviewed and improved such as the rota arrangements, communication with and involvement of staff and financial systems. As a result the service was in breach of Regulation 9 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made two recommendations about keeping people’s information saf

At the last inspection in November 2015, the service was rated as ‘Good’. At this inspection in March 2018 we rated the service as ‘Requires improvement.’ The inspection was unannounced.

Glenroyd House provides accommodation and personal care for up to eight people with a learning disability, on the autistic spectrum and with mental ill health. At the time of our inspection, eight people were receiving care and support at the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was 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.

Some people who used the service were unable to verbally tell us about what it was like living at Glenroyd House. We therefore used observation to help us understand people’s experiences.

People were not always receiving care which was appropriate and responded to their needs and preferences in relation to accessing the community and following their social and leisure interests. Improvements were also needed to the management of the service. Some systems had not been reviewed in order for them to be improved such as the rota arrangements, communication with and involvement of staff and financial systems.

Procedures were in place to safeguarded people who used the service from the potential risk of abuse. Risks to people’s health and wellbeing were managed well whilst maintaining their independence. These were reviewed to ensure people’s needs were met effectively and safely.

There were sufficient numbers of staff to support people and safe recruitment practices were followed. The administration of medicines were managed safely to keep people well. Staff knew how to report any concerns and incidents were investigated.

People’s needs and choices were assessed in line with current guidance. Appropriate training, supervision and appraisals were in place to enable staff to provide appropriate care to people. Staff had a range of skills, knowledge and experience to care for people effectively.

People were supported to eat and drink enough to meet their needs and to make informed choices about what meals they had. People received regular and on-going health checks and support to attend appointments. Professionals worked together to support people with their mental and physical health and wellbeing.

Staff had an understanding of the principles of the Mental Capacity Act (MCA) 2005. Capacity to make specific decisions was recorded in people's care plans. 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.

Staff interacted with people in a caring and friendly way and treated them with dignity and respect. People’s individual communication needs were recorded in their care files and information was provided in accessible formats. The premises were adapted and accessible to meet people’s needs.

Care plans contained information about people's wishes and preferences. They were involved in reviews of their care arrangement. People were encouraged to pursue their interests and to maintain links within the community. There was an effective complaints procedure in place and people and their relatives knew how to make a complaint should they need to.

There was a management structure in place which provided clear lines of responsibility and accountability. The ma

The inspection was completed on 13 November 2015 and there were eight people living in the service when we inspected.

Glenroyd House is one of several services owned by Caretech Community Services. The service provides accommodation and personal care for up to eight people who have a learning disability and/or who have a diagnosis of autism.

The service had a registered manager in post. 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.

Staff had a good understanding and knowledge of safeguarding procedures and were clear about the actions they would take to protect the people they supported.

There were sufficient numbers of staff available to meet people’s needs. Appropriate recruitment checks were in place which helped to protect people and ensure staff were suitable to work at the service. Staff told us that they felt well supported in their role and received regular supervision.

Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. Support plans were sufficiently detailed and provided an accurate description of people’s care and support needs. People were supported to maintain good healthcare and had access to a range of healthcare services. The management of medicines within the service ensured people’s safety.

Appropriate assessments had been carried out where people living at the service were not able to make decisions for themselves and to help ensure their rights were protected.

People were supported to be able to eat and drink satisfactory amounts to meet their nutritional needs and the mealtime experience for people was positive.

People were treated with kindness and respected by staff. Staff understood people’s needs and provided care and support accordingly. Staff had a good relationship with the people they supported.

An effective system was in place to respond to complaints and concerns. The provider’s quality assurance arrangements were appropriate to ensure that where improvements to the quality of the service was identified, these were addressed. 

A single inspector carried out this inspection. Below is a summary of what we found.

At the time of our inspection there were eight people using the service. As part of this inspection we spoke with four people using the service, four staff and the registered manager. We also reviewed records relating to the management of the service and to the support needs of people who were using the service. These included four support plans, daily support records, staffing records and service quality monitoring processes.

If you want to see the evidence supporting our summary please read our full report. We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

People were treated with respect and dignity by the staff. Appropriate safeguarding procedures were in place and staff knew how to safeguard the people they supported.

The home had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). This was to ensure that people who could not make decisions themselves were protected. Relevant staff had been trained to understand when a DoLS application should be made, and how to submit one. This meant that people were safeguarded as required.

Staff we spoke with said they had been properly trained. Staff told us that they received good line management support in their roles which helped them to provide an enabling and responsive service.

Is the service effective?

There was an advocacy service available if people needed it. This meant that, when required, people had access to additional support to help them make decisions.

People’s health and care needs were assessed and they were involved in their plans of care. Specialist dietary and equipment needs had been identified in care plans where required.

The people we spoke with who used the service said they were satisfied with their rooms and the facilities. One person we spoke with told us, “I like my room and I can choose the furniture I have in my room."

People were supported by pleasant and attentive staff. We saw that care workers showed understanding and gave encouragement when supporting people. A person who used the service we spoke with told us, “The staff are lovely and I like living here."

The responses and views of people who used the service and their relatives were asked for as part of regular quality monitoring reviews of the service. Any shortfalls or concerns raised were addressed.

People’s preferences, interests and diverse needs had been recorded and care and support had been provided by staff in accordance with people’s wishes.

Is the service responsive?

Where concerns about an individual's wellbeing had been identified, staff had taken appropriate action that ensured people were provided with the healthcare support they needed. This included seeking support and guidance from care professionals, including psychiatrists and doctors.

People had the opportunity to enjoy a broad range of activities and interests and, mostly with staff support, were able to get out and about in the local and wider community.

A person who used the service we spoke with told us, “The staff are always around if I need them.”

Is the service well-led?

The service worked well with other agencies and services to ensure all aspects of people's needs were being met.

Staff were clear about their roles and responsibilities. Staff had a good understanding of the aims of the home and of the standards of care and support that was expected of them.

Regular service monitoring processes were in place. This helped to ensure that people received a good quality service at all times. A person who used the service we spoke with told us, “I get asked about what I want to do each day and the staff help me to do the things I tell them.”

Since our last visit in August 2013 a new manager was in place at Glenroyd House. They told us they would apply to become the registered manager. There were seven people using the service when we visited and we spoke with four people and seven staff.

People told us that staff gave them support and they could approach them if they had any issues. One person told us that, “It’s nice.” Another told us, “Nothing needs improving.”

We found that the provider had systems for storing and administering medication to people.

The provider had made improvements to people’s records and the safe and accessible storage of records.

We found that staff understood the need to report any abuse. People we spoke with told us they felt ‘safe’ living at Glenroyd House.

We considered that the provider needed to make improvement’s to ensure staff received regular support. Improvements were required to ensure that systems were in place for the assessing and monitoring of the service.

We spoke with five out of six people using the service. People told us that staff gave them support and talked to them about their care and gained their consent. We spoke with four staff who told us they felt supported in their work.

We saw that improvements had been made to ensure the premises were suitable and safe and that systems for infection control were in place.

A manager was employed to ensure the service was well led and had systems in place. We found that some systems relating to records needed improvements to ensure they were effective.

We spoke with six people using the service. People told us that staff gave them support and they could approach them if they had any issues. People told us that they liked living at Glenroyd House and told us they felt safe.

A relative told us that their relative living in the home always seemed happy, clean and tidy when they saw them. They told us that, ”X loves it there.”

We found that where possible, people were involved in the development of their care plans and care plans were person centred.

We found that not all infection control systems were in place. We also found that further maintenance work was required on the premises.

The provider had systems in place for the recruitment of staff.

Some of the people using this service have difficulty in understanding and responding to verbal communication. During our visit on 26 January 2012 we spoke with four people. Most of the information about people's experiences of Glenroyd House was gathered through our observations and discussions with the Service Improvement Manager, Locality Manager and representatives of Essex County Council Quality Monitoring Team.

People, with whom we spoke, told us that they were satisfied with the staff, the food and their activities. They told us that they were able to choose their new furniture and that they helped to make up their support plan. Some people accessed the community independently, others told us that staff supported them in accessing the local and wider community, so that they could take part in their chosen interests and activities. Relatives indicated that they were satisfied with the way the home is run and with staff attitudes towards people who lived there.