Glottenham Manor Care Home is situated in a rural location in East Sussex. The service is registered to provide accommodation and nursing care for up to 50 people who are older or have a physical disability. There were 38 people living at the service when we visited.

The accommodation is set in large grounds; the service was clean, bright and airy with various communal areas for people to use both inside and outside.

At the last inspection, the service was rated Good overall and Requires Improvement in the ‘safe’ domain.

We carried out an unannounced comprehensive inspection of this service on 31 October 2016. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach of Regulation 18 of the Health and Social Care Act Regulated Activities Regulations 2014, Person Centred Care. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Glottenham Manor Care Home on our website at www.cqc.org.uk

At this inspection we found the service remained Good overall and is now rated Good in the ‘safe’ domain. The breach of Regulation 18 has now been met.

The service had improved since the last inspection. People’s call bells were now being answered quickly and there were enough staff on duty to meet people’s needs. Regular audits of the call bell responses were completed; any issues investigated and addressed.

People told us they felt safe at the service. Staff recognised different types of abuse and knew who they would report any concerns to, they were confident that the manager or deputy manager would address any issues. Risks to people were identified, assessed and plans were put in place which gave staff the guidance needed to manage and minimise the risks.

People’s medicines were managed safely and in the way they preferred. Staff were recruited safely using systems to ensure they were suitable to support people.

We inspected Glottenham Manor on 31 October and 1 November 2016. The inspection was unannounced. Glottenham Manor is a nursing home registered to provide accommodation and personal care for people who require nursing for a maximum of 46 people. The home specialises in providing care to older people. At the time of our visit there were 36 people living in the home. Glottenham Manor is located in a rural setting, in its own grounds, and has accommodation over two floors; many of the bedrooms are on the ground floor together with the communal areas, such as the lounges and the dining area. The first floor is accessed via stairs or a lift and some bedrooms are on the first floor. Some people had illnesses or disabilities associated with old age such as limited mobility, physical frailty or lived with health conditions such as dementia. At the time of our inspection there was not 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. However there was an acting manager who was in the process of registering with CQC.

There was sufficient staff to provide care to people throughout the day and night. However, we found some call bells were not answered quickly enough. You can see what action we told the provider to take at the back of the full version of the report.

People received a person centred service that enabled them to live active and meaningful lives in the way they wanted. However, we observed some inappropriate use of language, such as addressing people by their room number and not their name. We have made a recommendation about this in our report.

Care plans ensured people received the support they needed in the way they wanted. However, people’s preferences and views about their care were not always recorded. We have made a recommendation about this in our report.

When staff were employed they were subject to checks to ensure they were safe to work with people in the service.

Risks to people’s safety had been assessed and actions taken to protect people from the risk of harm. The provider had systems in place to protect people against abuse and harm. The provider had effective policies and procedures that gave staff guidance on how to report abuse. Staff were trained to identify the different types of abuse and knew who to report to if they had any concerns.

Medicines were managed safely and people had access to their medicines when they needed them.

Staff were well trained with the right skills and knowledge to provide people with the care and assistance they needed. Staff met together regularly and felt supported by the manager. Staff were able to meet their line manager on a one to one basis regularly.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had enough to eat and drink, and received support from staff where a need had been identified. People’s special dietary needs were clearly documented and staff ensured these needs were met.

The staff were kind and caring and treated people with dignity and respect. Caring relationships were seen throughout the day of our inspection. Staff knew the people they cared for well. People could have visitors from family and friends whenever they wanted. People spoke positively about the care and support they received from staff members.

People had freed

We used a number of different methods to help us understand the experiences of people using the service. Not all of the people who lived at Glottenham Manor were able to communicate with us. Those that could told us, "I am very happy here, the staff are kind," and " It's very clean and the food is good." We spoke to visitors who told us, "X feels safe here and we are pleased with the care." Another visitor said, "I think the staff are wonderful, they talk to me and also listen." Staff we spoke with said, "I enjoy working here," and "Good support and training."

We saw that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We found that care and treatment was planned and delivered in a way that ensured people's safety and welfare. Care plans were specific for individual people and evidenced regular review.

Safeguarding procedures and policies were in place and the home used them as required to ensure people’s safety.

There were effective recruitment and selection processes in place.

By direct observation and talking to the people who used the service, we found that there were enough qualified, skilled and experienced staff to meet people’s needs.

We examined the provider’s quality assurance files and spoke to staff and saw that there were effective systems in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

We used a number of different methods to help us understand the experiences of people using the service, because some of the people using the service had complex needs which meant they were not able to tell us their experiences. We looked at care records, observed care and talked with visitors.

People we spoke with told us "I enjoy living here", "the staff are kind and nothing is too much trouble", and "they are looking after me". We were also told, "the food is good, but sometimes I get bored". A visitor told us, "they have been very kind and helpful".

People we spoke with told us "I enjoy living here," "The staff are kind and nothing is too much trouble," and "They are looking after me." We were also told, "The food is good, but sometimes I get bored." A visitor told us, "They have been very kind and helpful."

Staff told us they had regular training and supervision. We saw records that showed that people were involved in decisions about their care and that people were treated with dignity and respect. We looked at training records that showed that staff had received career development to help them perform their roles safely and well. We found that the home was clean and comfortable and the food was well prepared and nutritious.

We haven’t been able to speak to people using the service because people were already asleep or settled for the night.

Some people we spoke with were able to tell us that they enjoyed living at Glottenham Manor and were happy. We were told “it’s nice here” “I am happy here” and “the food is usually good”. Other comments included “the food is okay” “it’s very good”, “I’m not always listened to”, “I get very bored”.