This inspection took place on 9 and 10 November 2017 and was unannounced. This inspection was partly prompted by an incident which had some impact on people using the service and this indicated a potential concern about the management of risk in the service. While we did not look at the circumstances of the specific incident, we did look at associated risks.

At our last inspection of the service on 13 and 14 September 2016 we found the service to be meeting regulatory requirements and was rated 'Good'. Glebe Court Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Glebe Court Nursing Home provides personal and nursing care support for up to 51 older people some of whom have a physical disability or sensory impairment and may be living with dementia. At the time of our inspection there were 46 people using the service. The home had a registered manager in post. However they had recently left the service and a new manager had been appointed and was applying to the CQC to become the 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.

Risks to people were assessed and recorded, and staff acted to manage identified risks safely. Medicines were managed, administered and stored safely. People were protected from the risk of abuse, because staff were aware of the types of abuse and the action to take if they had any concerns. There were systems in place to ensure people were protected from the risk of infection. Accidents and incidents were recorded and acted on appropriately. There were safe staff recruitment practices in place and appropriate numbers of staff were deployed throughout the home to meet people’s needs.

There were processes in place to ensure staff new to the home were inducted into the service appropriately. Staff received training, supervision and appraisals that enabled them to fulfil their roles effectively. Staff were aware of the importance of seeking consent from people and demonstrated an understanding of the Mental Capacity Act 2005. Staff were also aware of the conditions under which a person may be deprived or their liberty, and acted in accordance with the Deprivation of Liberty Safeguards, to ensure people were only lawfully deprived when this was in their best interests. People’s nutritional needs and preferences were met and people had access to health and social care professionals when required.

People told us staff treated them with kindness and their privacy and dignity were respected. People were involved in day to day decisions about their care and had care plans in place which reflected their individual needs and preferences. People were supported to maintain relationships with relatives and friends. There was a range of activities available to meet people’s interests and to promote stimulation. The service provided appropriate care and support to people at the end of their lives. People’s needs were reviewed and monitored on a regular basis. People were provided with information on how to make a complaint. The service worked with health and social care professionals to ensure people’s needs were met and the home made connections with people within the local community. There were regular volunteers who supported and facilitated entertainment and activities within the home.

People and relatives were aware of how to make a complaint and expressed confidence any concerns would be addressed by the management. There were robust systems and processes in place to monitor and evaluate the servic

This inspection took place on 13 and 14 September 2016 and was unannounced. At the last inspection of the service on 3 and 4 September 2015 we found breaches of the Health and Social Care Act 2008 in relation to medicines were not always stored, administered and managed appropriately. Staff supervision and appraisals were not always conducted on a regular basis in line with the provider’s policy and although the provider had procedures and systems in place to evaluate and monitor the quality of the service provided we found that these were not always followed or were not effective in ensuring the quality of care people received. We carried out this inspection to check the provider’s action plan had been completed and outstanding breaches had been met and also to provide a review of the rating for the service.

Glebe Court Nursing Home provides residential and nursing care for up to 51 older people and is situated in the London borough of Bromley. At the time of our inspection the home was providing support to 46 people. The home 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.

At this inspection we found the provider was compliant with the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Risks to the health and safety of people using the service were identified, assessed and reviewed in line with the provider's policy. Medicines were managed, administered and stored safely. There were arrangements in place to deal with foreseeable emergencies. There were safeguarding adult’s policies and procedures in place. Accidents and incidents were recorded and acted on appropriately. There were safe staff recruitment practices in place and appropriate numbers of staff were deployed throughout the home to meet people’s needs.

There were processes in place to ensure staff new to the home were inducted into the service appropriately. Staff received training, supervision and appraisals that enabled them to fulfil their roles effectively. There were systems in place which ensured the service complied with the Mental Capacity Act 2005 (MCA 2005). This provides protection for people who do not have capacity to make decisions for themselves. People’s nutritional needs and preferences were met and people had access to health and social care professionals when required.

People were treated with respect and were consulted about their care and support needs. Staff respected people’s dignity and privacy. People were supported to maintain relationships with relatives and friends. People’s support needs and risks were identified, assessed and documented within their care plan. People’s needs were reviewed and monitored on a regular basis. People were provided with information on how to make a complaint. The service worked with health and social care professionals to ensure people’s needs were met.

There were robust systems and processes in place to monitor and evaluate the service provided. People’s views about the service were sought and considered through residents meetings and satisfaction surveys.

We carried out an inspection on the 20 February 2014 in response to concerning information received prior to the inspection. The concerns related to the care and safety of people living at the home. At the inspection, we spoke were only able to speak with one resident as, the remaining people living at the home were asleep. The person we spoke to said "it’s okay here but it's not like living at home and I have no concerns for now".

We found that there were adequate staff on duty and there was no evidence after we gained entry to the home to support the allegation. We found that people had access to call buzzers and that documentation had been completed to suggest that people had received the appropriate care.

People told us that staff were very good and they enjoyed living at the home and the care was good. People said that they enjoyed having the pianist and the PAT dog visits to the home. People told us that they felt staff responded in a timely manner to call bells and that they did not have to wait for assistance. Some people we spoke with were aware that the provider carried out reviews of their care. A relative told us that his relative had settled in very well and although the surroundings were not plush, the home was clean and tidy and the staff were great.

People's needs were assessed and care was planned and regularly reviewed, however we found that sometimes care plans did not always reflect the care provided. The provider had systems in place to monitor the quality of the service and most care plans were clear and legible and records were stored securely.

People told us that staff treated them with respect, and the relatives we spoke with agreed. The relatives we spoke with said they had been involved in planning care for their family member and were kept informed of any changes. People told us that the care their relative had received was first class and that staff had exceeded their expectations in all aspects. One relative said that they came in every day and had lunch at the home and staff were always polite. People told us that call bells were answered fairly quickly and that staff were kind and caring.

We found that the people who used the service were involved in their care planning and received a personalised care and support which was based on an assessment of their needs. Staff received support and training in different aspects of care and demonstrated an understanding of safeguarding of vulnerable adults.

People we spoke with told us that the staff were kind and involved them in their care.

People we spoke with told us that they had been involved in decisions about their care and felt able to discuss their needs with the staff.

People we spoke with told us that the staff were kind and involved them in their care.

People told us that they enjoyed the activities.

This inspection took place on 3 and 4 September 2015 and was unannounced. At our previous inspection in February 2014, we found the provider was meeting the regulations in relation to the outcomes we inspected.

Glebe Court Nursing Home provides residential and nursing care for up to 51 older people and is situated in the London borough of Bromley. At the time of our inspection the home was providing support to 47 people. The home 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.

At this inspection we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Medicines were not always stored, administered, managed and recorded appropriately. Registered nursing staff were not always provided with regular appropriate training to ensure they were skilled and up to date with best practice. Staff supervision and appraisals were not always conducted on a regular basis and in line with the provider’s policy, although some recent improvements had been made.

Although the provider had procedures and systems in place to evaluate and monitor the quality of the service provided we found that these were not always followed or were not effective in ensuring the quality of care people received.

There were policies and procedures in place for the safeguarding of adults from the risk of abuse and staff knew how to respond to concerns appropriately. Risk assessments were conducted to assess and monitor levels of risk to people’s physical and mental health.

There were safe staff recruitment practices in place and there were adequate numbers of staff on duty deployed throughout the home to ensure people’s needs were met. There were suitable arrangements in place to ensure staff were provided with an appropriate induction into the service.

Accidents and incidents involving people using the service were recorded and acted on appropriately and there were processes in place to deal with foreseeable emergencies.

People were involved in decisions about their care and care plans contained mental capacity assessments where people’s capacity to make decisions was in doubt. People were provided with sufficient amounts of foods and drink to meet their needs.

Staff were familiar with people and knew how best to support them. Staff had good knowledge of people’s personalities and behaviour and were able to communicate effectively with people whose verbal communication and comprehension was limited.

People were provided with appropriate information that met their needs and were supported to understand the care and support choices available to them. Care plans showed that people’s care needs were regularly assessed and reviewed in line with the provider’s policy.

A range of activities were provided on a daily basis to ensure that people were supported to engage in meaningful activities that reflected their interests and supported their physical and mental well-being.

There was a complaints policy and process in place and people told us they knew how to make a compliant or raise a concern.

There were systems and process in place to monitor and evaluate the quality of the service and people were provided with opportunities to feedback about the service they received.