Gledwood Care 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.

Gledwood Care Home provides accommodation and personal care to five adults with mental health needs. The home was established in 2011 by a group of family members. There was a registered manager in post at the service at the time of our inspection. 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 the last inspection, the service was rated Good. At this inspection we found the service remained Good.

There were systems and processes in place to protect people from the risk of harm. There were enough staff on duty to meet people’s needs.

Checks were carried out during the recruitment process to ensure only suitable staff were employed.

There were arrangements in place for the safe management of people’s medicines and regular checks were undertaken.

The service was clean and had effective systems to protect people by the prevention and control of infection.

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.

People’s nutritional needs were met, and they were involved in the purchasing and cooking of their meals if they wished to.

People were supported by staff who were suitably trained, supervised and appraised.

Staff were caring and treated people with dignity and respect. Care plans addressed each person’s individual needs, including what was important to them, and how they wanted to be supported.

People were involved in undertaking activities of their choice, both in the home and the community. People were cared for in a way that took account of their diversity, values and human rights.

Where appropriate, people’s end of life wishes were discussed and recorded.

People living at the home, their relatives and stakeholders told us that the management team was approachable and supportive. People and their relatives were supported to raise concerns and make suggestions about where improvements could be made.

The provider had effective systems in place to monitor the quality of the service and ensure that areas for improvement were identified and addressed.

The registered manager kept themselves informed of developments within the social care sector and cascaded important information to the rest of the staff team.

The inspection took place on 4 January 2016 and was unannounced. The service was last inspected on 24 April 2014 and at the time was found to be meeting the regulations we checked.

Gledwood Care Home provides accommodation and personal care for up to five adults with mental health needs. There were four people living at the service at the time of our inspection.

Gledwood Care Home was established in 2011 by a group of family members. There was a registered manager in post at the service at the time of our inspection. 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 and we saw there were systems and processes in place to protect people from the risk of harm. There were enough staff on duty to meet people’s needs and staff were always available to cover at short notice to ensure people’s safety.

Staff had undertaken training about the Mental Capacity Act 2005 (MCA) and were aware of their responsibilities in relation to the Deprivation of Liberty Safeguards (DoLS). They ensured people were given choices and opportunities to make their own decisions.

There were arrangements in place for the management of people’s medicines and staff had received training in administration of medicines.

People’s nutritional needs were met, and they were involved in devising their menus. Staff supported people with shopping for food, preparing and cooking their meals.

Staff received effective training. The management team carried out supervision and appraisal of staff, although this was not always regular. The registered manager, operations manager and the provider kept themselves informed of developments within the social care sector and cascaded important information to the rest of the team, thus ensuring they were well informed and trained to deliver effective support to people.

Staff were caring and treated people with dignity and respect. Care plans were clear and comprehensive and written in a way to address each person’s individual needs, including what was important to them, and how they wanted their care to be provided.

A range of activities were provided both in the home and in the community. We saw that people were cared for in a way that took account of their diversity, values and human rights.

People living at the home, their relatives, staff and other stakeholders told us that the management team was approachable and supportive. There was a clear management structure, and they encouraged an open and transparent culture within the service. People and their relatives were supported to raise concerns and make suggestions about where improvements could be made.

The provider had effective systems in place to monitor the quality of the service and ensure that areas of improvement were identified and addressed.

During this inspection we spoke with five people who used the service, two relatives and three staff including; the service provider, registered manager and deputy manager. We viewed three care records and six staff training files. Five people were using the service at the time of our visit.

We focused on answering five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People received care and treatment in an environment that was safe. The communal areas and bedrooms that we looked at within the home were clean and tidy. A survey completed by a relative said “The accommodation is very homely and not like a typical residential home, it is warm, clean and comfortable.”

We found there were enough staff on duty to meet the needs of the people living at the home and the service provider was available on call in case of emergencies. Staff training records we looked at showed people had the skills and experience needed to support people living in the home.

There were procedures in place to identify and prevent abuse to people occurring. Referral procedures to external agencies were in place and staff spoken with were aware of whom to contact, both internally and externally, should they suspect someone had been the victim of abuse.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DOLS) which applies to care homes. The registered manager had been trained to understand when an application should be made, and how to submit one. At the time of our inspection no applications had been made.

We spoke with five people who used the service. They all told us they could speak to any member of staff if they had any worries or concerns. One relative commented in a recent survey “X trusts the carers and understands that they have their well-being foremost in their minds.” We spoke with one relative who told us "I feel totally reassured that X is safe and well cared for."

Is the service effective?

We saw that people who used the service, their relatives and health and social care professionals were all involved in making decisions about people’s care and treatment. People’s needs were assessed and care was delivered in line with their individual care records. In each of the three care records we looked at we saw people had risk assessments in place for staff to follow which ensured they supported people appropriately with their physical and mental health well-being.

We reviewed six staff training files and saw that training identified as mandatory by the provider such as safeguarding, moving and handling, food hygiene, fire safety, first aid, and infection control was up to date. We saw training that assisted the professional development of staff was in the process of being arranged. Further training was scheduled for mental capacity, DOLs and dementia.

The manager and staff told us they treated people as individuals, promoted independence and encouraged everyone to do what they could for themselves. One person told us, "I like going to the cinema.” Another person told us “I like going to the day centre.” During our inspection three people went out to take part in community activities of their choice.

Is the service caring?

We observed staff interact with people at different times during the day. We observed breakfast and lunch being served as well as medicines being administered. Staff were friendly, patient and calm. People were encouraged to be as independent as they could and where they needed assistance this was provided in a way that was appropriate for their needs.

The environment was relaxed and all staff had a calming demeanour and good rapport with people using the service. One person who used the service told us, "The staff are good at looking after me.” Another person said “They are very kind and caring towards me.”

Is the service responsive?

The provider had in some cases assessed people over many months before they moved into the home to ensure they could meet their needs. This ensured the risk to a breakdown in the placement was minimised. We saw that people’s health and social care needs were reviewed frequently with other professionals.

People were confident they would receive the support they needed quickly should their health needs change. This was demonstrated by the registered manager and deputy manager who were able to recognise changes in one person who was at risk of physical health deterioration. This was monitored closely and medical help arranged as necessary.

Is the service well led?

The registered manager was a former health care professional with over 30 years’ experience working with people with mental health support needs. We spoke with the service provider who showed a good understanding of what was required to ensure staff were led by an effective management team.

A relative commented in a survey “We have regular discussions and I am very happy with the way the home is run and the care and support given to X.” One person we spoke to told us “It’s excellent here.” Another relative we spoke to told us "If we didn't have Gledwood as a family we wouldn't know what to do."

Systems were in place to ensure that people were happy with the service they received and to ensure their health and safety was protected.

We spoke with the manager of the home, two other members of staff and two people who were using the service. People told us that their choices were respected and we saw that they were involved in planning their care and support.

We observed positive interactions between staff and the people using the service. One person told us "the staff are fine, they are very kind" and another said, "staff help me to go and see my family". People told us that they felt their needs were being met.

Staff were working with a local pharmacist to ensure that appropriate systems were in place for the safe receipt, storage, administration and disposal of medicines. We found that medicines were stored safely and medicine administration record sheets were fully completed.

There were suitable numbers of staff on duty at the time of our visit, however, the home did not have a duty roster detailing the staffing arrangements on other days and therefore we could not check the staffing levels on these days.

The records kept in the home were kept securely, in good order and accessible to staff.

Although people were asked for their consent to care and support staff did not have sufficient knowledge about the Mental Capacity Act 2005 and their responsibilities with regard to this legislation.

At the time of our visit there were two people using the service. We spoke to both people. They told us that they got good support from the staff and that they could generally spend their time as they wanted. We observed positive interactions between the staff and people who use the service.

People told us about the different activities they got involved in, such as going shopping, visiting family, going to the library and attending day centres.