About the service: Glen Tanar is a residential care home located close to the promenade and busy shopping area of Bispham. The home provides accommodation for a maximum of 21 people. The accommodation comprises of 21 single bedrooms, only one of which has ensuite facilities. At the time of our inspection there were 21 people who lived at the home.

People’s experience of using this service:

People told us they were happy with the care provided for them and staff were caring and compassionate. They said staff were kind and attentive and treated them with respect.

We observed daily routines and practices and found people were treated equally and their human rights were respected.

People’s care and support had been planned proactively and in partnership with them. People felt consulted and listened to about how their care would be delivered.

There was an emphasis on promoting dignity, respect and independence for people. People told us they were treated as individuals and received person-centred care.

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.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. People told us they felt safe when supported by staff.

People were safely supported to receive their medicines as prescribed. Staff received regular training and competency checks to ensure they were safe to administer medicines.

Meal times were relaxed and organised around people’s individual daily routines. People who required help to eat their meals were supported by caring, attentive and patient staff.

The service used a variety of methods to assess and monitor the quality of the service. These included regular audits and satisfaction surveys to seek people’s views about the service provided.

Rating at last inspection: At the last inspection the service was rated requires improvement (report published 11 June 2018).

Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider is no longer in breach of regulations.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 12 and 14 March 2018, and was unannounced on the first day.

Glen Tanar Rest 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.

Glen Tanar Rest Home is registered to provide accommodation for up to 21 people who require 24-hour care. At the time of our inspection, 19 people were living at the home. The premises are an adapted house in Bispham, near Blackpool. Accommodation is provided over two floors, with a through-floor lift and stair-lift for access between floors.

At the last inspection in September 2015, we found the provider was meeting all legal requirements. At that inspection, we rated the service ‘Good’.

During this inspection, we found the provider was not meeting all legal requirements and have rated the service ‘Requires improvement’.

The service had 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.

The provider had not ensured written plans of care were in place, in order to guide staff to deliver safe and effective support which met people’s needs and reflected their preferences. This was in breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The lack of written plans of care was in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following our inspection, we received confirmation from the provider that they had begun work to implement new care planning documentation in order to address this shortfall. You can see what action we told the provider to take at the back of the full version of the report.

The provider’s systems to assess, monitor and improve the service had not been effective in identifying the concerns we raised during our inspection. This was in breach of Regulation 17 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.

We looked at how the service managed medicines. Staff who administered medicines had all been trained to do so safely. However, we found information to guide staff on the use of ‘when required’ medicines was not in place and handwritten entries on medicines administration records were not countersigned, in line with best practice guidance. We have made a recommendation about this.

Staff had received training in relation to infection control and were aware of their responsibilities. However, we found communal toiletries were being used, which was not in line with best practice. We have made a recommendation about this.

Staff had assessed risks to individual people and risks posed by the environment. However, these had not been kept under review and updated accordingly. We have made a recommendation about this.

We received mixed feedback about meal provision. We saw meals looked appetising and were well presented. People raised concerns about the variety of choice on offer, particularly in the evenings. We found monitoring of people’s food and fluid intake was not consistent. We have made a recommendation about this.

People who used the service or, where appropriate, others acting on their behalf, were involved in planning people’s care at the initial assessment stage. However, people told us they were not involved in regular reviews of their care. We have made a recommendation about this.

We found confidential personal information was not always stored securely when not in use. We have made a recommendation about

During this inspection the Inspector gathered evidence to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them, visiting healthcare professionals and from looking at records.

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

Is the service safe?

People told us they felt safe and their rights and dignity was respected. They told us they were receiving safe and appropriate care which was meeting their needs. Safeguarding procedures were in place and staff understood how to safeguard the people they supported. The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant that people would be safeguarded as required. Equipment had been maintained and serviced regularly ensuring people were not put at unnecessary risk. We found staffing levels were adequate with an appropriate skill mix to meet the needs of people using the service.

Is the service effective?

People’s health and care needs had been assessed with them, and they were involved in writing their plans of care. Specialist dietary needs had been identified where required. People said that their care plans were up to date and reflected their current needs. Visitors confirmed that they were able to see people in private and that visiting times were flexible.

Is the service caring?

People were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. The people we spoke with were very happy with the care being provided. One person said, “I am very happy with my care. The staff look after me really well”. A visiting relative said, “Mum is comfortable and clean at all times. Her health has greatly improved since she moved into the home”. Two visiting healthcare professionals told us people living at the home were being well looked after. Care plans had been maintained recording the care and support people were receiving. Good care practices were observed and people told us they were happy with the support they were receiving.

Is the service responsive?

We found a range of activities were organised to keep people entertained. People told us they enjoyed participating in these and they had fun with staff. Two visiting healthcare professionals told us they were pleased staff spent time with people talking and enjoying discussing topical subjects. People spoken with said they were happy with their care and had no complaints.

Is the service well-led?

The service had a quality assurance system in place. Records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving. Staff had a good understanding of their roles and responsibilities. People we spoke with said they received a good quality service at all times. Two visiting healthcare professionals told us the service followed their instructions and advice to ensure people’s healthcare needs were met.

During our inspection we looked at care, staff training records and staff supervision arrangements. We spoke with people living at the home, people visiting, three staff members and the manager. Care practices were also observed throughout the inspection and we monitored meal times. We did this to confirm people were having their care needs met. We also wanted to identify that appropriate arrangements were in place to support staff members.

The people we spoke with said they were receiving safe and appropriate care which was meeting their needs. One person said, “I have no concerns about my care or the staff who look after me. I am very happy and settled. I enjoy all my meals and we get plenty to eat. You can always ask for more if you are still hungry ”. A visiting relative said, “I visit mum four times a week and I am always made welcome. I have complete confidence that mum is being well looked after and I don’t have to worry about her”.

We observed meal times were served in a relaxed and unhurried manner. Staff members were seen being attentive to the needs of people who required assistance.

During our inspection we contacted the Blackpool contracts monitoring team. They informed us about some observations they made during a recent visit regarding choice of meals and staff attitude. These were addressed by us during the inspection.

During our inspection we looked at care records and the homes duty rota. We did this to confirm people were being well supported and staffing levels were sufficient to meet people’s needs. We also spoke with people staying at the home, a visiting healthcare worker, a visiting relative and the manager. The people we spoke with said they were receiving safe and appropriate care which was meeting their needs. They told us the staff were polite, caring and professional when undertaking their work. Comments received included:

“I have no concerns about the care here. The residents seem to be well looked after and are always clean and presentable”.

“Dad is really happy living here. He has been unwell recently and we had thought he might have to move to a nursing home. He’s adamant he is going nowhere”.

“The staff are as good as gold. They will do anything for you within reason. I cannot praise them high enough”.

People told us they had been given plenty of information about the service being provided to make an informed choice about whether the home was the right place to meet their needs.

We spoke to people about their experiences living in the home and were told the staff team provided sensitive and flexible personal care support and they felt well cared for.

“We feel fully involved in dad’s care. We are always updated about his health whenever we visit and informed about any changes that are required to the support the home is providing”.

“I have been involved in mum’s care from day one. I visited the home before she moved in and after talking to the manager and staff was satisfied it was the right place for her. I am very happy with the care she is receiving”.

"The staff are all very kind and do their best for you".

“I am very happy and settled. I couldn’t ask for better care”.

“I am very satisfied with the care being provided. Mum is settled and looks really well. She has put weight on since she moved in and tells me she really enjoys her meals”.

“I find the staff very approachable and responsive when I visit. I am satisfied mum is safe and well looked after”.

“I visit most days and never worry about mum. I always sit in the lounge with her and observe the staff with the other residents. They are always so kind and patient with them. I have never seen anything that has concerned me”.

This inspection took place on 18 and 21 September 2015 and was an unannounced inspection.

Glen Tanar is situated in a residential area within easy access of the promenade and shopping area of Bispham. The home is registered for 21 older people with 19 single rooms and one double room. Most are not en-suite. Communal bathing facilities and toilets are available throughout the home. The building has two floors with lift access to the first floor. There are gardens to the front and rear. At the time of the inspection visit 20 people were living at the home.

At the last inspection in April 2014. The service was meeting the requirements of the regulations that were inspected at that time.

There was a registered manager in place. 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.

The registered manager had procedures in place to protect people from abuse and unsafe care. Risks to people were minimised because risk assessments were in place. People told us they felt safe living at Glen Tanar and liked living there. One person said, “I feel safe in the home and trust the staff and can talk with them about anything.” Another person told us, “I was falling at home but I feel very safe here.”

We looked at how the home was being staffed. We saw there were enough staff on shifts to provide safe care. People we spoke with were satisfied with staffing levels. One person said, “There are always staff about when you want them.” A relative said, “The staffing levels are excellent. There are always plenty of staff on duty.”

Recruitment and selection was carried out safely with appropriate checks made before new staff could start working in the home.

Staff managed medicines competently. They were given as prescribed and stored and disposed of correctly. People were able to manage their own medicines if they were able to do so safely. People told us they felt staff gave them their medicines correctly and when they needed them.

People’s health needs were met and any changes in health managed in a timely manner. One person said, “When I was ill the staff could not have treated me better. I was soon in hospital where they sorted me out so that I could come back home.” A relative told us, “The staff are knowledgeable about [my family member’s] condition and were on the ball and got the doctor out. They were spot on about this and they always keep me up to date.”

The environment was well maintained, clean and hygienic when we visited. There were no unpleasant odours. The people we spoke with said they were pleased with the standard of hygiene in place. One person told us, “I like my room and it is cleaned every day.”

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. One person said of the staff team, “They all seem to know how to help us and what we like and don’t like.” A member of staff told us, “We have loads of training. It really helps us to do things right.”

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS). The registered manager discussed an application she had submitted. This showed us staff were working within the law to support people who may lack capacity to make their own decisions.

People were offered a choice of healthy and nutritious meals. Staff made sure people’s dietary and fluid intake was sufficient for good nutrition. People were very complimentary about the food. One person said, “We are so well fed here. The meals are lovely - excellent.” People said the meals were very good and they had no problems getting snacks or drinks outside of meal times. One person commented, “The food is good and we can have snacks at any time during the day and night.”

People we spoke with told us staff were caring and helpful. One person told us, “I only came in for a short time but decided to stay. The staff are fantastic. They do everything they can to make you happy.” Another person said, “Glen Tanar is a smashing place to stay. The staff are so good it is like a big happy family.”

Staff frequently interacted with people. People were not left without support and staff were attentive, responding to any requests for assistance promptly. One person told us, “If you want anything the staff come straight away. If they say they will be back in two minutes they always are. We are never kept waiting.”

Staff knew and understood people’s history, likes, dislikes, needs and wishes. They knew and responded to each person’s diverse cultural, gender and spiritual needs and treated people with respect and patience. Staff offered choices and encouraged people to retain their independence wherever possible. People felt they could trust staff and they were friendly and respected their privacy. One person said, “When they shower me they treat me with dignity and respect and allow me to have privacy. The staff talk to us and we talk to them and they listen to me. I would definitely recommend this home to others.”

Staff recognised the importance of social contact, companionship and activities. There was a broad and varied activities programme. One person said, “It’s not a bad place to live, there are plenty of activities to do if you want. I have no complaints.” A relative told us, “This is an excellent home with good activities and a good activities co-ordinator.”

Staff were very welcoming to people’s friends and relatives. One person told us, “My family are welcomed at any time. The staff always make a fuss of them.” A relative said, “I am always welcomed in. The staff are so friendly. I would stay here myself.”

We asked people if they knew how to raise a concern or to make a complaint if they were unhappy with something. They told us they knew how to and when they had told staff of any concerns they listened to them and took action to improve things. One person said, “There have been little niggles but these have been sorted out.”

There were procedures in place to monitor the quality of the service. The registered manager sought people’s views in a variety of ways and dealt with any issues of quality quickly and appropriately. One person told us, “I feel comfortable in speaking up and have completed a survey for the home.”

There was a transparent and open culture that encouraged people to express any ideas or concerns. People and their relatives felt their needs and wishes were listened to and acted on. They said staff were easy to talk to and encouraged people to raise questions at any time. One person said, “If you have a problem here they have time sit and talk it through with you.”