This was an unannounced inspection carried out on 26 April 2017.

Glenbrooke House is registered to provide accommodation and personal care to a maximum of 10 people. Nursing care is not provided. Care is provided to younger people who have learning disabilities including some people who have a physical disability.

At the last inspection in March 2015 we had rated the service as 'Good'. At this inspection we found the service remained 'Good' and met each of the fundamental standards we inspected.

People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. There were enough staff to provide individual care and support to people. Staff received opportunities for training to meet peoples' care needs and in a safe way. A system was in place for staff to receive supervision and appraisal and there were robust recruitment processes being used when staff were employed.

The registered manager was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Staff had a good understanding of the Mental Capacity Act 2005 and best interest decision making, when people were unable to make decisions themselves. 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 were provided with opportunities to follow their interests and hobbies and they were introduced to new activities. They were supported to contribute and to be part of the local community. Staff had developed good relationships with people, were caring in their approach and treated people with respect. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care.

People had access to health care professionals to make sure they received care and treatment. Staff followed advice given by professionals to make sure people received the treatment they needed. People received their medicines in a safe and timely way. People who used the service received a varied diet and had food and drink to meet their needs.

There was regular consultation with people and/or family members. A complaints procedure was available and written in a way to help people understand if they did not read. People we spoke with said they knew how to complain but they hadn’t needed to.

Staff and relatives felt there was an open, approachable and stable management team. The registered manager had worked at the home for several years. The provider continuously sought to make improvements to the service people received. The provider had effective quality assurance processes that included checks of the quality and safety of the service.

The provider undertook a range of audits to check on the quality of care provided. We have made a recommendation that the quality assurance system used to collect people’s views about service provision should be further developed.

Further information is in the detailed findings below

We carried out an unannounced comprehensive inspection of this service on 25 March 2015. 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 relating to record keeping.

We undertook this focused inspection on 16 December 2015 to check that they had followed their plan and to confirm that they now met the 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 Glenbrooke House on our website at www.cqc.org.uk.

We found the provider had met the assurances they had given in their action plan and were no longer in breach of the regulations.

This was an unannounced inspection which we carried out on 25 March 2015.

We last inspected Glenbrooke House on 8 August 2014. At that inspection we found the service was in breach of its legal requirements with regard to regulation 15 and regulation 10 of the Health and Social Care Act 2008. (Regulated Activities) Regulations 2010.

Glenbrooke House is registered to provide accommodation and personal care to a maximum of ten adults with learning and physical disabilities.

A registered manager was 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.

Due to their health conditions and complex needs not all of the people were able to share their views about the service they received. During our visit people were relaxed and staff engaged with them. People said they felt safe and they could speak to staff as they were approachable. Comments included, “The staff are kind.” And, “I feel safe living here.” We found there were enough staff on duty to provide individual care and support to people and to keep them safe.

People said staff were kind and caring. Comments included, “I think the staff are lovely, they listen to me.” A relative told us, “(Name) is more content and happy than I have seen him in years and he really feels part of a family at Glenbrooke House.” Another relative said, “Overall I am extremely happy with the care given to my relative.”

People had food and drink to meet their needs. Menus were varied and a choice was offered at each mealtime.

Glenbrooke House was making plans to ensure it meets the requirements of the Deprivation of Liberty Safeguards (DoLS). Staff had received training and had an understanding of the Mental Capacity Act 2005 (MCA) and Best Interest Decision Making, when people were unable to make decisions themselves.

Staff were provided with training to give them some knowledge and insight into the specialist conditions of people in order to meet their care and support needs.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the treatment they needed.

People told us they were supported to be part of the local community. They were provided with opportunities to follow their interests and hobbies and they were introduced to new activities.

People had the opportunity to give their views about the service. There was regular consultation with people and/or family members and their views were used to improve the service.

A complaints procedure was available and written in a way to help people understand if they did not read. People we spoke with said they knew how to complain but they had not needed to.

The provider undertook a range of audits to check on the quality of care provided.

We found that the provider did not always provide person centred care because of inaccurate record keeping. This was in breach of regulation 20 of the Health and Social Care Act 2008(Regulated Activities) Regulations 2010, which corresponds to regulation 9 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 considered our inspection findings to answer questions we always ask:

. Is the service safe?

. Is the service effective?

. Is the service caring?

. Is the service responsive?

. Is the service well-led?

This is the summary of what we found.

Is the service safe?

An assessment of people's care and support needs was carried out before people started to use the service. This was to ensure staff had the skills in order to meet the person's support requirements.

Risk assessments were in place to help protect people and keep them safe but at the same time promote their independence. We noted the service had documentation in place to support "positive risk taking."

An effective regular environmental audit was required to ensure the premises were safe and well maintained for the safety and comfort of people who used the service.

Is the service effective?

We observed staff were enthusiastic and keen to help people develop and become more independent in aspects of daily living. Staff were very knowledgeable about people's care and support needs and through consistent working helped to calm and reassure people with some complex care and support needs. They encouraged the involvement of people by offering them choices in ways that were appropriate to the person.

We saw staff had received some training to help them understand some of the different care and support needs of people they worked with.

Is the service caring?

We observed staff were helpful and offered people information and support about their care. Records showed staff kept people's relatives up to date with what was happening with their relative's care.

People who used the service were introduced to new experiences and activities to help them develop and provide them with stimulation and interests.

Is the service responsive?

Information was collected by the service with regard to the person's ability and level of independence before they started to use the service. Various assessments were completed by the manager of the service with the person and/or their family to help make sure staff could meet their needs. Reviews were carried out with the person who used the service and their representative to make sure the person's care and support needs had not changed. This helped ensure staff supplied the correct amount of care and support.

People's individual needs were taken into account and they, or their representative if they were not able, were involved in all decision making with regard to their care. They were kept informed and given information to help them understand the care and choices available to them.

Regular meetings took place with staff and people who used the service to discuss the running of the service and to ensure the service was responsive in meeting the changing needs of people.

Is the service well-led?

The service was managed by a manager who promoted the ethos of individual care and involvement of the person. This needed to be evidenced by more individual support plans to show the individualised care and support that staff provided to people.

Staff spoken with commented they felt supported by the manager. They said they were provided with training opportunities to help them have more understanding of people's care and support needs.

A more effective audit system was required by the manager in order to ensure all records showed the care and support provided by staff to people. An external quality assurance system needed to be introduced to monitor the quality of care provided to people.

The reason for this visit was to check if improvements had been made to staffing and laundry equipment following a previous inspection. We spoke with some people who received care. They made very positive comments about the care they received. One person said; "I like living here." Another person said; "the staff are great." Another; "I go out shopping."

We found staffing levels had increased which ensured there were enough qualified, skilled and experienced staff to meet people's needs.

We saw the washing machine had been replaced which benefited the people who used the service.

We spoke with four people who lived at the home who told us staff were kind and helpful. One person said," Staff are very kind." Another person said; "I like living here."

Two relatives we spoke with said staff were caring and their relative loved living at the home.

Some of the people who used the service had complex needs and were unable to tell us about their experiences. We carried out an observation of care delivery to help us understand their experiences of the care they received. During our observations we found people appeared calm and happy. Staff were polite, patient and treated people in a respectful way. The atmosphere around the home was calm and relaxed, this was also observed at the lunch time meal.

We saw people were treated with respect and they were involved in all decisions with regard to their daily living needs.

Staff we spoke with said there were opportunities for training.

There was equipment for the use of people who lived in the home but the washing machine was not effective for all the requirements of people who lived in the home.

There were not enough qualified, skilled and experienced staff to meet people's needs as enough staff were not available at evenings and weekends to give people the opportunity to either go out or stay in their home.

We saw the provider had systems in place to gather feedback from people, who used the service, and some systems were in place to regularly assess and monitor the quality of service people received.

People using the service told us they were happy and felt safe at the home. They said they liked the staff, were treated well and had no complaints about their care. Their comments included, “They give me good support” and “I get to do what I want”.

We also spoke with a relative and a friend of a person living at the home. They told us the manager and staff did “a first class job” in supporting the person and the friend said, “This is the best home I’ve known”.

People using the service and relatives told us they were happy with the support provided. Their comments included, “I have a good life. I get to do new things”, “The staff look after me here” and, “They help me to go out”.