Glencoe is a nursing home which offers care and support for up to 20 predominantly older people. At the time of the inspection there were 19 people living at the service. Some of these people were living with dementia. The home is situated on the outskirts of Gwithian, near Hayle. The service is a detached house on two floors with a passenger lift to assist people to the upper floor. Eight of the rooms had en-suite facilities. There were two further bathrooms one with an assisted bath and another was a shower room. There is a rear garden area.

This unannounced comprehensive inspection took place on the 23 April 2018.

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.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 services general environment required decoration where wallpaper had been damaged due to lounge chairs being brushed against them. There was extensive chipping of paintwork throughout the service due to the movement of hoists and wheelchairs. The ground floor carpet was heavily stained in places. At the time of the inspection the dining room was being decorated and there was a maintenance plan in place to improve the environment.

Both sluice facilities were broken in the days before the inspection. One sluice was being repaired on the day of the inspection. The additional sluice required specialist maintenance and this was being sought. Staff had been instructed of the issues and were working to maintain effective infection control measures. Staff wore protective clothing such as gloves and aprons when needed and there were appropriate procedures in place to manage infection control risks.

One person was receiving oxygen in their room. The machine holding the oxygen was being stored outside the door of the room and had a hazard warning in place. However, it was not obvious and a more prominent warning would have alerted people to the hazards where oxygen was being used. We shared this with the registered manager who acted to improve signage.

There were no Personal Emergency Evacuation Plans [PEEPS]. The purpose of these is to support people in the case of emergency by providing individual emergency evacuation plans to support staff and emergency services. The registered manager acknowledged the need to improve this and put a plan in place to develop PEEPS with immediate effect.

People received their medicines as prescribed. Systems and processes relating to the administration and storage of medicines helped ensure medicines were managed safely. Regular audits were being carried out. However, we found an excess of some prescribed medicines and creams which had been opened without having the date of opening recorded. Meaning the expiration date could not be determined by staff. There was no effective system in place to ensure staff recorded when they had applied creams to people in line with their care plan.

The service had sufficient staffing levels in place to provide the level of support people required. The registered manager told us they made sure they worked a shift at least once a week to “Keep in touch with what’s going on”. There was limited use of agency nurses to ensure continuity. People told us and we observed staff were responsive and available when they needed them. Call bells were answered quickly.

Staff were sufficiently skilled to meet people’s needs. Necessary pre-employment checks had been completed and there were systems in place to provide new staff with appropriate induction trainin

Glencoe is a care home which provides accommodation for up to 20 older people who require personal care. At the time of the inspection 20 people were using the service. Some of the people who lived at the service needed care and support due to dementia, mental health needs, sensory and /or physical disabilities.

There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

We inspected Glencoe on 20 and 21 April 2016. The inspection was unannounced. The service was last inspected in July 2013 when it was found to be meeting the requirements of the regulations.

People told us they felt safe at the service and with the staff who supported them. People told us, “It is lovely, it is my home. I like it here. People are lovely,” and “It is a very good place to stay. I had no hesitation to come here. ” A health professional told us, “We have always held the home in high regard.”

People told us they received their medicines on time. Medicines administration records were kept appropriately and medicines were stored and managed to a good standard.

Staff had been suitably trained to recognise potential signs of abuse. Staff told us they would be confident to report concerns to management, and thought management would deal with any issues appropriately.

Staff training was delivered to a good standard, and staff received updates about important skills such as moving and handling at regular intervals. Staff also received training about the needs of people with dementia.

Recruitment processes were satisfactory as pre-employment checks had been completed to help ensure people’s safety. This included written references and an enhanced Disclosure and Barring Service check, which helped find out if a person was suitable to work with vulnerable adults.

People had access to medical professionals such as a general practitioner, dentist, chiropodist and an optician. People said they received enough support from these professionals. However records of when people had last seen a dentist were variable. The registered manager said she would look into this, as the dentist did see people regularly.

There were enough staff on duty and people said they received timely support from staff when it was needed. People said call bells were answered promptly and we observed staff being attentive to people’s needs.

The service had a programme of organised activities, and an activity organiser was employed two days a week. These activities included activities such as board games, singing, drawing, bingo and baking. The activities organiser also spent individual time with people in their rooms. Some external entertainers such as musicians and singers visited. People went out on occasional outings.

Care files contained information such as a care plan and these were regularly reviewed. The service had appropriate systems in place to assess people’s capacity in line with legislation and guidance, for example using the Mental Capacity Act (2005).

People were very happy with their meals. Everyone said they always had enough to eat and drink. Comments received about the meals included, “The food is very good,” “and people said they had a choice. People said they received enough support when they needed help with eating or drinking.

People we spoke with said if they had any concerns or complaints they would feel confident discussing these with staff members or management, or they would ask their relative to resolve the problem. They were sure the correct action would be taken if they made a complaint.

People felt the service was well managed. We were told. “The manager is really relaxed and supportive.” Staff told us the new owner was “Extremely approachable” and had “Done an awful lot for the