This unannounced inspection took place on 27 June, 4 and 19 July 2017. This residential care home is registered to provide accommodation and personal care for up to 30 adults. At the time of our inspection there were 24 people living at the home.

There was 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.

Improvements were required to ensure that people were kept safe in the home. People had risk assessments in place which did not specifically address their identified needs or reduce the matters which put them at risk. The environment in which people lived was not always kept clean and hygienic or free from strong odours.

People were not supported to receive the hydration and nutrition that was necessary to keep them in optimum health. Some people had been identified as being underweight and appropriate support was not always in place to monitor, review and help people to improve their nutritional intake.

Ineffective quality assurance systems were in place to monitor the care and support people received. The improvements that were required to the environment and people’s care had not been identified in a prompt and timely manner, and there had been significant shortfalls as a result.

Improvements were required to ensure people received their medicines. Staff did not always take the time to ensure people had swallowed them and this meant there was a risk that people did not always consume the medicines they required. Improvements were required to review staffing arrangements to ensure people consistently received timely support, particularly around mealtimes which had been slow and unorganised.

People did not always receive appropriate support with their healthcare conditions, or the monitoring and on-going support with long term health conditions. In addition staff needed to be alive to people’s changing needs to ensure they received the support they required at all times.

Further consideration needed to be given to the training, support and supervision staff received to ensure they were competent and capable of providing good care to everyone within the home. Staff had not received regular reviews or feedback about their performance and this was an area which required improvement.

People were not always treated with dignity or respect or have their choices respected. We saw that there were examples of good care however we also saw that some people were not supported to have clean and undamaged clothing and appeared unkempt. Staff did not always display caring attitudes or put people’s needs at the forefront of their mind.

People’s care plans were detailed and written in great length however they were also repetitive and not specific to each identified need. Improvements were required to make them clear and succinct so care staff were in no doubt about the care each person received.

Many people and their relatives provided positive comments to the inspection team about the care they received. An activities programme was in place to add variety to people’s day and we saw examples of staff interacting and praising people when they made attempts to join in.

Staff had an understanding of safeguarding procedures and how they should report any concerns and appropriate procedures were in place for the safe recruitment of staff. There were examples of good care and the registered manager was able to explain how they had made significant efforts to ensure one person could spend their birthday with the people they cared about.

We identified that the service was in breach of four of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3) and we have issued Requirem

The inspection took place on 26 June 2015 and was unannounced.

A registered manager was 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.

The home cares for up to 30 people living with dementia and mental health illness at the time of our inspection 24 people were living at the home.

Robust staff recruitment systems were practiced and staff new staff were provided with comprehensive induction training and all staff were provided with on-going training, which covered vocational training specific to meeting the individual needs of people living at the home. The staff had also achieved accredited training.

All staff were provided with one to one supervision and annual staff appraisals that enabled them to plan their learning and development aims and objectives.

The staff treated people dignity and respect and ensured their rights were upheld. They were knowledgeable about what constituted abuse and the reporting procedures to follow when raising safeguarding concerns.

People had individualised care plans in place that were detailed and reflected their needs and choices about how they preferred their care and support to be provided. The care plans took into consideration people’s occupational, social and recreational preferences and staff spent time engaging people in activities of their choice.

Risk assessments were in place to reduce and manage the risks to peoples’ health and welfare and suitable arrangements were in place for the safe administration and management of medicines.

Robust quality assurance systems were carried out to assess and monitor the quality of the service. The views of people living at the home and their representatives were sought about the quality of the service and acted upon to make positive changes.

People were encouraged to raise any concerns they had about the quality of the service they received and complaints were taken seriously and responded to immediately. There was an emphasis on the service continually striving to improve.

Effective quality monitoring systems were in place. Regular management audits were carried out and used to continually drive improvements. The service worked in partnership with other care organisations and regularly attended care provider forums to keep abreast of current best practice.

The vision and values of the service were person-centred and made sure people living at the home and their representatives were fully consulted, involved and in control of their care. People and their representatives were complimentary about the care they received and the feedback from health and social care professionals involved in monitoring people’s care was positive.

The provider ensured that people’s rights were respected and acted in accordance with legal requirements in reaching best interest decisions which took account of people’s changing needs.

We found that detailed care assessments formed the basis of the individual care plans, which gave information on people’s support requirements, daily routines, hobbies and interests.

We observed how people with dementia were supported over lunch time. We saw that people were encouraged to maintain their independence with eating and drinking. People who required more support with their daily living needs had this provided by staff who treated them with respect and supported people at a relaxed pace.

We saw that records of people's care were held under a secure electronic filing system and records within people's individual care plans were regularly reviewed and updated as people's needs changed.

We spoke with four people using the service; they told us they were happy living at the home and the food was good. People said the staff were friendly; one person said “I have a good laugh with the staff, their lovely”. All of the people we spoke with said they felt safe at Glenside Residential Home.