This inspection took place on 27 March 2018 and was unannounced, which meant that the staff and provider did not know we would be visiting.

Glenthorne Court is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service provides support and accommodation for up to eight people living with a mental health condition and / or learning disability. The service is based in a house which has been adapted into eight individual flats over three floors with a small communal area on one floor. The building was located in a residential area of Norton within its own grounds. It had on-site parking and was close to local amenities. At the time of our inspection there were eight people using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our previous inspection in July 2016 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There was a breach of Regulation 12 Safe care and treatment, as risks to the health and safety of people, the building and outside areas were identified during inspection. Water temperatures were outside of safe limits which increased the risk of injury from scalds. Staff had failed to report these risks and ensure appropriate action was taken. There was also a breach of Regulation 17 Good governance. This related to record keeping, a lack of meetings for people using the service and quality assurance processes which had not identified the concerns with the premises or records which we identified during inspection.

Following the inspection we issued requirement notices for these two breaches. The provider sent us an action plan detailing how they would become compliant with the regulations. At this inspection we found the provider had made improvements in some areas. The building was secure, the grounds were safe and repairs identified as required had been undertaken. There was however a continued breach of Regulation 12, Safe care and treatment, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to risk assessments, water temperatures and medicines management. You can see what action we asked the provider to take at the back of the full version of this report.

Since the last inspection some improvements had been made in auditing processes. Care plans were regularly reviewed. Care plan records were comprehensive and did not have the gaps in them we identified at the last inspection. Meetings for people had not previously been taking place, however during this inspection we found that they were taking place regularly. Minutes of staff meetings that were missing at the last inspection were made available to us on this inspection. There was however a continued breach of Regulation 17 Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, as the governance arrangements in place had not identified the issues we found during this inspection with medicine recordings and risk assessment. You can see what action we asked the provider to take at the back of the full version of this report.

The service had a registered manager. A registered manager is a person who has registered with the 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.

Policies and procedures were in place to

This inspection took place on 26 July and 1 August 2016. Both days of inspection were unannounced which meant the registered provider and staff did not know that we would be attending.

Glenthorne Court is registered to provide support and accommodation for up to eight people living with a mental health condition and / or learning disability. The service is a house which has been adapted into eight individual flats over three floors with a small communal area on one floor. The service was located in a residential area of Norton within its own grounds and had on-site parking. The service was located close to local amenities and a short distance from local amenities.

At the time of inspection there were four people using the service who were supported by a deputy manager and five care staff.

The registered manager had been registered with the Commission since November 2015, however they were not based at the service. They told us they visited the service each week. 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.

During inspection we identified a number of risks to the safety of people and staff. These included risks to the security of the building, hazards to personal safety, rubbish and failure to carry out repairs needed to one person’s flat in a timely manner. Water temperatures were noted to be outside of safe temperature limits. Staff had failed to report and act upon these risks. Health and safety audits had not highlighted any of these risks.

Care plans were in place however lacked the detail needed. Care plans were also in place where no care needs had been identified. Care plan reviews did not show if people had been involved in them or what they had said.

There were gaps in care records and records relating to the day running of the service. This meant information needed was not always available. These gaps had not been identified within quality assurance checks by the registered manager and registered provider.

Quality assurance processes required improvement. The concerns which we had identified during inspection had not been identified during quality assurance checks. No quality assurance checks had been carried out in relation to care plans or records.

No meetings for people had been carried out since the service opened. This meant we could not be sure if appropriate information was shared with people. Staff meetings were carried out each month, however minutes were not available for all meetings.

The registered manager had failed to notify the Commission about an incident at the service where contact with police was made. The deputy manager told us this was because of confusion about when notifications needed to be made.

Staff told us they enjoyed working at the service and felt supported by the deputy manager who was based at the service. A registered manager was in post, however not based at the service but staff felt able to approach them if needed. Staff told us the registered manager did visit the service.

The registered manager was responsible for providing information about safeguarding, accidents and incidents and outcomes of audits with the registered provider regularly.

No complaints had been made at the service, however everyone we spoke with told us they knew how to make a complaint and felt confident that this would be taken seriously.

People told us they received their medicines when they needed them. Some people were given assistance with their medicines and some people managed their own medicines. Records were in place to support this. Staff had received training in medicines; however no competency checks had been carried out.

Topical creams intended for use as ‘homely remedies’ did not contain dates