Great Glens Facility is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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.

Great Glens Facility provides a rehabilitation and personal care service for up to 22 people who have long-term mental health needs. The home is located in a residential area of Wellingborough near to the town centre. There were 19 people using the service when we inspected.

At our last inspection in February 2017, the service was rated overall as requires improvement. At this inspection, improvements had been made and sustained and the service is rated overall good.

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.

The service met all relevant fundamental standards related to staff recruitment, training and the care people received. People’s care was regularly reviewed with them and their mental health needs were monitored so they received the timely support they needed. Staff sought people’s consent before providing any care and support. They were knowledgeable about the requirements of the Mental Capacity Act (MCA) 2005 legislation.

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.

Staff were friendly, kind and compassionate. They had insight into people’s capabilities and aspirations as well as their dependencies and need for support. They respected people's diverse individual preferences for the way they liked to receive their care.

People’s physical and mental healthcare needs were met. They had access to community based healthcare professionals, such as GP’s and psychiatrists, and had regular check-ups. They received timely medical attention when needed. Medicines were safely managed. People were supported to have a balanced diet and they had enough to eat and drink.

The provider and registered manager led staff by example and enabled the staff team to deliver individualised care that consistently achieved good outcomes for all people using the service. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong so that the quality of care across the service was improved.

This inspection took place on 24 February 2017 and was unannounced.

This was the second comprehensive inspection carried out at Great Glens Facility.

Great Glens Facility provides rehabilitation and personal care for up to 22 people who have long-term mental health needs. The facilities include 18 single rooms in the main building with a pair of two bedroomed houses allowing care on different levels to suit each stage of rehabilitation. There were 18 people using the service when we visited.

The service had a registered manager. They were not available on the day we visited. 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 and associated Regulations about how the service is run.

People had not been protected against the risks associated with unsafe or unsuitable premises and equipment. We found that many areas of the premises were unsafe and had not been regularly maintained and risk assessed to ensure people were safe.

We found there was a lack of management oversight of the environment and potential risks to people. Accidents and incidents were recorded, however they were not analysed for identified trends so that measures could be put in place to minimise further occurrence. In addition we found that quality assurance processes had not been used effectively to drive continuous improvement at the service.

Staff had been provided with safeguarding training to enable them to recognise signs and symptoms of abuse and how to report them. There were individual risk management plans in place to protect and promote people’s safety. Staffing numbers were appropriate to keep people safe. There were safe recruitment practices in place and these were being followed to ensure staff employed were suitable for their role. People’s medicines were managed safely and in line with best practice guidelines.

Staff received regular training that provided them with the knowledge and skills to meet people’s needs. They were well supported by the registered manager and had regular one to one supervision and annual appraisals. Staff sought people’s consent before providing any care and support. They were knowledgeable about the requirements of the Mental Capacity Act (MCA) 2005 legislation. People were supported by staff to access food and drink of their choice to promote healthy eating. Staff supported people to access healthcare services to maintain good health. .

People were treated with kindness and compassion by staff; and had established positive and caring relationships with them. People were able to express their views and to be involved in making decisions in relation to their care and support needs. Staff ensured people’s privacy and dignity was promoted.

People’s needs were assessed prior to them receiving a service. This ensured the care provided would be appropriate and able to fully meet their needs. People’s care plans were updated on a regular basis or when there was a change to their care needs. People were supported to take part in meaningful activities and pursue hobbies and interests. The service had a complaints procedure to enable people to raise a complaint if the need arose, however this was not displayed within the service. We were told this would be addressed with immediate effect and made visible to people and visitors. .

There was a culture of openness and transparency at the service. Staff were positive about the management and leadership and felt supported in their roles.

Great Glens Facility provides rehabilitation and personal care for up to 22 people who have long-term mental health needs. The facilities include 18 single rooms in the main building with a pair of two bedroomed houses allowing care on different levels to suit each stage of rehabilitation. There were 20 people using the service when we visited.

We carried out an unannounced comprehensive inspection of this service on 01 September 2015 and found a legal requirement had been breached. 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 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We undertook this focused inspection 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 these areas. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Great Glens Facility on our website at www.cqc.org.uk.

During this inspection on 6 January 2016, we found that improvements had been made.

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.

Comprehensive risk management plans had been drawn up with the involvement of people using the service to promote and protect their safety.

Although we found that the service was no longer in breach of legal requirements, we have not changed the rating for the service on this occasion, because to do this this would require consistent good practice over a sustained period of time. We therefore plan to check this area again during our next planned comprehensive inspection.

This inspection took place on 01 September 2015 and was unannounced.

Great Glens Facility provides rehabilitation and personal care for up to 22 people who have long-term mental health needs. The facilities include 18 single rooms in the main building with a pair of two bedroomed houses allowing care on different levels to suit each stage of rehabilitation. There were 20 people using the service when we visited.

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.

Risk management plans were not always in place for people who used the service, to promote and protect their safety.

People were protected from abuse and felt safe. Staff were knowledgeable about the risks of abuse and reporting procedures.

There were appropriate numbers of staff employed to meet people’s needs and safe and effective recruitment practices were followed.

There were suitable arrangements in place for the safe management of medicines.

Staff were appropriately trained and skilled and provided care in a safe environment. They all received a thorough induction when they started work at the home and fully understood their roles and responsibilities, as well as the values and philosophy of the service. The staff had also completed training to make sure that the care provided to people living with mental health needs was safe and effective to meet their needs.

People’s consent to care and treatment was sought in line with current legislation. Throughout our inspection we saw examples of good quality care that helped make the service a place where people felt included and consulted.

People were supported to eat and drink sufficient amounts to ensure their dietary needs were met.

Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required.

People were looked after by staff that were caring, compassionate and promoted their privacy and dignity.

People’s needs were assessed and regularly reviewed. People and their families contributed to their care plans and they were updated regularly to ensure they were still accurate and relevant.

People were supported to take part in meaningful activities and pursue hobbies and interests.

Systems were in place to obtain people’s view and opinions about their care. People were able to raise concerns or complaints with the service and felt that these would be acted upon.

The service had an open, positive and welcoming culture.

We saw that people were encouraged to have their say about how the quality of services could be improved and were positive about the leadership provided by the registered manager.

The service had a registered manager in post. They were supportive of people and staff and worked alongside them to ensure people received the correct care.

There was a range of quality control and audit procedures in place to help maintain high standards of care and identify areas for development.

We identified that the provider was not meeting the regulatory requirements and was in breach of one 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 spoke with nine people who used the service. One person told us, “It is a very nice environment. The staff do a good job and make sure no-one feels left out.”

People who used the service were encouraged to express their views and preferences. We saw that care staff spoke with people and supported them in a calm and professional manner.

We saw that people who used the service were consulted about their care and support and encouraged to be as independent as possible.

We saw that people’s care and support plans were detailed and took account of their individual needs and preferences and how these would be supported. The provider took appropriate steps to identify any potential risks and to protect people from harm.

People were cared for in a well maintained environment which took into account their needs and preferences.

People were encouraged to express their views and make choices. We saw that care staff spoke with and supported people in a professional sensitive calm and respectful manner and referred to people by their preferred name.

People who used the service told us that they were consulted with the care arranged for them and told us that they felt involved in every aspect of the care and support arrangements. One person we spoke with said, ‘’This place is good. The staff always listen to me and support me when I am down.’’

We saw that people’s support plans were detailed and took account of their individual needs and how these would be supported. The provider took adequate steps to protect the people they cared for and their carers from harm.

The provider had adequate quality assurance systems which made sure the safety and comfort of the people they cared for were maintained and any problems quickly resolved.