This was an unannounced inspection that took place on 15 June 2016.Glendale Lodge offers care and support for up to 30 older people, some of whom may be living with dementia. The majority of bedrooms are on the ground floor and have en-suite bathrooms. The service is located on the outskirts of Deal overlooking countryside. At the time of our inspection there were 30 people using the service.
The service is run by the registered manager with a deputy manager. Both were present on the day of our inspection. 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.
At the previous unannounced comprehensive inspection of this service on 28 and 29 April 2015, four breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements. At the time of this inspection the provider has complied with the breaches and had met their legal requirements.
People, relatives and staff told us they were very satisfied with the service. People said they felt safe and trusted the staff.
Risks to people had been assessed and there were measures in place to reduce risks to keep people as safe as possible. Staff told us how they moved people safely but further detail was required in moving and handling risk assessments to make sure they were personalised to people’s mobility needs. This was an area for improvement.
People told us they received their medicines regularly. Medicines were stored, administered, recorded and disposed of safely. Further detail was required to ensure ‘as and when’ medicines were given in line with people’s needs. This was an area for improvement.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS applications were made for anyone who had their liberties restricted. Policies and procedures were in place relating to the Mental Capacity Act 2005 (MCA) and the DoLS. When people lacked the mental capacity to make decisions the staff were guided by the principles of the MCA to ensure any specific decisions were made in the person’s best interests. Some people living at the service had DoLs authorisations in place and others had been applied for.
Staff had received safeguarding training to protect people and they knew the action to take in the event of any suspicion of abuse. They told us they would not hesitate to report staff bad practice and understood the whistle blowing policy. They were confident the registered manager would take action if they raised concerns and outside agencies would be contacted if required.
Accidents and incidents were summarised to reduce the risk of further occurrence and plans to keep people safe in an emergency were in place. Checks were carried out to ensure the premises were safe and well maintained. Procedures were in place to protect people in the event of an emergency.
There was enough staff on duty to meet people’s needs. People received care from trained staff who had the right skills to ensure their needs were fully met. Staff were recruited safely. All of the relevant checks had been made to ensure they were suitable to work at the service. Staff were supported in their role by the registered manager. They received one to one supervision with their line manager to discuss their development, training and performance. Staff had an annual appraisal to ensure their training and development needs were identified.
People told us the food was good and they enjoyed their meals. The menu offered a variety of meals and people said there was lots of choice. The service had a ‘café area’ where people, visitors and staff could make tea or coffee. There was a cake stand with fruit and cold drinks available nearby.
People and relatives were confident their health care needs were fully met. Referrals were made to health care professionals, such as district nurses or dieticians when required and people told us the doctor was called when they felt unwell.
People and relatives told us that they were treated with dignity and staff were polite and respectful. They said staff were very professional in their manner. Staff had received special training to promote communication and consistency of care to make sure people felt valued and they were involved in the running of the service. Staff respected people’s decisions when they choose what they wanted to do, where they wanted to go or spend time.
Friends and relatives were made welcome and visited during the inspection. They told us they were very satisfied with the service. One relative told us how the staff always made visitors welcome and they were able to make tea whenever they wanted especially since the ‘cafe area’ had been installed.
Before people came to live at the service, they were involved in the assessment of the care they needed so they were aware of what to expect from the service. In some cases relatives were also involved to support people to express their needs.
People’s care plans were reviewed and updated regularly to ensure staff were aware of people’s current needs. Records had been improved; they had also been checked by the registered manager to ensure they were completed accurately and were accurate and up to date.
People’s individual hobbies and pastimes were recorded in their care plan and tailored to meet their needs. People were observed doing things they liked to do, such as art, having their nails painted or doing household tasks. People were enjoying a reminiscing session at the time of the inspection. People told us they enjoyed the sessions very much and looked forward to them every week.
People and relatives knew how to complain but did not have any concerns about the service. Information on how to complain was clearly displayed to ensure people, relatives and visitors knew the procedures to raise a complaint. A new complaints procedure had been implemented and complaints had been managed and resolved in line with this policy.
The registered manager had oversight and scrutiny of the service due to a robust and effective quality assurance system. Staff told us there were supported by the registered manager and deputy manager to develop their skills and knowledge. They understood their roles and responsibilities and were motivated to provide good quality care.
There were robust systems in place for monitoring the quality of the service provided and actions were taken to address any shortfalls. Since the previous inspection the registered manager had undertaken additional training and put this into practice to continuously improve the service. They had implemented new person centred care plans, monitoring systems and networked with other organisations to improve care practice. They were passionate and motivated to provide good quality care and put people at the front of the service. It was clear that advice and guidance had been sought and put into practice to promote and improve the culture and values of the service.