The inspection of Glebe Cottage took place on 27 February 2017 and was unannounced.Glebe Cottage is a care home which provides accommodation and personal care for up to six people, who have different forms of learning disabilities such as Pica syndrome (an eating disorder), and Autism whilst living with other complex needs such as: epilepsy and mental health issues. These conditions made daily tasks an increased challenge. At the time of our inspection there were six people living there.
Most of the people living at the home were unable to engage in a full discussion; we were able to briefly speak with them at the home and observe how they interacted with staff. The premises consisted of a detached house with communal lounge, dining room, kitchen and bathroom facilities. There was also a spacious and secure garden for people to use.
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.
Relatives told us their family members were safe at the home and with the staff who provided care. Staff had a clear understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place. There were systems and processes in place to protect people from harm.
There were sufficient numbers of staff deployed to meet people’s needs safely. Recruitment practices were safe and relevant checks had been completed before staff started work. The provider ensured staff had the skills and experience which were necessary to carry out their role. Staff had received appropriate support that promoted their development. The staff team had an in depth knowledge about people’s care needs. People told us they felt supported by staff.
Medicines were managed, stored and disposed of safely. Any changes to people’s medicines were prescribed by the person’s GP or psychiatrist and administered appropriately.
Fire safety arrangements and risk assessments for the environment were in place to help keep people safe. The service had a contingency plan that identified how the home would function in the event of an unforeseeable emergency such as fire, adverse weather conditions, flooding or power cuts.
Staff were up to date with current guidance to support people to make decisions. Staff had a clear understanding of Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act (MCA) as well as their responsibilities in respect of this. Where people had restrictions placed on them these were done in their best interests using appropriate safeguards.
People had enough to eat and drink and there were arrangements in place to identify and support people who were nutritionally at risk. People were supported to have access to healthcare services and healthcare professionals were involved in the regular monitoring of their well-being. The provider worked effectively with healthcare professionals and was pro-active in referring people for assessment or treatment.
Staff treated people with compassion, kindness, dignity and respect. People’s preferences, likes and dislikes had been taken into consideration and support was provided in accordance with people’s wishes. People’s privacy and dignity were respected and promoted when personal care was undertaken.
People’s care and support were planned proactively in partnership with them. People’s needs were assessed when they entered the home and on a continuous basis to reflect changes in their needs. Staff understood the importance of promoting independence and choice. People were happy and their confidence and ability to be as independent as possible had grown since being at Glebe Cottage. The way staff have developed a good understanding of each person and then supported them to build their skills and confidence and reach their goals is an outstanding feature of the service.
People were able to personalise their room with their own furniture and personal items so that they were surrounded by things that were familiar to them.
People had access to activities that were important and relevant to them. There were a range of activities available within the home and out in the community
People were at the heart of the service. The provider's philosophy was understood and shared across the staff team. People's right to lead a fulfilling life was enshrined in the ethos of the home.
Relatives were really positive about the kindness, thoughtfulness and compassion of staff. Relatives described the home as “having a family atmosphere and it was a home.”
People and relatives were encouraged to voice their concerns or complaints about the service and there were different ways for their voice to be heard.
People’s care and welfare was monitored regularly to ensure their needs were met. The provider had systems in place to regularly assess and monitor the quality of the care provided.
Relatives and professionals told us the staff were friendly and management were always approachable. Staff were encouraged to contribute to the improvement of the home. Staff told us they would report any concerns to their manager and felt supported by the management. The provider recognised and celebrated staff's achievements.