Glenbrooke House

We found the following examples of good practice.

¿ The provider had worked with relatives to ensure testing arrangements met their needs and helped facilitate more visits. These included window and outdoor visits when restrictions were in place.

¿ Staff had worked hard to ensure the service did not rely on agency staff, including covering additional shifts to ensure high levels of continuity.

¿ The service was clean throughout.

¿ The registered manager had repurposed a downstairs quiet room to enable one person to isolate and have their own bathroom space, when the service had experienced an outbreak.

Further information is in the detailed findings below.

Glenbrook House is a residential care home providing accommodation and personal care. The home accommodates up to 10 people in one house. At the time of our inspection nine people with learning disabilities were living at the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found.

People said they were happy living at Glenbrook House and had positive relationships with their peers and staff team. An advocate told us that the people they worked with were happy living at Glenbrooke and enjoyed the homely environment.

People received person centred support and staff knew people very well. People were supported to build and maintain important personal relationships that mattered to them, with their peers and relatives. The provider had systems in place for communicating with staff, people and their relatives to ensure they were fully informed via team meetings. People had good links to the local community through regular access to local services.

People were supported to be independent, their rights were respected and access to advocacy was regularly available. Support was provided in a way that put the people and their preferences first. Information was readily available for people in the correct format for them, including easy read and the use of an ‘Alexa’ for easy access to information.

The environment was clean and very homely. The décor was personalised in people’s bedrooms and also in communal areas. Audits and monitoring systems were used effectively to manage the service and to make improvements as and when required. Medicines were managed well, safely administered and recorded accurately.

There were enough staff to support people. Staff received support and a variety of appropriate training to meet people’s needs.

Individualised risk assessments were in place. Staff were confident to raise concerns appropriately to safeguard people. Robust recruitment and selection procedures reduced the risk of unsuitable staff being employed.

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.

Appropriate healthcare professionals were included in people’s care and support as and when this was needed. People were supported to have enough to eat and drink in addition people who needed specialist diets were assisted with these.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 24 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Glenbrooke House is registered to provide accommodation and personal care to a maximum of 10 people. Nursing care is not provided. Care is provided to younger people who have learning disabilities including some people who have a physical disability.

At the last inspection in March 2015 we had rated the service as 'Good'. At this inspection we found the service remained 'Good' and met each of the fundamental standards we inspected.

People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. There were enough staff to provide individual care and support to people. Staff received opportunities for training to meet peoples' care needs and in a safe way. A system was in place for staff to receive supervision and appraisal and there were robust recruitment processes being used when staff were employed.

The registered manager was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Staff had a good understanding of the Mental Capacity Act 2005 and best interest decision making, when people were unable to make decisions themselves. 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.

People were provided with opportunities to follow their interests and hobbies and they were introduced to new activities. They were supported to contribute and to be part of the local community. Staff had developed good relationships with people, were caring in their approach and treated people with respect. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care.

People had access to health care professionals to make sure they received care and treatment. Staff followed advice given by professionals to make sure people received the treatment they needed. People received their medicines in a safe and timely way. People who used the service received a varied diet and had food and drink to meet their needs.

There was regular consultation with people and/or family members. A complaints procedure was available and written in a way to help people understand if they did not read. People we spoke with said they knew how to complain but they hadn’t needed to.

Staff and relatives felt there was an open, approachable and stable management team. The registered manager had worked at the home for several years. The provider continuously sought to make improvements to the service people received. The provider had effective quality assurance processes that included checks of the quality and safety of the service.

The provider undertook a range of audits to check on the quality of care provided. We have made a recommendation that the quality assurance system used to collect people’s views about service provision should be further developed.

Further information is in the detailed findings below

. Is the service safe?

. Is the service effective?

. Is the service caring?

. Is the service responsive?

. Is the service well-led?

This is the summary of what we found.

Is the service safe?

An assessment of people's care and support needs was carried out before people started to use the service. This was to ensure staff had the skills in order to meet the person's support requirements.

Risk assessments were in place to help protect people and keep them safe but at the same time promote their independence. We noted the service had documentation in place to support "positive risk taking."

An effective regular environmental audit was required to ensure the premises were safe and well maintained for the safety and comfort of people who used the service.

Is the service effective?

We observed staff were enthusiastic and keen to help people develop and become more independent in aspects of daily living. Staff were very knowledgeable about people's care and support needs and through consistent working helped to calm and reassure people with some complex care and support needs. They encouraged the involvement of people by offering them choices in ways that were appropriate to the person.

We saw staff had received some training to help them understand some of the different care and support needs of people they worked with.

Is the service caring?

We observed staff were helpful and offered people information and support about their care. Records showed staff kept people's relatives up to date with what was happening with their relative's care.

People who used the service were introduced to new experiences and activities to help them develop and provide them with stimulation and interests.

Is the service responsive?

Information was collected by the service with regard to the person's ability and level of independence before they started to use the service. Various assessments were completed by the manager of the service with the person and/or their family to help make sure staff could meet their needs. Reviews were carried out with the person who used the service and their representative to make sure the person's care and support needs had not changed. This helped ensure staff supplied the correct amount of care and support.

People's individual needs were taken into account and they, or their representative if they were not able, were involved in all decision making with regard to their care. They were kept informed and given information to help them understand the care and choices available to them.

Regular meetings took place with staff and people who used the service to discuss the running of the service and to ensure the service was responsive in meeting the changing needs of people.

Is the service well-led?

The service was managed by a manager who promoted the ethos of individual care and involvement of the person. This needed to be evidenced by more individual support plans to show the individualised care and support that staff provided to people.

Staff spoken with commented they felt supported by the manager. They said they were provided with training opportunities to help them have more understanding of people's care and support needs.

A more effective audit system was required by the manager in order to ensure all records showed the care and support provided by staff to people. An external quality assurance system needed to be introduced to monitor the quality of care provided to people.

We found staffing levels had increased which ensured there were enough qualified, skilled and experienced staff to meet people's needs.

We saw the washing machine had been replaced which benefited the people who used the service.

Two relatives we spoke with said staff were caring and their relative loved living at the home.

Some of the people who used the service had complex needs and were unable to tell us about their experiences. We carried out an observation of care delivery to help us understand their experiences of the care they received. During our observations we found people appeared calm and happy. Staff were polite, patient and treated people in a respectful way. The atmosphere around the home was calm and relaxed, this was also observed at the lunch time meal.

We saw people were treated with respect and they were involved in all decisions with regard to their daily living needs.

Staff we spoke with said there were opportunities for training.

There was equipment for the use of people who lived in the home but the washing machine was not effective for all the requirements of people who lived in the home.

There were not enough qualified, skilled and experienced staff to meet people's needs as enough staff were not available at evenings and weekends to give people the opportunity to either go out or stay in their home.

We saw the provider had systems in place to gather feedback from people, who used the service, and some systems were in place to regularly assess and monitor the quality of service people received.