Archived: RNIB Gladstone House

Updated 13 July 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 23 June 2016 and was unannounced. The inspection team consisted of one inspector and an expert by experience. An expert by experience is someone who has personal experience of using or caring for someone who uses this type of service.

Before the inspection, we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the registered person is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection. On this occasion we did not ask the provider to complete a Provider Information Return (PIR) before our inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This was because we were re-inspecting this service to follow-up on previous breaches of the regulations.

As part of our inspection we met with the six people who lived at the home. We interviewed five staff, including the team leader who was responsible for the day to day management of the service. After the inspection we gathered feedback from two relatives. We also reviewed a variety of documents which included the care plans for two people, two staff files, medicines records and various other documentation relevant to the management of the home.

We last inspected this service in June 2015 where we found three breaches in Regulations.

Updated 13 July 2016

RNIB Gladstone House is a care home that is registered to provide residential care to a maximum of six adults who are either blind or partially sighted. They may also have additional learning disabilities, autism, emotional or mental health needs. There were six people living in the home at the time of our inspection.

The inspection took place on 23 June 2016 and was unannounced.

The service did not have a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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. The previous registered manager had left the organisation in January 2016 and another manager within the RNIB Charity is in the process of applying to be the registered manager for this service.

We previously carried out an unannounced comprehensive inspection of this service on 22 June 2015. At that inspection three breaches of legal requirements were found. As a result the service was rated as Requires Improvement overall and we issued three requirement actions. Following that inspection, the provider submitted an action plan which outlined the ways it intended to improve the way the service was managed, staffed and safely maintained.

At this inspection, we found that the provider had made the improvements they told us they would and the previous requirement actions had been complied with. An experienced team leader was now responsible for the day to day running of the service and this had had a positive influence on the way the service was managed.

The culture within the service had improved and both people and staff were empowered by the new leadership arrangements. Improved monitoring systems had been embedded which had enabled the service to self-develop and operate in accordance with the principles of reflective learning.

The physical environment was now safe for people with visual impairment because risks had been properly assessed and managed. The garden had been landscaped to provide people with an attractive and safe outside space.

Staffing levels had been reviewed and steps taken to ensure the service was appropriately staffed. Some staffing vacancies meant that the service regularly used agency staff. The impact of using temporary workers had however been mitigated by the use of the same agency staff who were familiar to people and their needs.

There were systems in place to ensure staff were safely recruited and had access to relevant training in order to perform their roles effectively. People were safeguarded from the risk of abuse and their legal rights protected because staff understood their roles and responsibilities.

People received person centred care that was responsive to their needs. Each person had a detailed plan of care that was kept under regular review. People were involved in making decisions about their lives and supported to access a range of activities that were meaningful to them.

People had good relationships with staff and the atmosphere within the service was relaxed and friendly. Staff were kind and caring and respected people’s privacy and dignity at all times.

People were supported to maintain good health. The service had good links with other health care professionals to ensure people kept healthy and well. Medicines were managed safely and there were good processes in place to ensure people received the right medication at the right time.

People had choice and control over their meals and were effectively supported to maintain a healthy and balanced diet. Specialist dietary needs were managed well.