Background to this inspection
Updated
2 August 2018
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 09 July 2018 and was unannounced. It was carried out by an adult social care inspector and expert by experience. An expert by experience is person who has personal experience of using or caring for someone who uses this type of service.
Before the inspection we contacted Liverpool City Council for their feedback on the service. We also looked at the information we had received about and from the service since the last inspection.
During the inspection we spoke with the registered manager, the area manager and the nurse on duty. We spoke with eleven people who lived in the home. We looked at the care records belonging to three people, a selection of medication administration charts, staff recruitment and training information, staff rotas and other records relating to the management of the service.
Updated
2 August 2018
We carried out this inspection on 09 July 2018. The inspection was unannounced.
Glenarie Manor Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
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.
The home supports people living with complex mental health needs and provides accommodation with nursing care. It can accommodate up to 26 people and at the time of our visit, 26 people lived at the home.
The home is a large victorian house situated in Sefton Park. Local shops and public transport are within walking distance. Accommodation consists of 26 single bedrooms. On the ground floor, there is a communal dining room for people to use and on the first floor there is TV room and games room.
Although the home was clean and well-maintained, improvements to the home’s fire safety arrangements home needed to be made. During our inspection we saw that an action plan of improvements was in place with regards to this and we received assurance from the home’s fire consultant that these improvements were in progress and would be completed in a timely manner.
The home had a smoking room that was in need of improvement. This was because the smoking room lacked adequate ventilation and contained smoking debris that needed to be addressed. We spoke with the manager, area manager and fire consultant about this. They told us that improvements to the safety of the smoking room were planned. Shortly after the inspection we received confirmation from the provider that these improvements were now in progress.
We looked at the way medicines were administered in the home. We found that the time that people’s medicines were administered was not recorded. This meant that staff could not be sure that time specific medicines or medicines that required a set time period between doses (such as Paracetamol) had been given safely. We also saw that the manager’s medication audits had identified a pattern of missing signatures and medication errors. This indicated improvements to the way medicines were managed was required. We saw that the manager had taken action to raise the standards of medication administration. This work was on-going at the time of the inspection. On the day of the inspection people’s medication had been administered appropriately.
We spoke with eleven people who lived in the home. They spoke highly of the home and the staff who supported them. It was clear that the manager and staff team were well thought of. People told us the manager and staff were caring and that the support provided was good.
People’s care records contained information about people’s needs and risks and how to support them effectively. People’s life histories were included and gave staff information about their families, life prior to coming to live at the home and the things that were important to them in their day to day lives. This gave staff an understanding of the people they supported so that positive relationships could be developed.
The manager and the nurse on duty who we spoke with had a good knowledge of people’s needs and spoke with genuine affection about the people they supported. The atmosphere at the home was warm, homely and relaxed. People and staff chatted socially to each other and we saw that these conversations were natural and spontaneous. It was clear staff knew people well and vice versa.
Staff recruitment was safe and there were enough staff on duty to meet people’s needs. People we spoke with confirmed this. They told us that staff helped them as and when they required for example, by supporting them to attend appointments or by helping them with their personal care. It was clear from what people said that people liked and trusted the staff team supporting them.
People’s mental health was at the forefront of the service. People’s health was supported in partnership with other health and social care services to ensure they remained well. People’s records showed the involvement of social services, community psychiatric teams, dieticians, GP’s and specialist health professionals. People’s ability to make decisions about their care and treatment was promoted with appropriate support in accordance with the Mental Capacity Act 2005.
People received enough to eat and drink and had a choice. People told us the food was of a good quality. People’s special dietary requirements were catered for and people’s nutritional heath was monitored.
People had access to in-house group activities ranging from a music sessions, quizzes and games. This promoted people’s social and emotional well-being. People told us they were free to come and go from the home as they pleased and during our visit some people popped to the local shops for shopping or for a coffee.
We found the service to be well-led. The manager was passionate and committed to the people who lived at the home and had a clear understanding of the provider’s vision and ethos with regards to their care. The culture of the service and the staff team was positive, open and transparent. There were a range of effective mechanisms in place to monitor the quality and safety of the service and people’s views on the service provided were sought to ensure they were happy with the support provided.