CQC report explained · a residential care home
What the CQC found at Glebe House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, October 2022
Rated Requires Improvement; inspectors found enough staff and positive support, but medicines were not always managed safely.
The unannounced inspection took place on 6 July 2022. Inspectors spoke with six people and six staff, and reviewed care plans, medicine records, staff files and management records. They also checked infection prevention and control.
The home had enough staff, robust recruitment checks and systems to protect people from abuse. People's risks were assessed and monitored. People and staff described a positive, person-centred culture, and visitors were allowed in line with infection control guidance.
However, medicine records had gaps. Some medicines were out of stock, a record had not been signed, and one medicine to be taken when needed had the wrong guidance. The home's quality checks had not found these problems.
The overall rating changed from Good at the previous inspection, published in March 2019, to Requires Improvement. The home sent evidence of changes after the inspection, and the CQC said it would check these changes at the next inspection.
Enough staff
Inspectors found enough staff to meet people's needs. Recruitment checks were also described as robust.
“There were enough staff working at the service and recruitment processes were robust.” from the report
Risk management
People's risks were recorded in personalised care plans. The plans also supported people's choices and positive risk-taking.
“Care plans recorded risks to people. These were personalised and focused on people's needs and preferences and raised potential areas of concerns appropriate to each individual.” from the report
Positive culture
People and staff spoke positively about the home. Staff aimed to provide care based on people's individual needs and preferences.
“A positive person-centred culture was promoted. People and staff thought highly of the service management.” from the report
Learning from incidents
The home recorded incidents and accidents, reviewed them and took action to reduce the chance of problems happening again.
“Incidents and accidents were recorded, and improvements made when things went wrong.” from the report
Medicine records and guidance
seriousMedicine administration records contained gaps. Staff did not always sign records at the time, and guidance for medicines taken when needed was incorrect in one case and missing in another.
“We found gaps in people's medicine administration records.” from the report
Quality checks missed problems
needs fixingThe home's checks had not identified the medicine concerns found during the inspection. The CQC recommended reviewing the quality assurance systems.
“Quality assurance systems were not sufficiently robust to identify all concerns.” from the report
- 01What changes have been made to prevent gaps in medicine administration records?
- 02How are staff now checking and recording medicines at the time they are given?
- 03Are there now correct written protocols for every medicine that people may take when needed?
- 04What evidence can you show that the new medicine checks, stock checks and refresher training are working?
- 05How often are medicine audits reviewed by someone independent of the home's day-to-day management?
The report gives ratings for Safe and Well-led only; it does not give ratings or detailed findings for Effective, Caring or Responsive. This explanation was written from the published report of 14 October 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2019
Rated Good; inspectors found safe, kind and personalised care, with a small confidentiality issue.
This was an unannounced planned inspection on 12 March 2019. One inspector visited the home, spoke with five people, four staff members and two relatives, and reviewed care, medicines, safeguarding, complaints and quality records.
The inspectors rated the home Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and were happy with their care. Staff were suitably recruited, trained and supported, and medicines were managed safely.
Care plans recorded people's needs, choices and interests. People were supported with health care, activities and decision-making. Inspectors found that some observation notes had been left in an unlocked room and recommended better confidentiality practice.
The home was also rated Good at its previous inspection in 2016. The report says the next inspection will be planned for a future date based on this rating.
People felt safe
People said they felt safe, and the home had safeguarding procedures, risk assessments and suitable staffing arrangements.
“There were safeguarding systems in place.” from the report
Personalised care
Care plans recorded people's needs, preferences and how staff should support them. People could choose activities and were supported to stay involved in the community.
“People's care plans recorded their needs and preferences in detail.” from the report
Kind and respectful support
People and relatives spoke positively about the care. Inspectors found that staff respected privacy, dignity, independence and individual cultural needs.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Staff training and oversight
Staff received induction, training, supervision and appraisals. Their competency was also checked through ongoing spot checks.
“All staff received supervision and appraisals, where their competency in their role was checked” from the report
Active quality monitoring
The provider used audits, staff observations, meetings and questionnaires to monitor and improve the service.
“The provider had quality assurance systems in place to ensure they provided high quality care and support” from the report
Confidential records
minorInspectors found one person's observation notes in an unlocked room. They recommended that the home follow best practice on confidentiality.
“However, we found a person's observation notes left in an unlocked room.” from the report
- 01How are observation notes and other confidential records kept locked away now?
- 02How often are care plans reviewed, and how are changes in people's preferences recorded?
- 03What activities and community visits are available, and how do residents choose them?
- 04How are medicines checked and reviewed with each person?
- 05How would the home support someone needing end of life care?
This was an unannounced planned inspection that looked at the care home, its premises and care provided, and rated all five CQC questions. This explanation was written from the published report of 27 March 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Glebe House
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- October 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Goodstayed GoodSafe: GoodWell-led: Good
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- September 2013
Registered with the Care Quality Commission on 13 September 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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Most charge £980 to £1,230 a week. 81 can care for a couple. 11 years' experience on average.
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