We carried out a review of the data available to us about Gledholt on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Gledholt, you can give feedback on this service.
We found the following examples of good practice.
Through checks were followed before visitors were allowed into the home. Visitors had to provide evidence of a negative COVID-19 lateral flow test and their COVID-19 passport to show they were doubly vaccinated. Body temperatures were checked and a COVID-19 questionnaire had to be completed.
We observed staff wearing PPE correctly throughout the inspection. The home had a dedicated area for donning and doffing PPE. There were numerous stations around the home where hand gel was available. There was a good supply of PPE and hand washing products in the home.
Posters were on display for all individuals in the home which referred to the importance of hand washing and wearing PPE. Daily meetings were taking place with people where COVID-19 was discussed when needed. The home was well ventilated. Staff had received COVID-19 training and understood their responsibilities to maintain good standards of infection control.
People had COVID-19 care plans and information was available to them in easy read format, if they preferred this. Staff had COVID-19 risk assessments in place.
People we spoke with confirmed they had received their COVID-19 vaccinations and staff also fulfilled this requirement. People and staff were also part of a regular programme of testing for COVID-19.
Cleaning schedules were fully completed and we observed domestic staff going around the home every two hours to keep frequent touch points clean.
The provider’s infection control policy referred to current guidance. Regular infection control audits were being carried out and we saw these had led to actions and improvements.
Gledholt is a care home providing care and support for people with learning disabilities and mental health needs, who may at times display behaviours that challenge others. The service is designed to offer transitional support while people are improving their skills to live more independently.
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 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.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 9 people. Eight people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, cameras, industrial bins or anything else outside to indicate it was a care home.
People’s experience of using this service and what we found
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The provider was completing some decision specific mental capacity assessments and related best interest decisions for relevant aspects of people’s care. We have made a recommendation for the provider to always complete these records and to consult relevant guidance and best practice in relation to the Mental Capacity Act 2005.
People told us the service provided safe care and people's feedback was positive about the support offered by staff. Risk assessments were in place to manage risks to people's care, and staff we spoke with felt safe supporting people with a wide range of needs. Medication was administered safely.
The provider completed person centred assessments and most care plans were updated when required. People were supported to access relevant healthcare services when they needed them, and they were supported to eat and drink well.
People remained supported by staff who were caring and respectful. People and, where appropriate, relatives were involved in making decisions about the care people received.
People's independence was promoted and encouraged. People received care that met their needs. People had opportunities to take part in activities in the house and outings of their choice.
People and most staff shared positive feedback about the quality of care and the management of the service. There was an open culture within the service, where people, staff and healthcare professionals could approach the management team if they had concerns or suggestions.
There were systems in place to monitor and improve the quality of the service.
There was not a registered manager, however we found appropriate management arrangements were in place to ensure the service was well led. A new manager had recently been appointed and they told us about their plans and vision to develop the service.
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 9 June 2017).
Why we inspected
This was a planned inspection based on a 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.
Gledholt is an enhanced community residential home providing outcome focused care for adults with learning disabilities, who may have behaviours that challenge and associated complex needs. The service has two buildings at the same location, with one of those designed for two people to live more independently as part of their ‘step on’ from Gledholt.
At the time of our inspection there was a registered manager 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.
People felt safe, although one person expressed concerns about a member of staff which we discussed with the registered manager. They were aware of this and were taking action. We found some areas of medicine management required improvement and have made recommendations in the body of our report.
Based on feedback from people and staff as well as our observations during this inspection, we identified there were adequate staffing levels to meet people’s needs. Recruitment was appropriately managed, although a risk assessment which should have been completed was not in place.
We found the home was clean and tidy and records showed regularly scheduled maintenance had been completed. This included all relevant fire safety checks. Risks to people had been identified, managed and reviewed. Staff had access to this information which described risks and action which should be taken to manage this appropriately.
Staff completed an induction and received ongoing support through a programme of supervision and training. Staff appraisals had already started before our inspection.
Mental capacity assessments and Deprivation of Liberty Safeguards (DoLS) were documented in care records. Staff were able to explain how the Mental Capacity Act (2005) applied to their work, but were less sure about who was affected by DoLS. We recommended the registered manager clarify this with staff.
People were supported by staff to access a range of healthcare professionals. Visiting healthcare professionals spoke positively about this service. People were involved in meal planning and preparing meals.
People told us they liked the staff and felt confident approaching them. Staff were familiar with people’s care preferences and we observed a good rapport between staff and people they supported. People told us staff respected their privacy and dignity. People’s cultural, religious and sensory needs were met by staff at Gledholt.
Care plans identified how people preferred to live more independently and contained ‘pathways’ which showed how they would achieve this with support from Gledholt and other professionals. Regular review meetings with people, staff and other professionals took place.
Complaints were suitably managed. We recommended the registered manager add the date to their response letters. People were supported to take part in the community for voluntary work, paid jobs and for leisure purposes.
People and staff told us they liked the registered manager and could approach them with any concerns. Daily meetings between people and staff were taking place which helped people plan their days and later reflect on their experience.
Quality management systems were effective as they identified actions which we found had been completed within identified timescales.