• Care Home
  • Care home

Archived: Glynn Court Residential Home

Overall: Good read more about inspection ratings

Fryern Court Road, Burgate, Fordingbridge, Hampshire, SP6 1NG (01425) 652349

Provided and run by:
Glynn Court Limited

Important: The provider of this service changed. See new profile

All Inspections

11 August 2015

During a routine inspection

We inspected Glynn Court Residential Home on 11 August 2015 to check the provider had made improvements to meet the breaches of regulations we had identified during our previous inspection and the outstanding enforcement action we had taken. This was an unannounced inspection.

We had inspected Glynn Court Residential Home on 29 and 30 October 2014. This was an unannounced inspection to check they had made improvements to comply with the warning notices we had issued to them in September 2014. The provider had taken some steps to improve but had not made adequate improvements and had not complied with the warning notices issued.

We continued the enforcement action against the provider and the registered manager. The three warning notices (enforcement notices telling the provider why they had breached regulations and the date by which they must make improvements) remained in place in relation to care and welfare of people, record keeping, and monitoring and assessing the quality of the service provided.

We also took enforcement action against the registered manager who had consistently failed to make the improvements required and cancelled their registration in April 2015.

The provider kept us informed of actions they were taking during this time, including recruiting a new manager and deputy manager to oversee the improvement and development of the home.

At this inspection (August 2015) we found the manager, deputy manager and provider had worked together to make significant and visible improvements. They had met the requirements of the warning notices and all but one of the outstanding breaches of regulations we had found at our inspection in October 2014.

Glynn Court Residential Home is a care home for older people, some of whom are living with dementia. The home is registered to provide accommodation for up to 31 people. At the time of this inspection there were 25 people living there. The home is set in well maintained gardens and consists of a main house and a smaller detached house, this being for people with less complex needs.

The service did not have a registered manager in place on the day of the inspection, however the manager had a date for their registration interview with the commission in August and they were subsequently registered following a successful interview. 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 living at the home, their visitors and health care professionals were all complimentary about the quality of care and the management of the home. The manager and deputy manager promoted a culture of openness and there was a clear management structure, with systems to monitor the quality of care and deliver improvements. Staff told us the morale at the home was now good and they felt supported, which they hadn’t had before.

People were protected from possible harm. Staff were able to identify different types of abuse and what signs to look for. They were knowledgeable about the home’s safeguarding processes and procedures and who to contact if they had any concerns and this information was also on display for people and relatives if they needed it. Staff told us they felt they would be taken seriously and concerns would be acted upon now. They had not felt this before.

People told us they felt safe and staff treated them with respect and dignity. People’s safety was promoted through individualised risk assessments and effective management of the premises. There were systems in place to manage, record and administer medicines safely. Staff had good knowledge of medicines and their competency was checked regularly to ensure they remained aware of their responsibilities in relation to medicines.

The quality and consistency of care had improved since our last inspection. The manager had implemented a range of improvements, with the support of the deputy manager, provider and staff. There was a strong commitment to provide personalised care, in line with people’s needs and preferences, and to create a homely, welcoming environment. Staff interacted positively with people and were caring and kind. They were reassuring to people when required and supported them at a pace that suited them without rushing.

People’s health needs were looked after, and medical advice and treatment was sought promptly. A range of health professionals were involved in people’s care including GPs, community nurses, dentists and chiropodists. However, we found some inaccuracies within people’s records which meant staff may not have had up to date or correct information to guide them in how to provide appropriate care and support to people.

Staff encouraged people to maintain their independence and provided opportunities for people to socialise. Staff supported people to make decisions and to have as much control over their lives as possible. The staff had good natured encounters with people, seemed to know them well, and had time to sit and chat with them. The home employed an activities co-ordinator who had increased their hours to provide more support time. There was a range of activities on offer throughout the week. Most activities took place within the home, such as singing, entertainers and quiz games. Some people were supported to maintain links with their local community including visiting the shops or the local garden centre.

People were offered a varied diet, prepared in a way that met their specific needs, and were given choices. Important information, such as allergens in food, was available to people and staff. People were given support and encouragement by staff if they needed help to eat.

The provider operated safe recruitment processes and recruitment was continuing. There were sufficient staff deployed to provide care and staff were supported in their roles with training, supervision and appraisals. Staff understood their responsibility to provide care in the way people wished and worked well as a team. They were encouraged to maintain and develop their skills through relevant training.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The new manager understood this legislation and had submitted DoLS applications for some people living at the home. Staff were aware of their responsibilities under this legislation and under the Mental Capacity Act (2005).

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have asked the provider to take at the back of this report.

29 and 30 October 2014

During a routine inspection

We inspected Glynn Court Residential Home on 29 and 30 October 2014. This was an unannounced inspection to check they had made improvements to comply with enforcement action. The provider had taken some steps to improve but had not made adequate improvements and had not complied with the warning notices issued to them in September 2014.

At our inspections of the service in November 2012 and August 2013, we found that the provider was not compliant with the regulation about care and welfare of people who use the service. This was because people's needs were not assessed properly and care was not planned to ensure their safety and welfare.

Following our inspection in August 2013, we took enforcement action against Glynn Court Limited and the registered manager in respect of this regulation. We carried out a further inspection in October 2013, met with the provider and registered manager in November 2013 and carried out further inspections in January and February 2014. However, we found that not all risks had been assessed appropriately and care plans were not always followed. We also identified other concerns in relation to staff supervision and training, medicines management, and record keeping. We carried out a responsive weekend inspection in April 2014 in response to concerns and found staffing levels.

We inspected Glynn Court Residential Home again in August 2014 and found the provider had made some improvements and had become compliant in relation to staffing levels, staff supervision and training and medicines management. However, we found that there were still risks to people’s welfare and safety as record keeping was not always accurate and care plans were not always updated or followed. We also found the provider did not have effective systems in place to monitor and assess improvements that were required.

We took further enforcement action against the provider and the registered manager and issued three warning notices (enforcement notices telling the provider why they had breached regulations and the date by which they must make improvements) in relation to care and welfare of people, record keeping, and monitoring and assessing the quality of the service provided.

At this inspection (October 2014) we found the provider had made some improvements to the monitoring of the environment and identified actions had been completed. However, we found they had not made adequate improvement to care planning, monitoring and record keeping in relation to the care and welfare of people. Some records did not give staff adequate or up to date information and some people were at risk because of this.

Glynn Court Residential Home is a care home for older people, some of whom are living with dementia. The home is registered to provide accommodation for up to 31 people. At the time of this inspection there were 25 people living there. The home is set in well maintained gardens and consists of a main house and a smaller detached house, this being for people with less complex needs.

The home has 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.

Improvements were needed in relation to the safe management and administration of medicines. There were not effective systems in place to safely record and administer people’s medicines.

People who had developed pressure areas or bruising had not had their injuries investigated, recorded or monitored.

The registered manager had not always identified when people’s needs had changed. People’s care plans and risk assessments were not always updated when their needs had changed. Care was not always provided in line with people’s care plans.

People were not supported to take part in a comprehensive range of meaningful activities. We observed that people spent long periods of time without stimulation or meaningful interaction. People often appeared restless. We looked in six people’s records and found low numbers of recorded activities.

People and/or their relatives had not always been consulted about how they would like their care to be provided. People told us they hadn’t been involved in planning their care and care plans had not been signed by people or the relatives to show they had agreed with their plan of care.

People and their relatives had not been informed of, or consulted about the enforcement action taken against the provider and registered manager, or been given an opportunity to comment about how the required improvements should be achieved.

Improvements were needed in relation to how the provider and registered manager identified, assessed and managed risks relating to the safety of people and of the quality of the service. During the inspection we identified concerns in a number of areas. These included care and welfare, protecting people from harm and medicines management. These issues had not been identified by the registered manager before our visit, which showed that there was a lack of robust quality assurance systems in place.

Whilst most people told us they enjoyed their food, we found that the mealtime experience of people who ate in the lounge required improvement. Some people experienced a delay in their meals being served whilst others did not have the support they needed to be able to eat in a dignified manner and lost interest and did not eat anything.

The building was spacious and airy but thought had not been given to how it could be made more appropriate for people living with dementia, such as contrasting colours, good signage and effective lighting.

People were not always given sufficient information to make an informed decision or asked for their consent before care was provided. People’s mental capacity had not been assessed appropriately in line with the Mental Capacity Act 2005. People who had capacity had not always been consulted about important decisions that had been made and documented, such as whether or not they wanted to be resuscitated.

The registered manager had consistently failed to meet the requirements of the enforcement notices issued to them. They had not demonstrated they had the skills, qualifications and experience to manage the regulated activity of “Accommodation for people who require nursing or personal care” (not nursing).

People spoke positively about the care provided by the staff as did their relatives. One relative said, “The staff here are really caring, they put themselves out and work incredibly hard to make sure they have what they need”. A health and social care professional told us they considered the home “To be a good home. Even though I have limited knowledge of them, from my previous experience I found the staff to be caring and kind with a person who had reached the end of their life”.

We observed staff speaking to people with patience, warmth and respect. Staff respected people’s dignity and privacy. Some staff gave people gentle encouragement to prompt them to eat and drink and promoted their independence where possible.

The provider recruited staff who were suitable for the role and recruitment procedures were robust. Staff recruitment records were in place, such as Disclosure and Barring Service checks, references and proof of identity. Staff received regular training, appraisal and supervision which supported them to carry out their role.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

13 August 2014

During a routine inspection

We inspected Glynn Court Residential Home to check that they had made improvements to comply with enforcement action. At our inspections of the service in November 2012 and August 2013, we found that the provider was not compliant with the regulation about care and welfare of people who use the service. This was because people's needs were not assessed properly and care was not planned to ensure their safety and welfare.

Following our inspection in August 2013, we took enforcement action against Glynn Court Limited and the registered manager in respect of this regulation. We carried out further inspections in October 2013 and found the provider had made improvements to the assessment and planning of people's care needs. However, at the time of our inspection, not all risks had been assessed appropriately and care plans were not always followed.

We met with the provider and registered manager in November 2013 and the registered manager told us that they had taken action to comply with the regulations. We carried out a further two-day inspection in January and February 2014 and found that the provider had made some improvements to the assessment and planning of people's care needs. However, we again found that not all risks had been assessed appropriately and care plans were not always followed.

During our previous visits we also identified concerns with a number of other areas within the home; staffing levels, staff supervision and training, medicines management, and record keeping.

During our inspection in September 2014 we checked to make sure that improvements had been made in all areas where we had previously found non compliance.

We spoke with seven people who used the service and eight members of staff, as well as the registered manager. We gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People we spoke with told us that they felt safe. Friends and relatives told us they thought people were safe and had no concerns.

We found the service was safe in relation to the risks to people associated with medicines. The provider had appropriate arrangements in place to manage people's medicines safely.

However, people were not always safe because staff did not always know how to support them appropriately to protect them from identified risks and people were not always supported in line with their care plan.

The home did not have effective systems in place to identify, assess and monitor risks in relation to infection control and the environment.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We spoke with a senior member of staff who told us one person no longer had capacity. However, we found that a mental capacity assessment had not been completed. We were told this person was under supervision to prevent them leaving the premises. However a DoLS application had not been made. This meant that people were at risk of being deprived of their liberty unlawfully.

Is the service caring?

We found the home to be caring. People told us that they were treated well by staff and that they felt listened to and their wishes respected.

During our inspection, we observed staff interacting with people with kindness and respect. People were treated with dignity and their needs attended to.

Is the service effective?

We spoke to a visiting GP who told us they were contacted by the home on a regular basis to seek advice and support in relation to people's care. However, we found the service was not always effective in relation to people's care. Staff were not always aware of people's needs or the risks associated with these.

Is the service responsive?

We found that the service was not always responsive. Although we spoke to a visiting GP who told us they had no concerns about people's care, we found that care plans were not always updated to reflect their changing needs and we saw that where some people had risks relating to their behaviour, these had not been identified by the provider. People had not been protected from inappropriate care as staff had not always identified their changing needs or risks.

Is the service well lead?

We found that the service was not well led. The registered manager had not put systems in place to identify, assess and monitor people's medicines or infection control procedures. Some actions identified as a result of audits and external inspections had not been completed or had been missed.

Staff activities had not been effectively monitored to pick up errors in people's care plans and risk assessments.

Complaints had been responded to but there was no information to explain what investigation had taken place or how the outcome had been determined.

There was no analysis of incidents to inform staff how to learn from these and reduce the risks to people in future.

26, 28 April 2014

During an inspection in response to concerns

People who lived in the home spoke highly of the staff who worked there. They told us that staff were very good, understood their needs and were kind to them. However, we found that there were not always enough staff with suitable qualifications, knowledge and skills employed to work during the night.

Staffing levels at night varied between two and three members of staff. Staff told us that when three staff were working, they were able to meet people's needs in a more timely way and felt that the quality of people's care improved. This was echoed by a person who lived in the home who told us that they had noticed a difference when there were three staff on duty. They told us, "They themselves are not so pressurised when there are three of them."

The registered manager was aware of this concern and confirmed that they were taking action to employ more staff so that there were always three members of staff available during the night shift.

We found that night staff did not always have appropriate qualifications, skills and experience to meet people's needs in an emergency. There were some night shifts where no staff on duty had up-to-date training in first aid. This meant that there was a risk staff would not be able to respond effectively in an emergency situation. More robust arrangements were also needed to confirm the qualifications, skills and experience of agency staff who came to work in the home to ensure they were suitable to provide care.

21 February 2014

During an inspection in response to concerns

We looked at the processes and records held by the service relating to the use and management of medicines.

We reviewed the supply process, supporting information and administration records. Medicines were obtained in a timely manner. Staff showed us where and how medicines were stored and temperature records they kept. Since the medicines storage rooms were not secure and the temperature records were not complete we were not assured that the medicines were safe to be administered.

We reviewed the medicines administration records and supporting information. Whilst the service was preparing information to support staff in administering creams and ointments, similar information was lacking for 'how a person preferred to take their medicines', 'if required' and 'variable dose' medicines. Whilst the records for regular medicines were complete most of those with a variable dose lacked the exact dose taken.

We observed the administration of medicines at lunch time where we saw that staff knew how each person liked to take their medicines. We spoke with one person using the service who told us, 'They do not run out of medicines and we only receive those prescribed by the doctor.' We were also told that changes to medicines were explained to both them and their family.

31 January and 4 February 2014

During an inspection looking at part of the service

We carried out this inspection to check that the home had made improvements to people's care and welfare, support for staff, the handling of complaints and records. We also looked at the way the home was meeting people's nutritional needs.

We found that the home had made improvements where we had identified concerns at previous inspections. However, they had not identified and addressed new risks. For example, care had not been planned appropriately for two people who had recently come to live in the home. Records about their care were not always accurate or complete. Although staff who worked in the home felt supported, the home was not following their policy to ensure that new staff received appropriate supervision during their induction period or were supported with their induction training. This put people at risk of receiving unsafe or inappropriate care and meant that the home remains in breach of three regulations.

In spite of these failures, we found that staff were highly motivated and delivered people's care in a kind and sensitive way. Staff were attentive to people's needs and encouraged their independence and choice. We spoke with some people who lived in the home and their relatives. They were very positive about the care they received and told us that staff were very good and treated them well. For example, one person told us that they were "very happy" with their care while a relative told us that they were "very pleased" with the way staff looked after their family member. Staff were also aware of people's needs in relation to eating and drinking and ensured they were given appropriate support to eat their meals.

The registered manager had made some improvements to the handling of complaints. They had, for example, ensured that a person who had raised concerns had received a response in line with the home's policy. Most of the people we spoke with had confidence that staff would listen to them if they had concerns about their care and felt they would be taken seriously.

24 October 2013

During an inspection looking at part of the service

Following our inspection in August 2013 we took enforcement action against Glynn Court Residential Home. This was because we had found that people's needs were not assessed properly and care was not planned to ensure their safety and welfare.

During this inspection we found that the provider was making improvements to the way they assessed people's needs and planned people's care. People's care plans and risk assessments were being reviewed to ensure that their care was delivered in a safe way. However, we found that not all risks had been assessed appropriately and one person's care plan had not been followed. This meant that there was still a potential risk of people's needs not being met.

The registered manager told us that they would continue their review of people's care to ensure that people's needs were met. However, at the time of our inspection, we found that the home remained not compliant with the regulation about the care and welfare of people who use the service.

13, 15 August 2013

During a routine inspection

At our last inspection of the service on 13 and 16 November 2012, we found that the home was not compliant with four regulations. We carried out this inspection to check that the home had made improvements. We also looked at people's care records to check whether they contained appropriate information about people's needs.

During this inspection we found that people were satisfied with the care they received and the way they were treated by care staff. They told us that staff were kind, compassionate and responsive to their needs. However, we found that people's needs had not been assessed properly and care was not planned to ensure their safety and welfare. We also found that records about people's care were not accurate or complete. This put people at risk of receiving inappropriate or unsafe care.

There were arrangements in place to provide training and informal support to staff. Staff told us they felt supported and received training to help them develop in their roles. However, the home was not following their procedures to ensure that all staff received appropriate supervision and appraisal to carry out their work.

The provider had not ensured that complaints about the service were received, handled and responded to appropriately. Although the home had a procedure about managing complaints, we found that this had not been followed to ensure that people who raised concerns received an appropriate response.

The home was clean and there were procedures in place to ensure that standards of cleanliness were maintained. People who lived in the home and their relatives told us that the home was always clean because housekeeping staff worked hard to make this happen. There were some procedures in place to minimise the risk of cross infection.

13, 16 November 2012

During an inspection in response to concerns

We spoke with three people who lived in the home and four relatives. People spoke highly of the care they received from staff and told us they were treated with respect and dignity. They told us that staff were very kind and thoughtful and "nothing was too much trouble." We found that people were involved in making decisions about their care and the home liaised with various professionals to ensure people's health care needs were met.

People reported that the home was clean and that staff followed procedures to ensure that the risk of cross infection was minimised. They also told us they were comfortable and warm in the home and expressed high levels of satisfaction with the food and laundry services provided.

People told us that, on the whole, there were enough staff to meet their needs but there were occasions when staff seemed stretched and they had to wait a short time. However, people had confidence in their care workers, telling us they had the right skills and knowledge to support them effectively. People told us that the manager and staff were approachable, listened to any concerns they had and took action to put things right.

Although the feedback we received from people who used the service was positive, we identified some shortfalls in care planning, risk assessment, infection control audits, staff supervision and the home's complaints procedures. We have made compliance actions to ensure that the home fully complies with the regulations in these areas.