We carried out a review of the data available to us about Glenholme Residential Care Home 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 Glenholme Residential Care Home, you can give feedback on this service.
Glenholme is a residential care home providing accommodation and personal care to up to 40 older people including people who may live with dementia or a dementia related condition. At the time of our inspection there were 40 people using the service.
People’s experience of using this service and what we found
People and relatives were very positive about the caring nature of staff and had good relationships with them. They trusted the staff who supported them. A relative told us, “No words can describe the peace of mind and happiness that the staff have given back to my relative.” Another relative said, “So much respect for the residents from the staff, it is lovely to see my relative being cherished in this way.”
There were sufficient staff to support people safely. Staff had received safeguarding training and were clear on how and when to raise their concerns. Where appropriate, actions were taken to keep people safe. Staff followed effective processes to assess and provide the support people needed to take their medicines safely.
People's diversity as unique individuals with their own needs was well-respected by staff. A relative told us, “[Name] is vegetarian and they say the food is wonderful, and along with every activity on offer they are having a wonderful time.” The staff team knew people well and provided support discreetly and with compassion. A relative commented, “The care and staff, all of them are champion. People’s privacy was respected, and people were supported to maintain contact with relatives and friends.
Records provided guidance to ensure people received safe, person-centred care and support from all staff members. Risks were assessed and mitigated to keep people safe. Staff contacted health professionals when people’s health needs changed. A relative told us, “It is the care received that has allowed [Name] to be mobile again. When [Name] arrived they were bed bound, now they are getting around and enjoying themselves.”
Staff spoke very positively about working at the home and the people they cared for. Relatives and staff said communication was effective to ensure they were kept up-to-date about any changes in people’s care and support needs. A relative commented, “The managers are always available and are happy to field questions at any time of the day. We can also ring anytime.”
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.
There was a strong and effective governance system in place. People, relatives and staff were confident about approaching the registered manager if they needed to. They recognised that their views and feedback were valued and respected and used to support service development. Strong processes were in place to manage and respond to complaints and concerns.
Staff followed good infection control practices and the home was clean and well maintained. A relative commented, “The home is always clean and tidy and has a fresh smell at all times.”
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 6 October 2017).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Glenholme Residential Care Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
• The service had access to sufficient personal protective equipment (PPE) to reduce the risk of cross contamination and spread of infection. This included gloves, masks, aprons and visors. Staff had undertaken training and were aware of how to put on and take off PPE appropriately.
• People were supported to be able to see their loved ones safely. Relatives and friends were not permitted to access the home. A pod had been erected in the car park at the front of the building to support service users to be able to maintain contact with those people who were important to them. This helped minimise the impact of the pandemic on people’s wellbeing.
• Systems were in place to help prevent people, staff and visitors from spreading and catching the infection. This included the provision of taxi transport so staff did not have to use public transport, a separate entrance for health professionals to access the service safely and staff leaving their uniforms at work so they can be washed, dried and ironed ready for their next shift. This reduced the risk of transmission.
• There were systems in place to ensure infection control audits were carried out each month. The registered manager was unavailable and therefore the deputy manager supported the inspection. The deputy manager spoke positively about the changes the service and organisation had implemented to ensure the safety of service users, staff and visitors during the pandemic.
Further information is in the detailed findings below.
At the last inspection in April 2016 the service was not meeting all of the legal requirements with regard to governance. At this inspection we found improvements had been made and the service was no longer in breach of these requirements.
Glenholme Residential Care Home is registered to provide accommodation for personal care to a maximum of 37 older people, some who may live with dementia. Nursing care is not provided. At the time of inspection 31 people were living at the home.
A manager was in place who was in the process of applying to become registered with the Care Quality Commission. 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 said they felt safe and they could speak to staff as they were approachable. We considered there were sufficient staff on duty to provide safe care and support to people.
People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support. However, we have made a recommendation that volunteers who spend time in the home should also be vetted.
People told us their privacy, dignity and confidentiality were maintained. Staff understood the needs of people and care plans and associated documentation were clear and person centred. Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks.
People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. Systems were in place for people to receive their medicines in a safe way. People received a varied and balanced diet to meet their nutritional needs. People told us staff were kind and caring and they felt comfortable with all the staff who supported them
Appropriate training was provided and staff were supervised and supported. People were able to make choices about aspects of their daily lives. They were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.
People and staff spoke well of the manager and management team. There were effective systems to enable people to raise complaints, and to assess and monitor the quality of the service. People told us they would feel confident to speak to staff about any concerns if they needed to. The provider undertook a range of audits to check on the quality of care provided. These methods included feedback from people receiving care.
The service provides residential care for up to 37 older people who may be living with a dementia. Glenholme Residential Care Home is a two storey converted townhouse with bedrooms located on both floors.
At the time of the inspection 31 people were living at the home, 19 of these people were living with a diagnosed dementia.
There was a registered manager in place.
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.
Medication Administration Records (MAR) were not consistent. The service were using two differing MARs which had different codes for staff to use to determine whether a medicine had been given, refused or destroyed. Due to this we found conflicts in the coding system, it was unclear what medication had been administered. Medicines were not always disposed of in an appropriate and safe way. Liquid medicines were flushed down the sink.
The use of the dependency assessment tool, to determine staffing levels, was not effective in ensuring there were sufficient staff on duty, to meet the assessed needs of people who used the service. People who used the service were protected against other risks associated to their care and welfare by appropriate assessment and risk management measures being put in place.
People who used the service felt safe in the home and with the staff who supported and cared for them. Staff knew how to report any concerns about the safety and welfare of people who used the service. Robust recruitment procedures were in place and appropriate checks were carried out before people started work.
People were protected against the risks associated with the premises through appropriate legislative safety checks, in house safety checks and maintenance, such as portable appliance testing (PAT) and fire safety checks.
The home had not been adapted to meet the needs of people who are living with a dementia. The provider recognised the need for refurbishment to address this, but at the time of the inspection no work had been undertaken.
The service ensured that people were supported to have sufficient to eat, drink and maintain a balanced diet. Where people were identified as being at risk of malnutrition or dehydration the home did not monitor these needs effectively.
People were supported and had access to a range of healthcare professionals. This included GP's, opticians, dentists and chiropodists. The home included these professionals in the on-going care and treatment of people who used the service when necessary.
Consent to care and treatment was sought in line with legislation and guidance.
Positive and caring relationships were developed with people who used the service. The service had a stable staff team who knew people well. Staff knew and understood how people preferred to be cared for and supported.
Observations demonstrated that people were treat with kindness and compassion. People's privacy and dignity was respected and promoted. Staff were proactive in their approach to offering care and support discreetly to people who used the service.
People were supported to express their views and be actively involved in making decisions about their care, treatment and support.
People did not receive personalised care that was responsive to their needs. Planning and delivery of care and support was not person centred and did not always focus on assessed needs. People's needs were reviewed regularly to ensure care remained responsive to the needs and wishes of people who used the service.
The service had a complaints procedure in place that was accessible to people who used the service. The service listened and learnt from people's experiences, concerns and complaints but failed to record these investigations in line with their policy.
There were a lot of activities planned within the home to encourage stimulation and involvement from people who used the service. These activities not only met social needs but also captured cultural and religious needs.
The service promoted a positive culture that was open, inclusive and empowering. They ensured people who used the service and staff had opportunities to become involved and suggest ways in which the service could be improved.
The service could demonstrate that it had good management and leadership. The registered manager split her time between four days in the home and two half days in the adjourning day centre. In the weeks prior to the inspection we found that the registered manager had been heavily involved in offering support to another of the provider's service. From a review of documentation, discussions with staff and the management team it was identified that this had had a negative impact on the management of the service.
We saw the service had engaged with external stakeholders and worked in partnership with other agencies in the process of trying to deliver high quality care.
This inspection took place on 4 August 2015 and was unannounced. This meant the provider did not know we would be visiting. A second day of inspection took place on 5 August 2015 and was announced. The service was last inspected in May 2013. At that time it met all of the standards that we inspected against.
Glenholme Residential Care Home provides care for up to 37 people some of whom have nursing care needs. The service is based in a two-storey converted Victorian townhouse, and bedrooms are located on both floors. There is a separate day centre adjoining the building.
At the time of the inspection there were 33 people using the service. 22 people had general nursing needs. Eight people were living with dementia.
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 accommodation was not specifically adapted for people living with dementia, even though the home provided this support.
People said they felt safe and comfortable at the home. Staff knew how to recognise and report any suspicions of abuse. Staff told us they would report any concerns to make sure people were protected. Potential risks to people’s safety were assessed and managed. People’s medicines were managed in a safe way although the security of the storage could be improved.
People told us there were enough staff to meet their care needs. Care professionals told us it was a “very good” service and staff were familiar with each person’s individual needs. Staff attended quickly when people needed assistance. Staff were recruited in a safe way so that only suitable staff were employed.
The registered manager and staff understood the Mental Capacity Act 2005 for people who lacked capacity to make a decision and deprivation of liberty safeguards to make sure they were not restricted unnecessarily. Staff asked for permission before carrying out care tasks. People told us they made their own choices over their own daily lifestyle.
Staff were knowledgeable about people’s individual care needs and how they wanted to be assisted. People were supported to eat and drink enough and they had choices about their meals.
Health care professionals said the home responded quickly to any changes in people’s well-being.
We saw that people were treated with dignity and respect. People were positive about the service, and were happy with the care that they received. Staff were well liked by people and their families. We saw that people were treated in a caring way. People were involved in decisions about their care and support.
The service did not advertise the role of advocates. No-one at the service required an advocate but we made a recommendation about this.
Care plans were comprehensive and gave a good insight into people’s needs and how they would like them to be met. People’s needs were assessed in detail, and were reviewed regularly. The plans contained details of personalised care, and we saw that staff were able to use these to deliver the care that people wanted.
The service employed an activities co-ordinator and we saw that people enjoyed the activities on offer. People and their families were able to give feedback on activities, and this was acted on. However, we saw that carers did not always have the time to join in with activities.
People knew how to raise complaints, and we saw that where this had happened they had been quickly and appropriately responded to.
Resident and family meetings were arranged regularly which gave people the opportunity to provide any feedback or share ideas, though we saw that these were not advertised within the service. The registered manager also sent people an annual questionnaire, and we saw that this had been used to improve the service. People and staff told us that issues they raised were sorted out quickly.
We spoke with three relatives who were positive about the care their relatives received. One said, staff were 'Very good'. Another said 'I cannot fault the staff here' and another said her relative is 'Happy here'. They all felt their relative was safe.
We found people's privacy, dignity and independence were respected and people experienced care, treatment and support that met their needs and protected their rights. People who used the service were protected from the risk of abuse and people were cared for by suitably qualified, skilled and experienced staff. The provider had an effective system to regularly assess and monitor the quality of service that people received.
We saw appointments with dentists, chiropodists, psychiatrists, community psychiatric nurses, opticians and other health related activities. Details of contacts with healthcare professionals were recorded on each person's file. This showed that people received appropriate care and support from the NHS. Comments from the people who used the service included; 'I am very happy with the care I get here'; 'The doctors and nurses come to see their patients all the time'; 'The care here is excellent and I have no regrets coming here'.
The service users were complementary about the meals and said that there is always plenty to eat. Some of the comments included:
'The food is lovely here'.
'There is always plenty to eat and drink'.
'I enjoy my food, and I like the choice we are given'.
A visiting relative commented on the 'home cooking' and said that her friend who is a resident in the home has always been complementary about the food and the choices available to them.
Other comment by the service users included:
'I am here for a short stay but I think I will stay permanently. I like it so much here and the staff are very caring'.
'I can't complain about anything. We are well looked after'.
'You couldn't fault the staff or the care here. I am happy here'.
'I know of the home's complaints procedure and would know what to do if I am not happy with anything'.
'I can't complain. The staff are very kind and caring'.
' I am very happy with the home and everywhere is nice and clean'.