Background to this inspection
Updated
1 June 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection team consisted of one inspector.
Service and service type
Glenmuir House Residential Care Home is a care home. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Glenmuir House Residential Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed the information we held about the service and the service provider. We looked at notifications and any safeguarding alerts we had received for this service. We sought feedback from the local authority and professionals who work with the service. Notifications are information about important events the service is required to send us by law.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.
During the inspection
We looked around the service and met with the people who lived there. We spoke with eight people to understand their views and experiences of the service and we observed how staff supported people. We spoke with the registered manager, deputy managers and four further staff members.
We reviewed the care records of five people and a range of other documents. For example, medicine records, staff training records and records relating to the management of the service. We also looked at staff rotas, and records relating to health and safety.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with three relatives and two health care professionals.
Updated
1 June 2022
About the service:
Glenmuir House Residential Care Home provides accommodation and personal care for up to 20 older people with increasing physical frailty, diabetes, strokes and those approaching end of life. There were also people who were living with dementia. There were 15 people living at the home at the time of the inspection.
People’s experience of using this service and what we found:
The manager and provider had systems and processes to safely assess and manage risks to people, including their medicines and the environment. However, these had not identified some of the shortfalls we found. The audits for care plans and risk assessments had not identified that there was no guidance to manage diabetes and administration of insulin, placing people at possible risk of health complications.
The premises was not always maintained to a good standard. Improvements were required throughout the building, such as in relation to fire doors, radiator covers and hot water temperatures, which the registered manager and provider were prioritising and actioning. The cleaning of the premises needed to improve to ensure all areas of the home were clean and hygienic for people.
We have made a recommendation about the procedures of giving medicines.
People received safe care and support by enough numbers of staff who had been appropriately recruited and trained to recognise signs of abuse or risk and understood what to do to safely support people. As identified in the report however the lack of a dedicated house keeper had impacted on the cleanliness of the premises. One person said, “I like it here.” Most peoples care plans and risk assessments meant peoples’ safety and well-being were protected. Medicines were stored, administered and disposed of safely.
Staff had all received essential training to meet peoples support and care needs. There was an induction programme to introduce new staff to the service and during this process they got to know people and their needs well. Staff told us that they felt the induction had been a good introduction to the home. People's dietary needs were assessed, and people were provided with a choice of cooked meals each day, including breakfast. Feedback about the food was positive and people said they enjoyed the meals. People’s health needs were consistently met with involvement from a variety of health and social care professionals.
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.
Staff were caring in their approach to the people they supported and at this inspection we saw people were treated with respect, humour and dignity. People and visitors to the service were consistent in their views that staff were caring and supportive. People were relaxed, comfortable and happy in the company of staff and engaged with in a positive way.
People told us they felt involved in planning their care. End of life care planning and documentation guided staff in providing care at this important stage of people’s lives.
Complaints made by people were taken seriously and investigated.
The registered manager and staff team were committed to continuously improve and had plans to develop the service and improve their care delivery to a good standard. Staff said the leadership was positive, “It’s a good place to work, the residents are family.”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update:
The last rating for this service was Good (published 20 October 2017)
The overall rating for the service has changed to Requires Improvement. This is based on the findings at this inspection.
Why we inspected:
We undertook this inspection as part of a random selection of services rated Good and Outstanding.
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.
Enforcement and Recommendations:
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified a breach in relation to good governance at this inspection. This was related to the maintenance and cleanliness of the service and records relating to people’s care.
Please see the action we have told the provider to take at the end of this report.
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.