12 April 2022
During a routine inspection
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.