Archived: Glencairn House Retirement Home

We found the following examples of good practice.

Measures were in place to prevent the spread of infection by visitors to the service. All visitors were required to answer questions about their health to screen for Covid-19 symptoms and their temperature was taken on arrival.

The provider had invested in screens to support indoor visiting in the entrance to the home. At the time of our inspection visiting had been paused due to local Public Health guidance. The main doors had been closed due to cold weather. The provider told us they would review the ventilation of this area before visiting restarted.

People were supported to understand the measures that were in place regarding infection prevention and control.

People were supported to stay in touch with their loved ones in ways that were meaningful to them. Staff understood the impact the isolation could have on people and sought to support people’s emotional wellbeing. Particular care was taken to support people who needed to quarantine in their room as part of the home’s admission process.

Staff were committed to keeping people safe. They had undertaken additional training and understood the importance of wearing appropriate PPE. There were sufficient stocks available including masks, gloves, aprons and hand sanitiser. Sanitisation and PPE stations were placed around the building and this enabled easy access. The provider reviewed risk assessments related to the wearing of cloth masks following advice from the Dorset Clinical Commissioning Group Quality Improvement team.

Additional cleaning measures were in place in line with good practice guidance.

Infection prevention and control audits took place and action plans were developed to follow up on any required actions. This ensured the registered manager had effective oversight of infection control measures.

Regular COVID testing was carried out at the service for both staff and people living there, and contingency plans were in place in the event of any outbreak of Covid-19 or other emergency.

Further information is in the detailed findings below.

Glencairn House Retirement Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Glencairn House Retirement Home is registered to accommodate 23 older people. The Home is split over three floors with the first and second floor having access via stairs or lift. On the ground floor there is a large lounge which leads into a dining room. There was level access to the outside patio area at the rear. There were 23 people living at the home at the time of inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were protected from avoidable harm as staff received training and understood how to recognise signs of abuse and who to report this to if abuse was suspected.

Staffing levels were adequate to provide safe care and recruitment checks had ensured staff were suitable to work with vulnerable adults. Staff had received an induction and continual learning that enabled them to carry out their role effectively.

Staff received regular supervision and felt supported and confident in their work.

When people were at risk staff had access to assessments and understood the actions needed to minimise avoidable harm.

Medicines were administered and managed safely by trained and competent staff. Medication stock checks took place together with daily and monthly audits to ensure safety with medicines.

Staff were clear on their responsibilities with regards to infection prevention and control and this contributed to keeping people safe.

Accident and incidents were all recorded and analysed by the registered manager. Lessons learnt were shared with staff through monthly meetings.

People and their relatives had been involved in assessments of care needs and had their choices and wishes respected including access to healthcare when required.

The service worked well with professionals such as doctors, occupational therapists and social workers.

People had their eating and drinking needs understood and were being met. People had mixed views about the quality, variety and quantity of the food.

People 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.

The registered manager actively sought to work in partnership with other organisations to improve outcomes for people using the service.

People, their relatives and professionals described the staff as caring, kind and approachable. People had their dignity, privacy and independence respected.

People had their care needs met by staff who were knowledgeable about how they were able to communicate their needs. Their life histories were detailed and relatives had been consulted.

The home had an effective complaints process and people were aware of it and knew how to make a complaint. The home actively encouraged feedback from people, their relatives and professionals.

People’s end of life needs were assessed and detailed. Records showed that people and their relatives had been involved in these plans. Feedback received by the service showed that end of life care provided was of a good standard.

Activities were provided and these included staff, people and their relatives. Individual activities were provided for those that preferred them.

Relatives and professionals had confidence in the service. The home had an open and positive culture that encouraged the involvement of everyone.

Leadership was visible within the home. Staff spoke positively about the management team and felt supported.

There were effective quality assurance and auditing processes in place and they contributed to service improvements. Action plans were carried out and lessons learnt.

The service understood their legal responsibilities for reporting and sharing information with other services.

Glencairn House is a residential care home in the centre of Dorchester which provides support for up to 23 people. They had one vacancy at the time of our inspection. The home is a large Victorian building which has been fully extended and refurbished by the current owners. Rooms are split over two floors and there is a central communal lounge and dining area. All rooms have a call bell system and en-suite. The first floor bedrooms can be accessed by a lift. People are able to access communal areas at the rear of the home and the home is located opposite a large park.

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.

People were supported safely by staff who understood the risks people faced and how to manage these, staff were also to explain how they would identify signs of possible abuse and report these and had received relevant safeguarding training.

There were enough staff to support people, but staff also managed several other tasks within the service. The registered manager assisted on the floor at busy times and the people we spoke with felt that there were enough staff to support them. People did not have to wait for assistance and although staff were busy, they were able to meet the needs of the people they were supporting.

People were supported to receive their medicines safely and they were stored appropriately. There were regular audits of medicines and these picked up and addressed any gaps or errors.

People were supported by staff who knew their liked and dislikes. There was a relaxed atmosphere and people were comfortable with staff with whom they had a good rapport. Staff were given regular support by the registered manager on an ad hoc basis and received regular supervision and relevant training to support people effectively.

People generally liked the food available at the service and people’s dietary needs were met. Some people required assistance to eat and staff took their meals promptly and supported them with this.

Staff knew about the personal histories of people and records included social profiles with details about people’s histories. Records also promoted people to be as independent as possible and were reviewed regularly with involvement of family members.

Staff understood and supported people to make choices about their care. People’s legal rights were protected because staff knew about and used appropriate legislation.

Information was not always stored confidentially at the home. People’s records were in a secure cabinet, but this was not locked during our inspection and confidential information could therefore be accessed by people.

People had mixed views about the activities available at the service. At the time of inspection, the service had a vacancy for a second activity co-ordinator. This meant that there were times when there were limited activities available to people. The registered manager and director were aware and had plans in place to address this.

The service was well led and people and visitors told us that communication with management was good. Both the registered manager and director were easily accessible and spent time on the floor with people living at the home.

People were able to feedback about the service in regular residents meetings and also using questionnnaires. Issues raised were discussed both at residents and also staff meetings so that everyone was aware and actions were then planned and taken in response.

Quality assurance audits at the service were frequent and robust. The registered manager and director both took responsibility for various audits within the service and met regularly to look at audit findings.

One person told us "I could not be happier here. The staff are very special and they go out of their way to help us all". Another person told us "we are very lucky here - the food is lovely and it always tastes really good. I like all the staff, they are caring and kind".

The manager told us "my staff team are brilliant - they work really well together. They are extremely supportive of one another. It is a lovely environment here and we do everything we can to make each resident happy".

During the inspection we found some decisions were made on people's behalf but not in line with legal requirements under the Mental Capacity Act 2005 (MCA). We could not find any evidence within the care plans we looked at to evidence that mental capacity assessments had been carried out. This meant that people's capacity to make decisions in relation to the treatment they received was not being assessed and therefore decisions were being made without their involvement.