Archived: Glenkealey

Updated 10 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 3 and 5 September 2018. The inspection team consisted of two adult social care inspectors on the first day and one adult social care inspector on the second day. We undertook this unannounced focused inspection of Glenkealey to look at whether people were receiving safe care and treatment. And to check that improvements to meet the legal requirements planned by the provider following our comprehensive inspection in January 2018 had been made.

Prior to the inspection, we reviewed the provider’s action plan, this showed what they would do and by when to improve the key questions of safe and well-led to at least good. We also reviewed the information we held about the home. This included previous inspection reports and statutory notifications we had received. A statutory notification contains information about significant events that effect people's safety, which the provider is required to send to us by law.

During the inspection we met and spoke with six people who lived at the home, two relatives, one visiting healthcare professional, four members of staff, the registered manager and the registered provider. We looked at the care records for five people. We also looked at records relating to staff recruitment, people’s medicines and the running of the home. Following the inspection, we spoke with one healthcare professional and two relatives.

Updated 10 October 2018

Glenkealey is a care home registered to provide accommodation and personal care for up to 15 older people. 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.

This focused inspection took place on 3 and 5 September 2018 and was unannounced. At the time of the inspection, there were 14 people living in the home.

Glenkealey was previously inspected in January 2018 and was rated ‘requires improvement’. We identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found improvements were needed as risks to people’s health and safety had not always been assessed or managed safely. People’s medicines were not being stored safely. Poor infection control procedures and the lack of clear workflow systems within the laundry had placed people at increased risk. Quality assurance systems had been ineffective.

Following our inspection in January 2018 we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well-led to at least good. We undertook this unannounced focused inspection of Glenkealey, in September 2018, to look at whether people were receiving safe care and treatment and to check that improvements to meet the legal requirements planned by the provider had been made.

We inspected the home against two of the five questions we ask about services: is the home safe and is the home well led? This was because the home was not meeting some legal requirements. No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

At this inspection, in September 2018, we found risks associated with people’s care were now being effectively managed. Medicines which required refrigeration were stored safely. Laundry processes had sufficiently improved to help prevent the spread of infection and reduce the risk of cross contamination. However, we found further improvements were needed to ensure people received their medicines as prescribed and that the environment was safe for people to live in.

The home had a registered manager in post. 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 home is run.

People’s medicines were not always managed safely. We looked at the Medication Administration Records (MARs) for 14 people. We found people’s MARs were not accurate and therefore staff were unable to assure themselves that people were receiving their medicines as prescribed by their doctor. Where people were prescribed medicines they only needed to take occasionally, such as for the management of pain or anxiety, staff had not been provided with guidance to aid their decision making and to help ensure those medicines were administered in a consistent way. There was some good practice in relation to the management of medicines. People were given time and encouragement to take their medicines at their own pace, staff had received training in the safe administration of medicines and people medicines were stored securely.

People were not always protected from the risk of harm as they were living in an environment that may not be safe. Whilst some premises checks had been completed we noted others had not, we found a number of fire doors did not close properly when tested. This would have significantly reduced resistance to the effects of fire and smoke. Where the home had carried out remedial works, this had left holes in the walls and cavities. These had not been filled with a suitable fire-resistant material and as such would not reduce the spread of smoke. We also noted that fire retardant ceiling tiles were missing in the downstairs office and residents’ lounge and the homes fire risk assessment needed to be updated.

People told us they were happy living at the home and liked the staff that supported them. Relatives did not have any concerns about people’s safety. People were protected from the risk of abuse. The registered manager and staff understood their role and responsibilities to keep people safe from harm and ensure people's rights were protected. Risks associated with people’s care had been appropriately assessed. There were enough staff to meet people's needs and checks were carried out on staff before they started work to assess their suitability.

People, relatives and staff were positive about the leadership of the home and told us the home was well managed. The provider had systems in place to review, monitor and improve the quality of care provided. We looked at the home’s quality assurance and governance systems and found while some systems were working well, others had not been effective and had not found the concerns we found during this inspection.

The registered manager had notified the Care Quality Commission of all significant events, which had occurred in line with their legal responsibilities. We found the provider had displayed their rating in the home and on their web site.

We identified continuing breaches in two of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.