Glynn Court Residential Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulations in relation to providing personalised care and consent.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective.

The provider relied on care provided by staff who knew people well and understood the care they needed. They lacked a robust system for ensuring care could be provided safely and effectively by staff who did not know people, for example, if several staff were off work at once and they had to use temporary staff.

Care plans lacked detail, which meant staff who did not know people well, and were not familiar with the care they needed, would have difficulty providing safe and effective care.

There were inconsistencies within some people’s care plans. For example, an end-of-life care plan made no mention of the person’s NHS recommended summary plan for emergency care and treatment.

However, people’s needs were assessed before they moved into Glynn Court and when reviewing care plans. This included their mobility and communication needs. Relatives said they were consulted as part of this process and told us their family members received the care they needed. A healthcare professional commented that the assessment process meant people only moved in if their care needs could be met at Glynn Court.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Although people’s health needs were met, staff did not follow good practice when planning their health care. Some care plans for health conditions were missing or lacked detail. For example, care plans relating to someone’s diabetes care mentioned the person should see a chiropodist but did not state how often, and there was no reference to NHS diabetic foot screening.

Staff did not follow good practice in ensuring consistent, complete information was available to inform clinical decision making by visiting health professionals, ambulance crews in an emergency, or hospital staff when people were admitted.

However, people and relatives told us the food was good and staff made sure they had enough to drink. We saw people enjoying their meals. However, they were not offered condiments, which might have added to the pleasure they took from their food.

The provider worked well across teams and services to support people.

Relatives told us the registered manager kept them well informed if their family member had an accident or showed signs of ill health. Some relatives who had been their family member’s carer previously, chose to continue aspects of their caring role at Glynn Court, by assisting their family member to eat and drink.

Staff confirmed changes in people’s health and needs were clearly communicated with them, principally through shift handovers. They told us the registered manager and staff worked well as a team, and that communication was clear. They worked collaboratively to plan and deliver people’s care.

Health professionals confirmed staff worked collaboratively with them, making referrals when needed with an appropriate level of information, and following the advice given.

Some staff had received training from district nurses to monitor blood sugar levels for some people living with diabetes. This is a task that would normally be performed by a registered nurse. The district nurses had delegated this to staff they had trained and signed off as competent.

The provider supported people to manage their health and wellbeing.

People received healthcare promptly when they needed it. Staff were alert to signs of people becoming unwell and sought healthcare advice promptly. Relatives confirmed the registered manager and staff sought healthcare advice for their family member when needed. People’s care records reflected people having the necessary access to healthcare, including GPs, hospital reviews, and opticians.

The provider had systems in place to monitor clinical outcomes from people’s care and treatment. They ensured these outcomes met clinical expectations and the expectations of people themselves. The provider did not consistently monitor outcomes from other aspects of people’s care to identify how these could improve.

Staff monitored key health indicators, including food and fluid intake, skin health, weight and signs of pain. They recorded care given in relation to these, such as assisting people at risk of developing pressure ulcers to reposition in their bed or chair. They understood people’s needs and recognised signs of possible health deterioration. They escalated these concerns promptly, enabling any necessary changes in people’s care and referrals to health care professionals as required.

However, there was no routine monitoring of the effect non-clinical aspects of care had on the quality of people’s lives. For example, in the absence of regular activity provision, there was no systematic consideration of how people passed their time and whether they were occupied with things they enjoyed and found meaningful. We observed people seated in the lounge during the morning; most remained withdrawn or asleep despite the music playing. When staff spoke with individuals, those people welcomed the interactions, making eye contact and smiling. Some people were keen to spend time in the company of members of the inspection team, telling us they liked to have someone to talk to.

The provider did not always obtain people’s consent and did not always respect their rights when delivering care and treatment.

People had not consented to all aspects of their care. Where people’s consent was recorded, staff did not regularly review it to ensure their decisions were up to date. Similarly, where there were grounds to think the person might not understand the implications of accepting or refusing that care, staff had not assessed their mental capacity and considered whether that care would be in their best interests. This included aspects of care staff recognised could be restrictive, such as using bed rails or sensor mats. It also included routine practices staff did not see as restrictive, such as stowing walking frames away from people who were using the lounge.

Where staff had undertaken mental capacity assessments and made decisions in people’s best interests, their records lacked detail. They had not always recorded how they ascertained whether the person understood the decision. Some people had multiple mental capacity assessments and best interest decisions recorded on the same day with identical wording. This presented a risk that people had not been involved in mental capacity assessments and best interest decisions to the extent they should have been. There was also a risk best interest decisions did not reflect the least restrictive care options for people.

However, staff understood they should only provide care and support if the person had consented to it, or that was in their best interests if the person lacked the mental capacity to decide about their care. We observed staff checking with people before assisting them with day-to-day tasks.

Relatives and staff had been involved in medical decisions about do not attempt cardio-pulmonary resuscitation notices and recommended summary plans for emergency care and treatment. This helped ensure the person’s known preferences were considered.