Glebe House Retirement 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 remained Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s health, wellbeing and communication needs were assessed before they received support. These assessments considered people’s preferences and levels of independence. Staff used recognised tools to assess risks and needs, and information was kept under review to ensure plans reflected any changes.

We received mixed feedback as to whether people had been involved in their assessment. A relative said, “When [relative] first arrived at Glebe we were involved in decisions about her care, ongoing no.” The provider had recently moved to an electronic care planning system which showed that people’s needs were regularly reviewed but did not record their involvement in any review.

Some care plans contained generic wording which did not demonstrate people’s involvement.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

On the first inspection visit we observed some practices which were not in line with up-to-date guidance. For example, we observed a poor layout in the lounge with chairs positioned around the edge of the room, a lack of drinks available and the television constantly on at a loud volume. One person had their back to the television and could not see the screen. This meant people could not socialise freely. We fed this back to the management team at the end of our first visit.

On our second visit we found the situation much improved. The television was not on as loud; chairs was arranged so that people were able to sit in both the lounge and in the conservatory enabling them to freely engage with each other. We discussed what we had found on our first visit with the registered manager who had not been present during our first inspection visit. They told us that what we had found was not typical and that staff had received training in appropriate dementia care.

Care documentation included several assessment tools. This ensured evidence-based practice and standards were met. Staff knew people well and were able to understand and anticipate their needs.

People were supported to maintain adequate nutrition and hydration in line with their preferences and assessed needs. We observed lunch in the dining room and saw staff were attentive and gained consent before providing support. People were offered a choice of food. We observed people socialising as they ate. A person said, “Food is always good, always a choice. I am kept well hydrated; it is possible to have a beer or wine.” Another person said, “The food is jolly good. I like the vegetables, get a proper Sunday dinner. Chef comes in, I said I was gluten free and allergic to mustard, he makes my Yorkshire pudding separate, makes me special small cakes and gets gluten free sausages.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us they were kept up to date when people’s needs changed. A member of care staff said, “I receive clear guidance at handovers at the start of each shift.” Staff mainly worked well as a team. We observed staff supporting each other to provide safe and effective care and to meet people’s needs promptly.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff encouraged people to remain as independent as possible and promoted healthy choices. A member of care staff said, “I support people to maintain their independence by promoting choice, dignity and person-centred care at all times. I encourage individuals to do as much as they are able to do for themselves, offering prompts or assistance only when needed rather than doing tasks for them.”

People were supported to attend appointments, manage long term‑ conditions and engage in activities that supported their wellbeing. Staff were proactive in noticing changes in people’s health and seeking professional advice. A member of care staff said, “I would ensure the change is clearly documented, including what was observed, when it occurred, any actions taken and who was informed.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Care plan audits were completed to monitor progress and identify any changes in people’s needs. The provider had recently introduced an electronic care planning system which supported regular monitoring. Recognised monitoring tools were used to identify and monitor emerging healthcare needs. For example, a MUST (Malnutrition Universal Screening Tool) was used to monitor people’s weights. The tool created a score which indicated whether a person required closer monitoring or a referral to other health professionals, such as dieticians.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA). We observed that people’s consent was obtained before any care interventions and care staff respected their choices. A member of care staff said, “I always explain the care being provided and ask for consent before carrying out any task. If person refuses care I respect their decision, reassure them and report this to a senior.”

Mental capacity assessments and best interest decisions were documented in some care plans. However, in other care plans where a person had a diagnosis of dementia no mental capacity assessment was recorded. Best interest decisions were recorded but did not always demonstrate that relevant people, such as family of someone holding a care and welfare power of attorney had been involved in the decision-making process. Lack of appropriate assessment and recording could mean people’s needs are not appropriately met.