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Glenkindie Lodge Residential Care Home Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 4 August 2020

During an inspection looking at part of the service

About the service

Glenkindie Lodge Residential Care Home is a residential care home providing personal care and support to 27 people aged 65 and over at the time of the inspection. The service can support up to 33 people.

Glenkindie Lodge Residential Care Home provides accommodation across two floors, with two lifts to the first floor. People with higher dependency needs are accommodated on the first floor. There are four communal lounges and a dining room on the ground floor and a communal lounge on the first floor. There are communal gardens with wheelchair access.

People’s experience of using this service and what we found

Measures were in place to mitigate risks to people. The appropriate recording of risk and mitigation required further development and would need embedding in practice to ensure staff have clear guidance. Measures were in place to reduce the risk of falls from heights.

An improved auditing system was in place to ensure better oversight of the safety and quality of the service. This would need to be continued and embedded to ensure all aspects of safety and quality were regularly monitored.

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. Improvements were still required around the recording of best interest decisions. The manager had implemented a tool to maintain oversight of deprivation of liberty safeguards (DoLs).

A training schedule now provided oversight of staff skills and there had been good progress in the update of training which was ongoing.

People received their ‘as and when’ required medicines in a safe and timely manner.

Measures were in place to ensure chilled foods were stored appropriately to prevent the risk of food poisoning.

A new manager was in post since our last inspection, they had begun to make the improvements required to the service. They had a good understanding of the work that was needed and were committed to ensuring positive change. These improvements now need to be embedded and sustained.

The manager and the deputy manager continued to work in partnership with other professionals to drive improvement and work towards full compliance with the warning notice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 18 March 2020) and there were multiple breaches of regulation.

Why we inspected

We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on a Warning Notice or other specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

We found the service to be partially compliant with the warning notice. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme where we will check that the provider is then fully compliant with the warning notice. If we receive any concerning information we may inspect sooner.

Inspection carried out on 16 December 2019

During a routine inspection

About the service

Glenkindie Lodge Residential Care Home is a residential care home providing personal care and support to 22 people aged 65 and over at the time of the inspection. The service can support up to 33 people.

Glenkindie Lodge Residential Care Home provides accommodation across two floors, with two lifts to the first floor. People with higher dependency needs are accommodated on the first floor. There are four communal lounges and a dining room on the ground floor and a communal lounge on the first floor. There are communal gardens with wheelchair access.

People’s experience of using this service and what we found

Risks to people had not been effectively assessed and recorded, the provider and registered manager had not maintained effective oversight in this area.

Lessons had not consistently been learnt when things went wrong. Accidents and incidents had been recorded and collated but had not triggered a review of risk to identify hazards and mitigate the risks going forward. People were protected from the risk of abuse.

As and when required medicine guidance for staff required further development to ensure people received their medicines as prescribed. Medicines were administered by trained senior members of staff and were stored and disposed of appropriately.

Recruitment procedures were not robust and did not ensure safe recruitment practices. The provider and registered manager had not ensured current legislative requirements were met in this area. However, Disclosure and Barring Service (DBS)checks were completed prior to staff working with people.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The provider did not have evidence of the deprivation of liberty safeguard authorisations which are the legal authorisation required when depriving people of their liberty. Mental capacity assessments had not consistently been completed and meetings had not been held to ensure people were being supported in their best interest until DoLs were applied for.

There were no daily planned activities at the time of the inspection Activities provided by care staff were ad hoc and inconsistent.

People did not receive dignified care at meal times staff were observed to support two people at a time to eat and leave people mid meal to attend to other duties. We have made a recommendation on improving support in this area.

Some of the staff training was overdue. Staff completed an induction and training schedule when they first started with the service.

People told us that staff were kind and caring and we saw that they knew people well. Privacy was supported during personal care and staff had a good understanding of gaining consent before delivering care.

Communal areas were not consistently deep cleaned. However, people’s rooms were clean and fresh. Personal protective equipment such as gloves and aprons were used by staff.

There were suitable numbers of staff to meet people’s needs. The staff and management team worked in partnership with health and social care professionals.

Peoples needs were assessed prior to moving into the service and personalised care plans were in place. People’s individual communication needs were met.

People had enough to eat and drink with nutritionally balanced meals and access to regular snacks and drinks.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 18 December 2018) and there were breaches of regulation. The service remains rated requires improvement.

This service had been rated requires improvement at the last inspection. At this inspection enough improvement had not been made and the provider was still in breach of regulat

Inspection carried out on 9 October 2018

During a routine inspection

This unannounced inspection took place on 9 and 16 October 2018.

Glenkindie Lodge Residential Home was registered by the Care Quality Commission (CQC) on the 2 November 2017 and this was the first time we had inspected this service.

Glenkindie Lodge Residential 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.

Glenkindie Lodge Residential Home provides care and support for up to 33 older people, some of who may be living with dementia. The premises had been adapted and consisted of two floors which included bedrooms, a main lounge, garden room, dining room and an activities room. At the time of our visit there were 26 people using the service.

There was 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 service is run.

During this inspection we found that risks to people had not always been identified and managed safely. For example, where people were using thickener in their drinks because of a risk of choking, there were no risk management plans in place to cover the risk of choking or dehydration. One person had numerous falls from their bed, but there was no risk management in place to help reduce that risk.

Mobility assessments did not always demonstrate how moving and handling slings had been safely assessed for people. People shared slings but we found they were not always used correctly, for example, toileting slings were used for general moving and handling procedures, not toileting. Slings were not checked to make sure they were safe to be used. Some people using wheelchairs were at risk of sliding out and there were no management plans in place to reduce this risk.

Some bedrooms doors had been wedged open with different pieces of furniture which meant that people may be put at risk if there was a fire at the service. Not everyone living at the service had in place a personal emergency evacuation plans (PEEPS) to make sure they would get the help they needed in an emergency to keep them safe.

Quality assurance checks were not used effectively to bring about improvements to people’s care and support. Records management was confusing and disorganised and records could not always be accessed at the time of our inspection.

We found two breaches 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.

Improvements were required to ensure people were protected from the spread of infection and that the service followed best practice guidance. We found that people were sharing slings used for moving and handling.

Senior staff required further training in relation to the Mental Capacity Act 2005 (MCA) and the process for making best interest decisions for people. Staff understood about safeguarding and the many different types of abuse. They knew how to report any concerns they may have. There had been ongoing recruitment by the provider to improve staffing numbers and the provider followed thorough recruitment procedures to ensure staff employed were suitable for their role.

People’s medicines were managed safely and in line with best practice guidelines. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service. These needed to be strengthened to make sure that the outcomes of accidents, incidents and complaints were shared with all staff to ensure lessons were learnt to reduce the possib