Glendon House

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 63 (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. However, the care records did not always reflect a person’s needs. One person had a risk assessment in place for malnutrition due to dementia, but they were not living with dementia. For someone with diabetes there was a detailed care plan in place which stated how it affected them, how it was managed and symptoms to be aware of. However, their diet and weight assessment did not reflect their diabetes was diet controlled, which meant they were at risk of not being offered the correct food choices.

A person’s needs were assessed prior and on admission by a comprehensive pre-admission assessment form which was completed and formed the basis of the initial care plans. This included their daily preferences, family and life history and what they enjoyed doing, as well as their physical and emotional needs.

People’s care records were reviewed as part of a ‘resident of the day’, where their care was reviewed, and their bedrooms were given a deep clean. This took place about once a month for each person. Their relatives were involved as part of this review. One relative told us, ‘Yes, I’m kept fully informed. They do a ‘Resident of the Day’ thing and they phone to tell me how the day went. It’s a bit special I think.’

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. The registered manager ensured staff were kept up to date with best practice using such things as a noticeboard to display guidance, which covered sepsis during our visit. Clinical tools such as MUST for monitoring of nutrition and Waterlow to identify people who are at risk of poor skin integrity were being used. Also other assessments to identify people’s risks for such things as falls and behaviour support were in place to help monitor and ensure people received appropriate support to mitigate risk of harm.

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 this is an area which had improved recently. There were handovers between each shift and an allocation sheet to ensure care staff were allocated to people to make sure they had positive and consistent support. Care records were detailed on interventions and guidance from health care professionals to ensure people received support required.

One relative told us due to a hip replacement the hospital had advised specific measures to prevent it happening again. They said, ‘the staff liaised with the hospital and know how to help [person] with it.’ This provided assurance that staff understood and followed professional guidance to keep the person safe.

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.

People were encouraged to drink with hydration stations in various places around the service and staff regularly offering drinks. People were provided with choice at meal times and we received positive feedback on the quality of food. One relative said, ‘[Person] loves the food and eats well. It’s home cooked you see, proper food.’ Another said, ‘[Person] is eating well and has put on weight which the home are monitoring. [Person] likes the food.’

People received support from the local GP surgery who provided routine care. One person told us they were up to date with all their vaccinations, and they had six monthly health check ups helping to maintain their health and identify potential concerns early.

People were encouraged to maintain their health and independence, including mobility, social engagement and participation in activities. One relative told us, ‘The staff encourage [person] to move out of [their] room. [Person] uses a frame and they get [person] moving around. It’s good for [their] confidence and wellbeing.’ Another said, ‘[Person] is unable to weight bear and has a special chair which they move [person] around in. It’s good for [person] to be with others or [person] would just be asleep in bed.’

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive andconsistent, or that they met both clinical expectations and the expectations of people themselves.

People’s care was being monitored for such things as fluid intake and output when required. However, there was a lack of guidance within the care records to guide staff on what to do if targets for intake or output were not meet. This meant staff did not always have the guidance to follow to ensure people received appropriate support, if required. We identified gaps where a person had not had their bowels opened for a number of days. The registered manager investigated and appropriate steps had been taken but this had not been recorded. This could have put the person at risk of not receiving appropriate support when required.

There were Antecedent, Behaviour and Consequence (ABC) forms used to help identify triggers, patterns and responses to people’s actions to ensure appropriate steps were taken to support them in the best way. However, there was a lack of reviewing these to identify themes and trends. This was important to help understand how people reacted to certain situations, especially when they were living with dementia or there were communication challenges. This meant staff may not be supporting people in the most appropriate way to reduce their anxiety. When this was raised the registered manager set up a system to capture and review this information.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Mental capacity assessments and best interest decisions were in place, although some required reviewing due to people’s changing needs. Without timely review, there was a risk decisions made on people’s behalf may no longer have reflected their current wishes or best interests, which could impact the appropriateness of the care provided.

Staff asked people’s consent before entering their room or supporting them to provide personal care. Relatives told us they were involved in decision making. One said, ‘Yes, we discussed and agreed this. It’s all in place.’