Archived: Glenview Nursing Home

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

There had been significant improvements following the inspection of 2 February 2021. Positive changes had been made to health and safety audits of the home, and the general health and safety checks of equipment. New systems and processes had been put in place and embedded into the way the staff worked. This demonstrated that the quality and safety of the home was managed effectively.

A computer system had been put into place to help monitor the overall health and safety of the home and the general maintenance. The registered manager every weekday with the maintenance person to discuss the day to day maintenance of the home. Referrals were made to external contractors when needed. Clear quality assurance systems were in place with audits of the home and of the health and safety of the building regularly carried out.

People told us they felt safe living at the home. Staff were trained in safeguarding and understood their responsibility to protect people from avoidable harm and abuse. Risks to people's health and safety were assessed with guidance for staff to follow. Staff were recruited safely and there were enough staff to provide safe and effective care. Medicines were stored and administered safely in line with people's prescriptions. Accidents and incidents were reported and recorded with audits in place to help identify any trends or patterns. We were assured by the infection, prevention and control measures.

People and staff felt positive about the registered manager and the management of the home. The registered manager was aware of their duty of candour. Effective quality assurance systems were in place to monitor the quality and safety of care. Audits had improved which helped to identify any shortfalls. There was an open and inclusive culture in the home. The registered manager worked closely with the clinical lead. The provider had good oversight of the home and visited daily.

Rating at last inspection

The last rating for this service was Requires Improvement (published 6 March 2021). At our last inspection we found there were shortfall in the systems to monitor the safety of the home and they were not effective. Health and safety audits of the home, general health and safety and equipment checks were not up to date. At this inspection we found improvements had been made.

Why we inspected

We carried out an inspection of this service on 2 February 2021. We rated the service requires improvement in Safe and Well Led due to the shortfalls, which we identified. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Glenview Nursing Home on our website at www.cqc.org.uk.

We found the following examples of good practice.

People we spoke with told us, "Yes I feel safe” and “I have no concerns”. Another person told us that they were looking forward to going out the weekend with family. They planned to go out for a meal when the homes isolation period had ended. The registered manager told us another person liked to go out regularly but was unable to due to the outbreak. They were able to spend time in the garden during the outbreak which they enjoyed.

People were supported to order items online whilst they were unable to go out. This included takeaways, clothes and personal items.

There was a clear process for visitors, which included a temperature check and the wearing of PPE. They were required to take a lateral flow COVID-19 test with a negative result before entering. Where people were isolating the use of phone calls were utilised to promote contact with family members.

Visitors were required to sign in and they had to show a negative lateral flow test. The vaccination status was checked for health and social care professionals and contractors. This was in line with legislation that had come into effect in November 2021.

People were supported to see friends and family in accordance with government guidance. Some relatives were the named essential carer givers for their loved one. This meant they will still able to visit during the outbreak at the home. In order to be an essential care giver, set procedures were followed. This included participating in regular testing for Covid.

The home was cleaned regularly and this was monitored through audits and checks. There were staff on duty during our inspection, carrying out cleaning duties.

The home took part in regular testing for COVID-19. The registered manager maintained an audit of the dates staff and people were last tested. The registered manager told us all staff had been double vaccinated. Some staff had received booster vaccinations and others planned to have this when they were able to. The Covid passports of staff had been checked by the management team.

The registered manager told us they had not experienced any workforce pressures during this outbreak. We were told the staff team picked up extra hours as overtime, but this was monitored to ensure staff were not over worked.

At our last inspection in May 2019 we found that quality audits were not effective and they had not picked up risks and areas of concern. For example around safe use of slings. At this inspection we found quality checking systems of the home were still not fully effective. A manager’s quality checking system was in place, however there was no evidence it had been used in the last 12 months to drive improvement. Nor was there any evidence recorded that certain risks had been identified and actions put in place.

The new area manager had put in place a slings audit to check and ensure slings were used safely. This had been a shortfall identified at the last inspection. They had also written a full action plan to address shortfalls in the home, including the ones found at this inspection.

People were supported by staff who were wearing suitable personal protective equipment. There were clear, easy to follow guidance in place to minimise risks to people and staff from Covid 19. There were no known cases of Covid 19 amongst staff and people who lived at the home when we visited.

Moving and handling risk assessments were now clear and set out how to keep people safe. These had not been in place at our last inspection. Staff were recruited safely. Checks of suitability were up to date. This had been a further shortfall at our last inspection. Concerns had been raised around wound care management. Care plans and risk assessments were in place to help staff support people around wound care management. Relatives told us these concerns had now been addressed.

Relatives gave us overall positive feedback about the care and support their family members received at the home. Relatives said since the area manager had started working with the service in August 2020 there had been real improvement. Specifically, around addressing shortfalls when they occurred and communication with them about their family member.

Staff also felt better supported and told us about ways that care had improved since the new area manager had taken up their post. They also said they now felt very able to make their views known to the management of the service who they said listened to them and were respectful of their views.

Why we inspected

We undertook this focused inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in response to concerns received about wound care management, care and cleanliness in the home. A decision was made for us to inspect and examine those risks.

At this inspection we found enough improvement had been made at this inspection and the provider was no longer in breach of regulation 12. However there continued to be shortfalls around the Safe domain. Specifically around health and safety audits not being fully embedded in the home.The provider recognised this and the area manager was putting in place a range of health and safety audits

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively

Glenview is a care home that provides personal and nursing care for up to 40 older people. The service is provided in accommodation over four floors. At the time of the inspection, 30 people were living at the home.

What life is like for people using this service:

People were not always protected from unsafe care. Staff were not all aware of how to safely use moving and handling equipment. The records did not provide detail about the equipment needed.

Staff did not always report injuries so appropriate safeguarding referrals were not always made.

Staff had not received sufficient training to carry out their roles. The records showed that staff had not all received moving and handling training or safeguarding training, so people were not always protected from unsafe care.

Medicines were safely managed.

People were supported to access health care services and regular visits were undertaken by their GP.

People’s dietary needs were assessed, and people were offered choices at mealtimes.

Where people’s foods, fluids and change of position needed monitoring, records were completed and up to date.

Audits were not consistently completed. Shortfalls were not always identified and where improvement actions were needed, actions were not always taken.

Medicines management checks were regularly completed and where improvement actions were needed, these were completed.

More information is in detailed findings below.

Rating at last inspection:

Good (report published in April 2019).

Why we inspected:

Safeguarding investigations were ongoing at the time of our inspection because there had been a number of concerns relating to the care and treatment of people living in the home and the ability of staff to effectively meet people’s needs. As a result, we undertook a focused inspection to review the Key Questions of Safe, Effective and Well-led only.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-led sections of this report.

We have identified breaches of the regulations in relation to safe care and treatment, staffing and quality assurance at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

Follow up:

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Staff understood their responsibility to keep people safe from harm. People were supported to take risks and promote their independence. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support. Checks were carried out on staff before they started work to assess their suitability to support people in a care setting. Medicines were well managed and people received their medicines as prescribed. People were protected by the homes infection control policy and procedures.

The service was effective in meeting people’s needs. Staff received regular supervision and training. Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People were provided with a healthy, balanced diet whilst promoting and respecting choice.

Everyone we spoke with agreed that staff were caring and kind. Comments included, “The staff are kind, caring and patient”, “Staff make you feel very welcome” and “They have very good staff”.

Staff had a good awareness of individuals' needs and treated people in a warm and respectful manner. They were knowledgeable about people's lives before they started using the service.

The service was responsive to people’s health and social needs. People received person-centred care and support. Regular monitoring and reviews meant that referrals had been made to appropriate health and social care professionals. Where necessary care and support had been changed to accurately reflect people's needs and improve their health and wellbeing. People were encouraged to make their views known and the service responded by making changes.

People benefitted from a service that was well led. One relative recently submitted feedback about Glenview Nursing Home on a national care website. They wrote, “They provided excellent care and friendly attention to my relative. The home is run very efficiently and nothing was too much trouble for the nurses and the care staff”. Quality assurance systems were in place and based upon regular, scheduled audits, which identified any action required to make improvements. This meant the quality of service people received was monitored on a regular basis and, where shortfalls were identified they were acted upon.

Rating at last inspection: This was the home’s first inspection since their registration in April 2018.

About the service: Glenview is a care home providing, nursing care, personal care and accommodation for up to 40 people. At the time of the inspection there were 32 people living at the service.

Why we inspected: This was a planned comprehensive inspection. All services registered with CQC must have an inspection within the first year of their registration.

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