Archived: Glynn Court Residential Home

Updated 24 September 2015

We inspected Glynn Court Residential Home on 11 August 2015 to check the provider had made improvements to meet the breaches of regulations we had previously identified during our last inspection. This was an unannounced inspection.

At our inspection in October 2014 we found the provider to be in breach of regulations relating to safeguarding people; supporting staff; safety and suitability of premises; consent to care and treatment; meeting nutritional needs; respecting and involving people who use services and the management of medicines. We took enforcement action against the provider and the registered manager and issued warning notices in relation to care and welfare of people; records and monitoring the quality of the service. The provider sent us an action plan telling us how they would meet the regulations. At this inspection we found improvements had been made following a restructure of the service and the appointment of a new manager and deputy manager who had identified other concerns and areas for improvement. Remedial action was already underway.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection team consisted of an inspector, a specialist adviser (a nurse with experience of older people and dementia care) and an expert by experience in the care of older people. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we reviewed all the information we held about the service including previous inspection reports and notifications received by the Care Quality Commission. A notification is when the registered manager tells us about important issues and events which have happened at the service.

We spoke with six people and a friend and a relative who were visiting, four care staff, an activities co-ordinator, as well as the new manager and deputy manager. We also spoke with provider. We carried out observations throughout the day in the lounge, dining room and while the lunch meal was served to six people in their rooms. We reviewed seven people’s care plans and pathway tracked five people’s care to check that they had received the care they needed. (We did this by looking at care documents to show what actions staff had taken, who else they had involved such as a GP, and the outcome for the person). We looked at other records relating to the management of the service, such as medication records, quality audits, maintenance and health and safety records, and seven staff recruitment, training and development records.

Updated 24 September 2015

We inspected Glynn Court Residential Home on 11 August 2015 to check the provider had made improvements to meet the breaches of regulations we had identified during our previous inspection and the outstanding enforcement action we had taken. This was an unannounced inspection.

We had inspected Glynn Court Residential Home on 29 and 30 October 2014. This was an unannounced inspection to check they had made improvements to comply with the warning notices we had issued to them in September 2014. The provider had taken some steps to improve but had not made adequate improvements and had not complied with the warning notices issued.

We continued the enforcement action against the provider and the registered manager. The three warning notices (enforcement notices telling the provider why they had breached regulations and the date by which they must make improvements) remained in place in relation to care and welfare of people, record keeping, and monitoring and assessing the quality of the service provided.

We also took enforcement action against the registered manager who had consistently failed to make the improvements required and cancelled their registration in April 2015.

The provider kept us informed of actions they were taking during this time, including recruiting a new manager and deputy manager to oversee the improvement and development of the home.

At this inspection (August 2015) we found the manager, deputy manager and provider had worked together to make significant and visible improvements. They had met the requirements of the warning notices and all but one of the outstanding breaches of regulations we had found at our inspection in October 2014.

Glynn Court Residential Home is a care home for older people, some of whom are living with dementia. The home is registered to provide accommodation for up to 31 people. At the time of this inspection there were 25 people living there. The home is set in well maintained gardens and consists of a main house and a smaller detached house, this being for people with less complex needs.

The service did not have a registered manager in place on the day of the inspection, however the manager had a date for their registration interview with the commission in August and they were subsequently registered following a successful interview. 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.

People living at the home, their visitors and health care professionals were all complimentary about the quality of care and the management of the home. The manager and deputy manager promoted a culture of openness and there was a clear management structure, with systems to monitor the quality of care and deliver improvements. Staff told us the morale at the home was now good and they felt supported, which they hadn’t had before.

People were protected from possible harm. Staff were able to identify different types of abuse and what signs to look for. They were knowledgeable about the home’s safeguarding processes and procedures and who to contact if they had any concerns and this information was also on display for people and relatives if they needed it. Staff told us they felt they would be taken seriously and concerns would be acted upon now. They had not felt this before.

People told us they felt safe and staff treated them with respect and dignity. People’s safety was promoted through individualised risk assessments and effective management of the premises. There were systems in place to manage, record and administer medicines safely. Staff had good knowledge of medicines and their competency was checked regularly to ensure they remained aware of their responsibilities in relation to medicines.

The quality and consistency of care had improved since our last inspection. The manager had implemented a range of improvements, with the support of the deputy manager, provider and staff. There was a strong commitment to provide personalised care, in line with people’s needs and preferences, and to create a homely, welcoming environment. Staff interacted positively with people and were caring and kind. They were reassuring to people when required and supported them at a pace that suited them without rushing.

People’s health needs were looked after, and medical advice and treatment was sought promptly. A range of health professionals were involved in people’s care including GPs, community nurses, dentists and chiropodists. However, we found some inaccuracies within people’s records which meant staff may not have had up to date or correct information to guide them in how to provide appropriate care and support to people.

Staff encouraged people to maintain their independence and provided opportunities for people to socialise. Staff supported people to make decisions and to have as much control over their lives as possible. The staff had good natured encounters with people, seemed to know them well, and had time to sit and chat with them. The home employed an activities co-ordinator who had increased their hours to provide more support time. There was a range of activities on offer throughout the week. Most activities took place within the home, such as singing, entertainers and quiz games. Some people were supported to maintain links with their local community including visiting the shops or the local garden centre.

People were offered a varied diet, prepared in a way that met their specific needs, and were given choices. Important information, such as allergens in food, was available to people and staff. People were given support and encouragement by staff if they needed help to eat.

The provider operated safe recruitment processes and recruitment was continuing. There were sufficient staff deployed to provide care and staff were supported in their roles with training, supervision and appraisals. Staff understood their responsibility to provide care in the way people wished and worked well as a team. They were encouraged to maintain and develop their skills through relevant training.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The new manager understood this legislation and had submitted DoLS applications for some people living at the home. Staff were aware of their responsibilities under this legislation and under the Mental Capacity Act (2005).

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have asked the provider to take at the back of this report.