Glenister Gardens

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We found some improvements were needed to medicines management to reduce risks to people's safety. The provider took action to address these concerns on the day of our assessment and sent us evidence of their actions after the assessment. People had risk assessments in place to help keep them safe and maintain their wellbeing. The service had enough appropriately trained staff to meet people's needs and keep them safe. The provider had policies and procedures for managing incidents, accidents, safeguarding alerts and complaints. This included lessons learned to help improve service delivery. We did not assess all the quality statements within this key question, as we did not identify concerns in the areas we judged as being met at our last inspection.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives knew who to speak with if they wanted to raise a concern. One relative said, “I’m comfortable complaining if I need to. They don’t make you feel bad for saying something.” Another relative confirmed the provider dealt with incidents and accidents and told us, “‘Most of the time [the person is] safe, there’s been a few incidents that have been remedied by the manager.”

Monthly team meetings provided the opportunity to discuss concerns or incidents.

The provider had appropriate processes in place for managing safeguarding alerts, incidents, accidents and complaints. These were investigated and action taken. For example, when medicines errors were identified all staff completed medicines training, who could administer medicines was restricted and daily audits were introduced as an interim measure to monitor the effectiveness. As a result, medicines errors have reduced. The provider also completed a quarterly lessons learned meeting which looked at trends and audits to help make improvements to the service.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Five out of six relatives told us they thought the service was safe. Relatives confirmed, “Yes, I feel [person] is safe, very much so” and “‘I do feel [person] is safe.” Some relatives commented about the staff not always understanding their relative’s culture or taking the initiative, but overall relatives felt staff had the skills to care for people safely.

Staff had received training around safeguarding and knew how to respond to concerns including abuse. Managers were aware of their responsibilities and what actions to take to help safeguard people from abuse. The service did not use any form of restraint. Care plans included guidance about how to manage people who might show aggression.

Appropriate safeguarding policies and procedures were in place for safeguarding people from abuse. The provider worked with the local authority safeguarding team and other professionals to help investigate concerns and to protect people from abuse. There was a system for recording and monitoring safeguarding concerns which helped managers to have oversight of concerns in the service.

People and their relatives were involved in risk assessments and care plans. People’s safety and wellbeing were risk assessed and appropriately managed to help maintain independence. The assessments included personalised details about people’s needs and how people wanted to be supported.

The provider had systems and processes in place to help keep people safe including risk assessments and risk management plans. Risk mitigation plans provided clear guidance for staff, and were regularly reviewed to help to keep people safe. There was evidence of referrals to other professionals to obtain support and advice as required.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People's relatives told us generally there was enough staff but not always. One relative commented, “Sometimes there’s not enough staff, sometimes there’s too much.” Others said, “‘There seems to be enough staff” and “‘There’s enough staff and they are very well trained and skilled at caring for [person].” Most relatives confirmed staff had the appropriate skills to care for people but in some cases could get to know the person’s needs better. They told us, “Some are more trained than others” and “The staff are friendly and welcoming, some are exceptionally good.” On the day of the assessment most people were out for at least part of the day or in their flats which meant our observations were limited. However, there was clearly enough staff to support people with their planned activities and the interaction we did observe between staff and people in service was appropriate. There were enough staff to meet people's needs and wishes.

Staff told us there were sufficient numbers of staff available to help keep people safe and meet their needs. One staff member said, “Yes definitely there are always staff around to help.” Staff were able to tell us about various training they had completed and how it helped them to care appropriately for people. Staff told us they felt supported by the management team and had regular team meetings.

The provider followed safe recruitment practices to help ensure only suitable staff were employed to care for people using the service. These included checks on their experience, skills, and eligibility to work in the United Kingdom. After being recruited, staff undertook an induction and training, so they had the required knowledge to care for people. Staff undertook annual refresher courses or when a need was identified. Records indicated regular supervision and staff confirmed they received support from managers

The relatives of people using the service told us they were satisfied with the cleanliness of the home. Comments included, “It’s kept clean and tidy. Sunday the washing machine is always on. I can’t fault them there” and “The flat is lovely. It’s a nice place, always clean and tidy.”

We found the medicines cupboard and trays were not clean enough. This was rectified once we pointed it out. Communal areas were clean and people were supported to maintain clean flats. There was enough available personal protective equipment (PPE) for staff. Food items were labelled and in in date. There were systems in place to help prevent and control infection, and to help keep people safe. The provider had cleaning schedules and audits which helped to ensure the environment was clean and infection free. Staff demonstrated an awareness of infection prevention control and this was reflected in the environment.

There had been a number of medicines incidents prior to this assessment, and this was reflected in the feedback from people’s relatives. However, the provider had taken action, and at the time of the assessment medicines management had improved. One relative confirmed, “They sort all medicines out. We trust them.”

All staff received appropriate medicines training but only identified staff members administered medicines. Staff said they had the relevant information to administer medicines safely and were assessed to help ensure they were competent to manage medicines safely.

Procedures used by staff did not always ensure all medicines were managed in a safe way. We saw medicines taken out of their original packaging, put in medicines pots and taken to people’s flats. Original records were not always used at the time of administration. The provider explained the issue with records which were completed electronically was due to their internet connection and showed us evidence that they had taken steps to address this prior to the assessment. Staff followed appropriate protocols for PRN (as required) medicines and for covert medicines administration. Medicines Administration Records (MARs) we reviewed were completed correctly. Regular medicines audits were undertaken to identify any concerns, mitigate any identified risk and improve practice.