Archived: Glencoe Care Home

Updated 21 August 2018

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 was prompted in part by notification of an incident following which a person using the service sustained a serious injury which is being investigated by the local authority. The information shared with CQC about the incident indicated potential concerns about the management of risk of falls and insufficient records relating to each person being in place. This inspection examined those risks.

Inspection site visits took place on 13 and 21 June 2018 and were unannounced. The inspection was conducted by an adult social care inspector.

As part of planning our inspection, we contacted Healthwatch and local authority safeguarding and quality performance teams to obtain their views about the service. Healthwatch is an independent consumer group, which gathers and represents the views of the public about health and social care services in England. We reviewed information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to tell us about within required timescales.

The provider sent us their Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan for the inspection.

During the inspection, we reviewed a range of records. These included three people's care records containing care planning documentation, daily records and medicine records. We looked at three staff files relating to their recruitment, supervision, appraisal and training. We reviewed records relating to the management of the service and a wide variety of policies and procedures.

We were unable to speak with some people who used the service due to their communication needs. However, we used the Short Observational Framework for Inspectors (SOFI) to observe staffs’ interaction with people. We spoke with three people who used the service and three relatives to gain their views. We also spoke with five members of staff including the registered manager and deputy manager.

Updated 21 August 2018

Glencoe Care 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.

Glencoe Care Home accommodates up to 19 people in one adapted building. At the time of this inspection there were 16 people living at the service. The service specialises in providing accommodation for people living with dementia.

At the last inspection in February 2016 we awarded a rating of good. At this inspection we found that improvements were needed.

Prior to this inspection, concerns had been raised by visiting professional and the local authority with regards to care and support that was being provided. As a result, the service was place into a collective care process so relevant professional could monitor the service and any improvements made. CQC had been involved in the collective care discussions.

There was a manager in post who registered with CQC in June 2011. 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.

Risk assessments had been completed but did not contain sufficient information to enable to staff to support people safely. Some risk assessments contained contradictory information and it was not clear from the information recorded what current risks were in relation to each person.

Safe recruitment process had not always been followed to ensure staff were suitable to work in the care sector. Gaps in employment history had not been explored and disclosure and barring checks had not always been completed prior to employment commencing.

Staff had not been provided with sufficient support to ensure they had the skills and competencies to carry out their roles. Regular one to one supervisions had not been conducted. We have made a recommendation about staff supervisions and support.

The provider and registered manager had failed to ensure they acted in accordance with the Mental Capacity Act 2005 (MCA). Where people lacked capacity to make particular decisions, appropriate best interest meetings had not taken place. When people had Lasting Power of Attorneys (LPA) in place, appropriate documentation was not in place to evidence this. People were not provided with information in a format they could understand.

Many quality assurance systems were not in place and the registered manager did not effectively monitor the safety and quality of the service. The provider did not conduct regular checks to ensure people were receiving good quality care.

People were not always supported to maintain their autonomy and independence as signage was lacking throughout the building. We have made a recommendation about the lack of appropriate signage.

The provider did not comply with the Accessible Information Standards (AIS). People had not been provided with information in a way they could understand. We have made a recommendation about complying with the AIS.

Medicine had been managed and stored safely. Records showed people had been administered their medicines in accordance with guidance provided. Staff were confident in raising any safeguarding concerns. There was enough staff on duty to support people where required.

Environmental checks had been completed on different areas of the service. However, they had failed to identify some of the concerns we found.

The service was clean throughout with no malodours. Accidents and incidents had been recorded by staff although action taken by the registered manager to reduce risks of reoccurrence had not been recorded.

People were encouraged to maintain a balanced diet and there was a variety of fresh food on offer. There were no printed menus available and consideration had not been given to people’s communication needs. We have made a recommendation about adaptations for people living with a dementia.

We observed staff to have a kind and caring approach to people and it was clear they knew people’s likes, dislikes and preferences very well.

Care plans did not always contain sufficient person-centred information although person-centred support was provided by staff who were familiar with people’s needs. People were able to participate in a range of activities that varied on a daily basis.

Staff felt well supported by the registered manager and told us they were approachable and had an open-door policy. Relatives we spoke with confirmed this. The registered manager encouraged people, relatives and staff to provide feedback although this was not always formally recorded.

We have identified five 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.