Archived: Glencoe Care Home

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.

Glencoe Care Home provides personal care for up to 19 older people whose needs are predominantly related to dementia and associated conditions. On the day of the inspection there were 18 people living in the home. The home is located in the town of Whitby, close to the park and shops. The home does not provide nursing care.

The home had a registered manager in post. 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.

Staff were able to tell us what they would do to ensure people were safe and people told us they felt safe at the home. The home had sufficient suitable staff to care for people safely and they were safely recruited. The environment of the home was safe for people and safety checks were regularly carried out. Medicines were handled safely to protect people.

Staff had received training to ensure that people received care appropriate for their needs. Training was up to date in areas such as infection control, health and safety, food hygiene and medicine handling and also in specialist areas of health care appropriate for the people being cared for.

Staff had received up to date training in Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff understood that people should be consulted about their care and that unless assessed otherwise they should assume that a person had capacity. They understood what needed to happen to protect the best interests of people whose capacity was impaired and we saw evidence that this was taking place.

People’s nutrition and hydration needs were met. People enjoyed the meals and they were of a good quality. Clinical care needs were met in consultation with health care professionals and people were accompanied to appointments when needed.

People were treated with exceptional kindness and compassion. We saw staff had an excellent rapport with people whilst treating them with dignity and respect. Staff had a detailed knowledge and understanding of people’s needs and worked together well as a team. Staff supported each other and it was clear that they were valued and respected by the registered manager of the home. The atmosphere within the home was one of care and affection. Care plans provided detailed information about people’s individual needs and preferences. Records and observations provided evidence that people were treated in a way which encouraged them to feel loved and listened to and that the wellbeing of every person mattered.

People were supported to engage in daily activities they enjoyed and which were in line with their preferences and interests. Staff were responsive to people’s wishes and understood people’s personal histories and social networks so that they could support them in the way they preferred. Care plans were kept up to date when needs changed, and people were encouraged to take part in their reviews and to give their views which were acted upon.

People told us their complaints were responded to and the results of complaint investigations were clearly recorded. People we spoke with told us that if they had concerns they were always addressed directly with the registered manager who responded quickly and with courtesy.

The service had an effective quality assurance system in place. Glencoe Care Home was well managed, and staff were well supported in their role. The registered manager had a clear understanding of their role and they consulted appropriately with people who lived at the service, people who mattered to them, staff and health care professionals to identify required improvements and put these in place.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is the service safe?

People were treated with respect and dignity by the staff. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was always available in case of emergencies. Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Staff had been trained to understand when an application should be made, and how to submit one. This meant that people were safeguarded as required.

Is the service effective?

People's health and care needs were assessed with them or their representative, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said that they had been involved in writing them and they reflected their current needs. People told us that they were happy with the care that had been delivered and their needs had been met. It was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs and that they knew them well. One person told us, "I'm happy here, I have everything I need." Staff had received training to meet the needs of the people living at the home. There was an advocacy service available if people needed it, this meant that when required people could access additional support.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People told us they were able to do things at their own pace and were not rushed. Our observations confirmed this. A visitor told us, "It's first class care." People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People's needs had been assessed before they moved into the home. People we spoke to told us they knew how to make a complaint if they were unhappy.

Is the service well-led?

Staff had a good understanding of the needs of the people who used the service and quality assurance processes were in place. Staff told us they were clear about their roles and responsibilities. The service had a quality assurance system and we saw records that showed us where identified shortfalls had been addressed promptly. As a result the quality of the service was continuingly improving.

We found that people were consulted about their care and that the home sought people's consent to their care and treatment. We saw that the home assessed people's capacity to make decisions. If a person was assessed to lack capacity, then decisions were made by a multidisciplinary team to ensure they were made in the person's best interests.

We saw that the home assessed people's care needs and developed care plans which were reviewed with risk assessments in place. We saw that staff had training in caring for people with a dementia and that care plans took account of people's dementia care needs. This meant that people received the care they needed. We saw that people were protected from risk of harm through the correct recruitment practice, staff training and appropriate checks.

The home monitored the quality of its service through surveys and internal systems so that improvements could be identified and put in place.