The Glen Care Home

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

People were supported to be safe and were protected from the risk of abuse. The registered manager and staff demonstrated an ethos of wanting to learn and continuously improve. People had their needs assessed before they came to the home. People’s care plans reflected their needs and provided staff with the information they needed to manage the identified risks. People were living in a home where the staff were working within the principles of the Mental Capacity Act (2005), and had ensured appropriate legal authorisations were in place when needed to deprive a person of their liberty. Medicines were managed safely, and people received their medicines as prescribed. The environment was being safely managed, with a range of health and safety checks undertaken. Improvements were being made by the registered manager to ensure signage at the home was in place to help guide people around the home. There were enough staff on duty with the skills required to meet people’s needs. Staff were safely recruited and received an induction and ongoing training to make sure their skills were appropriate and up to date. There were good infection prevention and control practices at the home. The home and equipment were kept clean and hygienic, and staff used personal protective equipment (PPE) appropriately.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were confident they could raise any safety concerns with the registered manager or staff. Relatives confirmed they were informed when their family member had any accidents or falls.

People and staff were encouraged to report any concerns. Daily meetings were held with the registered manager and senior staff and handover meetings were held between shifts. These were opportunities to share any learning points to prevent harm to people.

The registered manager and deputy manager were very active at the home, working alongside staff. They did not expect staff to do anything they were not prepared to do themselves. They demonstrated an ethos of wanting to learn and continuously improve.

People were involved in a pre-admission assessment before being admitted to the home. This ensured the staff had the skills and knowledge needed to meet their needs when they came into the home.

Staff worked well with external health and social care professionals to ensure people’s needs were met. Staff told us they felt well informed about people coming into the home and that communication was good. The registered manager told us they went with the deputy manager to undertake pre-admission assessments. They said they also undertook re-assessments of people in hospital ready to return to the home to ensure they could meet any new needs the person had. Staff had access to full information about people’s health in the event of an emergency.

External partners told us the home worked with them to support people with safe transitions between settings. One health and social care professional told us, “Any queries regarding individual clients are addressed promptly and efficiently and suggestions regarding further support are investigated, with the outcome clearly documented.”

Systems were in place to support people on admission with risk assessments undertaken to ensure people were safe. Care records showed people’s needs and risks were assessed prior to and on admission to the home. People’s health needs were detailed in their care plans and guidance was in place to guide staff.

People told us they were safe and did not feel they were exposed to abuse or harm. Comments included, “I know I’m safe here”, I didn’t at one time feel safe …. but now I’ve got used to being here it’s ok” and “I like it here, very much so, I feel safe here.” A relative told us, “My wife had lots of falls in her previous home…she’s had none here, that says something.”

Staff had received training on how to recognise abuse and were able to demonstrate how they would put this into practice. Staff told us they would not hesitate to raise any concerns about potential abuse. Staff told us they had confidence in the registered manager and deputy manager to take any concerns seriously. One staff member said, “Yes, I definitely think it’s a safe place to live. I have never had concerns about how people are treated. If I had a concern, I would go the staff member in charge or to (registered manager) they would help me. We also have a line we can phone, a whistle blowing line. Everyone is very supportive here.” Staff and leaders were aware of the need to support people to be involved in decisions about their care. Staff had received training in the Mental Capacity Act (2005) and were able to put that into practice. One staff member told us, “People have a choice here. People have capacity so they decide. If people lack capacity, then it may be a best interest decision for them.” They gave an example, “Someone may decide they don't want personal care. We respect that but will pass on to the next shift as a priority to see if they can persuade them, offer again.”

Staff supported people in a safe way and regularly checked on them throughout the day and night. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). We observed some people had restrictions placed on their movement. For instance, lap belts on wheelchairs and keypads around the building restricting access. This was to promote their safety and prevent harm and appropriate requests had been made. Not many people had bedrails in use at the home. The registered manager told us they had ultra-low beds and crash mats in place as the least restrictive option. People and staff had access to information about how to raise safeguarding concerns.

We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. We found systems were in place to monitor legal authorisations. For example, 1 person had a condition in their DoLS that staff needed to record every time the person requested to leave the home. This process was in place.

People understood the risks relating to them and staff supported them to understand what they could do to keep themselves safe.

Staff reviewed people’s individual risk assessments on a regular basis. Staff told us they felt any changes in people’s needs were updated and communicated to them. Staff said they were informed about people’s allergies, swallowing difficulties and dietary requirements. The management team had also put clear signs in people’s bedrooms reminding staff of these.

We observed staff supported people in a safe way. People who were at risk of pressure damage or risk of falling from their bed had appropriate equipment in place.

Individual risk assessments for people were in place to protect them when receiving care and support. Care plans contained risk assessments regarding falling, pressure damage, choking and malnutrition, as examples. Risk assessments were reviewed monthly as part of the resident of the day process used at the home or more regularly if a persons need changed. Systems were in place to discuss any changes to people’s risk of harm. Where necessary, referrals to external healthcare professionals were made in a timely manner.

People and relatives raised no concerns about the safety of the environment.

Staff told us the new provider had been very responsive to requests for new equipment. For example, the registered manager told us, they had requested 7 hospital beds, and these had been purchased. A staff member told us, “The home is run very well, we have everything we need, we had an issue with the hoist, so they bought us a new one.”

The home was a converted 3 storey detached period house set in large gardens surrounded by countryside. Access within the building was via 2 staircases, 2 passenger lifts and smaller stairlifts. There were 3 lounges, seating in the main entrance and two dining rooms on the ground floor which people could use. On the first day of our visit the flooring was being replaced in areas on the ground floor. We also observed work was being undertaken in the grounds for a dementia garden. The décor of the home was tired. The registered manager told us an external company had given a quote to redecorate the whole home.

A range of health and safety checks were undertaken incorporating fire, electricity and water safety. Equipment to assist people with moving had been serviced and was safe to use. Emergency evacuation plans had been written for each person, which outlined the support they would need to leave the premises. Fire drills had been carried out regularly, fire training and practice evacuations. There was very little signage around the home, to assist people in orientating themselves around the building, particularly people living with dementia. The registered manager had started to address this on the second day of our site visit.

People and relatives told us there were enough staff on duty to meet their needs and that their call bells were answered promptly. People’s comments included, “If I use the call bell, they usually come quickly” and “Staff are very good, day and night, they usually come quickly when I call.” Relatives said, “There’s enough staff to care for them safely, mum’s bell is always answered quickly, [whoever comes] it doesn’t matter if it’s not their job, they will always help” and “I visit most days, there are always plenty of staff about.”

Staff told us they felt well supported and received regular supervisions and appraisals. They felt there were enough staff allocated to meet people’s needs. Staff comments included, “Very good staffing day to day. Sickness absence is very low since the takeover as it is not as stressful.” Staff confirmed they were kept informed. One staff member told us, “We have a monthly staff meeting, last week we had a full meeting with all staff. We have a flash meeting, everyday kitchen, maintenance, care staff, managers and nurse at 11.30 am.”

There was a relaxed atmosphere at the home, staff responded promptly to people’s needs.

Recruitment processes were in place and appropriate checks had been carried out on newly recruited staff to ensure they were safe to work with people. There were processes for sharing information between staff. These included, a handover sheet, handover meetings, staff meetings and daily flash meetings, to share information and improve practice. Staff received an induction when they started working at the home. One staff member told us, “Overall, I thought the induction was good, it did cover everything I needed to know.” Another staff member said, “Here the induction was very good, senior staff went through the care of 1 person right through from the beginning to the end. They also covered safeguarding, whistle blowing and IPC, they gave me policies and procedures to read.” Staff were required to complete a range of training for their roles. Staff received training on specific conditions including dementia awareness and learning disabilities and autism. The registered manager was proud of the staff training compliance at the home. Records confirmed good compliance. Staff received 3 monthly supervisions and an annual appraisal. The deputy manager told us they had started a regular program of clinical supervisions with the nurses at the home as part of their on-going development needs.

People and their relatives provided positive feedback about the cleanliness of the home.

Staff spoken with said the home had the laundry and cleaning equipment it needed.

The home and equipment were kept clean and hygienic, and no malodours were noticed. The sluice rooms were clean, tidy and free of clutter and were locked when not in use. Staff were seen observing good infection prevention and control practices, such as tying back long hair. Staff wore disposable aprons when they assisted people at mealtimes. Personal protective equipment (PPE) was readily available throughout the home for staff when needed for personal care.

There were detailed infection prevention and control (IPC) procedures in place. All staff completed annual IPC training and had a 3 monthly IPC competency assessment. Cleaning schedules were in place and were consistently completed. Monthly audits were carried out of IPC practice and showed high levels of compliance.

People received their medicines safely and as prescribed. Where people needed their medicines administered at specific times they received them promptly. People’s care plans detailed the support they needed with their medicines. For example, 1 person required medicines to be placed in their hands so they could independently take them.

Staff had received relevant training to administer medicines, and had their competency assessed. One staff member told us, “The managers have supported me and given me lots of training, I have done all the online training. I needed to watch the clinical lead to see how to do medicines, then she watched me to see if I am doing it right.” Staff wore red tabards when administering medicines advising staff not to disturb them to minimise making any errors. One staff member told us, “When doing medicines, I wear my ‘do not disturb tabard’. I ask staff to only call me if it is an emergency, if it can wait then record it and I will get to it after the medicines are done.”

Medicines were managed safely. The provider had started to use an electronic medicines system the week of our first site visit. They had ensured staff had received the required training to use the system safely and had their competency assessed. The registered manager and deputy manager were overseeing the process and had been the point of contact for any issues found. There were appropriate arrangements for the ordering, storage, and disposal of medicines. There were protocols in place for medicines prescribed ‘as required.’ A system was in place to ensure emergency equipment, was regularly checked and cleaned. For example, syringe driver, suction machine and nebuliser machine. The registered manager had revised the homes medicine management policy to include the new electronic process. Regular medicines audits were completed, and where areas for improvement had been identified, action had been taken. The supplying pharmacy had undertaken an inspection of the medicine management at the home on the 2 February 2024 and had not identified any significant concerns.