Archived: Glen Lee

This inspection took place on 26 July and 1 August 2018 and unannounced.

At the last inspection of 25 July 2017, we found a breach of regulation 12 of the Health and Social Care Act (Regulated Activities) Regulations 2014. During this inspection we found improvements had been made and there was no longer a breach.

Glen Lee 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.

Glen Lee provides accommodation and personal care for up to 33 people who may be living with dementia. The accommodation is provided over two floors accessed by a passenger lift. There are a number of communal areas where people can sit together or alone if they wish. There is also a garden which is safe for people to access independently. On the first day of the inspection there were 12 people living at Glen Lee and this increased to 14 people on the second day of the inspection.

The registered manager had previously stopped working at the home and had applied to deregister with the CQC at the time of the inspection. 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. The provider had employed the services of an external consultancy company as a short-term arrangement to improve the quality of the service. During the inspection process, a new manager had been recruited.

Medicines were stored safely and at the correct temperatures. People received their medicines as prescribed, from trained staff. The provider had policies and procedures in place designed to protect people from abuse and people felt safe living at Glen Lee. Risk assessments identified when people were at risk and action was taken to minimise the risks. Where incidents had occurred, these were recorded appropriately and the incident reviewed to understand how the situation had occurred. Lessons were learned and improvements made when things went wrong. The home was clean.

People’s needs were met by suitable numbers of staff, who were trained and supported in their roles by the management structure. Staff supported people to eat and drink in line with their preferences, individual needs and dietary requirements. Staff knew people well and sought professional medical help when necessary. Mental capacity assessments and best interests decisions were completed where necessary. The provider had invested in the environment which was designed to meet people’s needs.

People were treated with kindness, respect and compassion. Staff were patient with people, offering and supporting their choices. People were supported to express their views and be involved in making decisions about their care and support. Staff supported people with their personal care whilst being mindful of their privacy and dignity.

People received personalised care that was responsive to their needs and enjoyed a range of activities, which were tailored to their interests and choices. People were consulted about their end of life care choices and wishes. People and their relatives had access to the complaints procedure.

The provider promoted a positive culture that was open and transparent and staff enjoyed going to work. The provider had a management structure throughout the organisation and staff were aware of their role within the structure. People, their relatives and staff were involved in how the service was managed. The provider and manager ensured the service was continuously learning and improving and there was an effective system of auditing to improve quality.

During this inspection on 25 April 2017 we found the provider had made some improvements but we also identified new concerns. Some people had care plans for medicines, but some did not. Records were not always accurate around medicines. New care plans for people’s care and support had been introduced but were not completed effectively. Activities did not always meet people’s needs. There were systems in place to monitor the quality and safety of the service provided but these were not always effective in identifying areas for improvement.

Glen Lee provides accommodation and personal care for up to 33 people who may be living with dementia. The accommodation is provided over two floors accessed by a passenger lift. There are a number of communal areas where people can sit together or alone if they wish. There is also a garden which is safe for people to access independently. On the day of the inspection there were 24 people living at Glen Lee.

There was a registered manager at the service. 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’s needs were met by suitable numbers of staff. Staff had completed training with regard to safeguarding people and were aware of how to use safeguarding procedures. People had risk assessments in place to ensure every day risks were identified and minimised where possible. The provider had taken action to ensure recruitment procedures were safe.

Staff had training in and followed legislation designed to protect people’s rights. People were supported by staff who had received an effective induction into their role, which enabled them to meet the needs of the people they were supporting. Staff were further supported through supervision, training and appraisal. People could choose what they wanted to eat and drink and the environment, such as the dining room, was decorated with their individual needs in mind. People had access to healthcare services when necessary.

Staff developed caring relationships with people using the service. People were encouraged to express their views and be involved in making decisions about their care and support. Staff were mindful of respecting people’s privacy and dignity when supporting them with personal care.

There were some good examples of how staff had considered the needs of people living with dementia within the service and responded to their views and ideas. The provider had a complaints procedure in place which was followed by the registered manager.

The registered manager and provider promoted a positive culture that was open and inclusive. Staff spoke highly of the registered manager. The registered manager ensured the home met registration requirements.

People told us they were happy at the service. One told us they 'always feel happy here', and another told us the staff were 'all very good, very good people'. A relative told us they were happy with the care and support their relative received from staff.

We reviewed care plans for four people using the service. They were person-centred and contained essential details about people's care and support needs.

We observed staff supporting people to take part in joint activities, and those people appeared happy and contented. Support was observed to be sincere, respectful and responsive to individual needs.

People were given choices and allowed to give their consent to care and support whenever possible. Where people lacked capacity to give their consent, the service followed clear guidelines to make sure people's rights were safeguarded in line with legal requirements.

The premises were well designed, laid out and maintained so as to be fit-for-purpose for meeting people's diffferent needs. There were enough qualified, skilled and experienced staff to meet people's needs. An effective complaints procedure meant any complaints were investigated and resolved to people's satisfaction.

Care plans and risk assessments were in place although these did not always reflect the current needs of people. People were provided a choice of meals that met their needs, although support with meals were at times lacking. Relatives were confident that any concerns they raised would be taken seriously and staff would help them to resolve the issue.

Medicines were not managed appropriately and may put people at risk to their health and welfare. There were not always adequate staff and this may impact on the care that people received. The infection control procedures at the time of the inspection were inadequate and may put people at risk to their health. There was an audit system that looked at the service delivery.