Glenmuir House Residential 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 received safe care from skilled staff who understood their individual risks and how best to support them. There were systems in place to keep people safe from abuse and harm. There were enough staff to support people well, and there were robust processes in place to ensure staff were recruited safely. Improvements had been made to the general appearance and safety of the premises, and the home was well maintained and clean. Care plans had been improved and contained better detail about risks, and provided staff with clearer guidance about people’s risks. Medicine administration was safe and was managed well.

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.

Relatives told us staff knew people well and understood their needs. One relative said, “Staff seem to be well trained.” All the feedback we received from people told us that people felt safe and that staff had received the necessary training to promote people’s safety and wellbeing.

Staff told us, “Anything we want to get training on – we get.” Staff said they use incidents or complaints as a tool for learning and improving. They explained how they have regular meetings where they discuss the home, people they support and training. They said they are encouraged by the registered manager to put forward their thoughts and ideas for improvement.

Accidents and incidents had been recorded and analysed to determine the cause, and actions had been planned to reduce the likelihood of recurrence. Reflective thinking sessions had been held within team meetings to consider how incidents had happened and what could be done differently next time to improve practice. Risk assessments had been regularly reviewed and updated to mitigate increasing risks. There were systems in place for families, people and staff to raise concerns or share their views. These included an internal post box for signed or anonymous comments.

People told us they had received appropriate support from relevant health professionals during the time when they were moving in to the service. People explained how they had met with staff or the manager prior to their moving in, and asked questions about themselves and their support needs. One relative told us how the staff had been proactive in resolving issues with delays around getting appropriate equipment to support their family member.

Staff told us how they are provided with any specialist training that is needed, prior to people moving in to the service. The registered manager told us they liaised with the hospital, relatives and other health professionals to get all relevant information needed before arrival.

A health professional provided us with feedback, telling us that staff are very knowledgeable and good to work with.

Senior staff carried out detailed pre-admission assessments at a face to face meeting to ensure that they were able to meet the person’s individual needs. The registered manager told us they liaised with the hospital, relatives and health professionals to get all relevant information needed before arrival. This was to ensure that they had the necessary skill and equipment required before care commenced and that the person was comfortable with the people already living in the home. There were organisational policies and procedures that underpinned the admission pathway.

People told us they felt safe living at the service and that staff supported them well. One person said, "I do feel safe, they look after me." Another person told us, "I forget things but they make sure I am safe here."

Staff and the registered manager were all very clear about their role in safeguarding people. Staff told us they had received training and felt confident about raising concerns and who to contact.

There was a friendly and relaxed atmosphere in the home, and staff interacted with people frequently and with genuine care and friendly humour. Staff attended to people in a timely manner, and attention had been given to people’s clothing, hair, nails and make up. We saw that people were regularly offered drinks and snacks.

Staff had received training in safeguarding and there was an up to date safeguarding policy in place. The organisation had followed safeguarding procedures and made referrals to the local authority as well as notifying the Care Quality Commission when required. Records showed referrals, investigation details and outcomes with action plans where required. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. 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 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS) We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. The documentation supported that each DoLS application was decision specific for that person. For example, regarding restrictive practices such as locked doors, sensor mats and bed rails. We saw that the conditions of the DoLS had been met.

People told us staff involve them in decisions about their care. One person said, “Staff talk to me about my care.” They said equipment they use is checked for safety by staff and well looked after, so it is safe to use. Another person described their risks to us and said they felt involved in managing the aspects of their life where they required support.

Staff understood how to manage and mitigate risks, and how to use the Mental Capacity Act to underpin decision making. Staff gave us many examples of where reviews of risks had been carried out and appropriate measures taken and recorded to further reduce risks. Staff told us how they use risk assessments in a positive way to enable people to be more active and independent.

Staff were visible throughout our visit and were mindful of where people were and checked on them regularly. People had a range of call bell devices appropriate to their ability, to summon staff support when they needed it. Some wore a wrist-watch style call bell and others had a device they could place close by. We observed when people pressed their call bell, staff responded immediately. Equipment was well maintained and clean, fire safety equipment had been regularly checked and fire exits were clear from obstruction. Emergency information in case of fire was stored correctly and appropriately.

At the last inspection we found improvements were needed to ensure people were safe from harm. This inspection found risks to people were safely managed. Staff knew people very well and worked with them and their families to create care plans specific to their needs. Care plans and risk assessments identified specific risks to each person and provided guidance for staff on how to minimise or prevent the risk of harm. These included risks associated with diabetes, mobility, skin integrity and eating and drinking. For example, people with fragile skin had guidance on how to prevent pressure damage using air flow mattresses, continence promotion and monitoring. People who had been identified as at risk from dehydration and weight loss were monitored closely and when asked, staff knew who needed encouragement and support to eat and drink. Accidents and incidents were recorded with details of what may have contributed to the incident. These details were also recorded on a central incident tracker, which enabled managers to review individual incidents and to identify any emerging themes. The organisation had a business continuity plan for Glenmuir to ensure people would continue to receive their care in the event of an emergency. Health and safety checks were carried out regularly and we saw documentary evidence of fire, gas, and electrical safety.

People told us the environment is kept clean and tidy. Comments we received from people included, “They keep the place really nice”, “My room is lovely, and everything is safe and looked after very well.”

We talked to staff who told us that they report any concerns or areas that need improving in the environment and that action is taken promptly. Staff said they carry out environmental audits to ensure nothing gets missed.

We saw the environment had been well maintained, although in some areas there were upgrades needed to the décor which appeared tired. We saw that this had been identified by the provider and was included in the plans for improvement. The kitchen area and equipment were clean and well maintained. We saw the dining room had been arranged in a way people preferred and they had chosen to eat all together at one large table, rather than at several smaller ones. We observed staff checking people regularly to ensure they were seated comfortably and safely. We saw staff checking a person’s footwear as they had been at risk following some recent falls.

The provider had a schedule of regular environmental checks to monitor the safety and upkeep of the premises. Records showed that external professionals carried out regular servicing of gas, electricity, fire equipment, call bells and water supply. The home was secure and staff had ensured that only authorised people could enter the premises. Health and safety audits took place regularly and areas for action had been addressed. Staff had access to Health and Safety policies and procedures that supported safe working practices, for example checking water temperatures prior to supporting people to have a bath or shower. Staff told us how they managed risks while encouraging independence. This related to the placement of sensor mats, monitoring and the use of call bells.

People and relatives told us there were enough staff to support people well and to spend time with them. One person said, “I think there are plenty of staff and there is always someone there to help.” Another told us, “There are enough, they are always helpful and anticipate my every need .” One relative said, “They answer the door bell very quickly and always greet us and offer tea or coffee. They are very welcoming.” People had been invited to share their views and ideas at residents meetings. Records showed people had been asked where they would like to go on their trips out, and people had said they would like to visit the seafront. This had been added to the schedule of activities.

Staff spoke positively about staffing levels currently, and told us they would need more staff if the numbers of people who live at the service increases. One staff said, “We have a tight knit team who are all very good, and share the same values” and another staff member agreed, saying, “We have very good team-working and we all support each other. We are not rushed off our feet and always have time for a chat with people.”

We observed people being responded to promptly when they required support. Staff had time to spend with people, having time for conversations and laughter. We saw people were spending meaningful time with staff, such as being supported with an activity, having their hair done, flower arranging, reading the newspaper and doing crosswords. Staff appeared to know people well, their care and health needs, likes and dislikes as well as their family set ups. One person who was experiencing anxiety was seen to be supported by staff in a positive way.

Staff rotas showed there were sufficient numbers of suitably qualified and trained staff consistently deployed to fully meet people’s needs. Staff deployment ensured people’s needs were met in a timely manner and in a way that met their preferences. Staff told us they didn’t work to time constraints and people had choice about when they got up, washed and had breakfast. There was an 'on-call' system that enabled staff to contact senior staff out of hours and at weekends to obtain advice and direction to meet people's needs safely. We looked at four staff personnel files and there was continued evidence of robust recruitment procedures. Staff were supported with regular one to one supervision meetings with managers, and could raise any issues in the time in between.

People and their relatives told us that the home is kept clean and tidy. One relative said, “The home is very clean, and always looks and smells fresh.” One person told us, “They keep my room lovely and clean and always make sure my bathroom is clean too.”

Care staff told us they currently carry out cleaning as part of their job role, but felt housekeepers would be needed if more residents were to move in. Staff told us they have regular infection control training and that management check their competency to ensure their standards remain high. Staff said that infection control has improved in recent years, and told us, “We are really proud now – a lot of knick-naks that collect dust have gone.”

There was an up to date infection control policy displayed on the noticeboard for staff or residents to see. We saw that the service was well stocked with PPE (Personal Protective Equipment) and that the home was clean and tidy, and walkways and surfaces were clear.

At the last inspection the provider had not ensured the premises were hygienic and clean. This assessment found this had improved and all areas of the home were clean and hygienic. Staff used appropriate cleaning materials to prevent cross contamination. Soap and paper towels were readily available to ensure good hand hygiene. Staff wore personal protective equipment (PPE) appropriately and disposed of it correctly. There was an infection prevention and control policy in place. This was updated regularly to ensure any new guidance was included. Staff confirmed they had received infection control training. Strict protocols with soiled linen were followed and the laundry was clean. Cleaning schedules were available, and staff had a good understanding of these. Regular audits were undertaken and action taken where necessary

People and relatives gave positive feedback about medicines administration. One person told us, “Such a relief not to have to worry about taking my pills, staff always give them to me.” Another said, “They always ask me if I need anything for pain – I have arthritis you see.” Relatives told us they feel medicines are given safely. One relative said, “My [relative] gets all the right medicines – I have no worries about that. If the doctor changes anything, the staff discuss it with me.” We observed people being given their medicines safely.

Staff who administer medicines spoke confidently about giving medicines safely. They told us they had received regular training and have their competency assessed annually. Staff said they are all trained to give insulin and are supported by a district nurse who gives them practice sessions in taking blood sugars so that they feel confident to do so.

People’s medicines were managed and administered safely and our observations confirmed this. Senior care staff known as medicine givers were trained to handle medicines in a safe way and completed competency assessments. This ensured they were competent and their knowledge was up to date. We saw that medicines remained stored securely when being given out, and staff administering the medicines ensured the trolley was locked. Medicines prescribed on an 'as and when required' basis (PRN) had protocols which informed staff of when the medicines were required.