Glencairn Residential Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We reviewed 5 Quality Statements in this key question. We found the service had shortfalls in all these Quality Statements which contributed to there being 3 breaches of Regulations. The provider was not involving people in assessing needs, following good practice guidance or escalating health concerns. There was a lack of current consents evident in peoples care records. People did not have person-centred assessments or care plans on record and told us they had not been involved in their assessments.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives told us they had some input into assessments and care plans. One relative told us they had been involved, and another said they had been asked to participate however had not been able to arrange to do so, a third chose not to be involved. One person told us they were admitted to the service without an assessment completed. No one we spoke to who is currently using the service told us they had been involved in assessments, care plans or reviews.

Staff and the acting manager told us there should be an assessment and care plan available for all residents of Glencairn. They also confirmed there were no assessments and care plans in place for some people who were admitted under the registered manager. Staff told us they learned about people as they worked with them and if they learned anything about how they preferred their care delivered, shared this with colleagues.

There were care plans in place for long term residents of Glencairn but no assessments for more recent admissions. Care plans were not all current or accurate. For example, a person living with dementia had a care plan written in 2021 stating they had mental capacity. There was no evidence this had been reviewed while they had been using the service. Dementia is a progressive condition and it is unlikely the person would have the same understanding 3 years later. We found there were some inaccuracies in a person’s nutritional risk assessment. They had 3 different textures of modified food listed to be provided with no supporting guidance from speech and language therapy (SaLT) to indicate which was the correct texture. This was a significant concern as providing them with food of the wrong texture could cause choking or aspiration, both of which could potentially be fatal. A person who had proved to have complex needs had no assessments or care plans in place bar an urgent DoLS authorisation that had expired. Staff had no plan to guide their support of this person and had learnt about them as they worked with them.

People did not feedback specifically about this area.

Staff told us about people's needs and had an awareness of their long-term health conditions and dietary requirements. Staff were aware of good practice guidance however had not been supported to learn about this.

We found staff knew people well so many of their care needs, such as knowing if they needed extra snacks to help increase their weight, were completed. However, we saw people who had malnutrition universal screening tool (MUST) scores, with no referrals to health professionals or actions such as fortifying their meals in care plans. We were told by staff there was a monthly weight record maintained. When we visited, this was being recorded on a scrap of paper as the file of weights had been removed from the store cupboard and not returned. This was the case with numerous records at the service. Safe swallow assessment referrals had not been requested by the provider. It is important to obtain advice from healthcare professionals when people are identified as not managing meals without coughing or experiencing discomfort.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

People and their relatives did not recall being asked for feedback about their care and had not been involved in care reviews.

Staff reflected they had not been able to contribute to peoples care planning and new learning about people was not always noted. Fortunately care staff shared information informally which had enabled them to provide appropriate care to people without care plans in place.

We were unable to review audits as we were unable to find any dating back further than January 2024. These had been completed by the interim manager and reflected a small glimpse of service provision in limited areas. We spoke with the care consultant who had been involved with the service for some time. They had previously reviewed audits within the service, however these were no longer available and believed to have been disposed of. There were clear reflections of aspects of the service such as activities which suggested improvements may have happened, however there is no actual evidence to support this.

Some people were aware they had powers of attorney in place. People told us they found the consent forms quite confusing to complete, even with staff support. When we inspected, people were being supported on a 1-to-1 basis to complete new consent forms.

Staff spoke about asking people for permission each time they needed any care. They offered choices as much as possible and for those who lacked capacity to make, for example, choices about drinks or food, staff were aware of their preferences and could support them with this. The acting manager told us they were completing consent forms with everyone as they had recognised there were missing consents or some that had been agreed some years ago. Staff were meeting with people and completing 1 or 2 consent forms at a time so as not to confuse them.

Additional work was needed to ensure consents had been sought from the most appropriate person and recorded in peoples care records. There were several different concerns about consents. Some people had no consents on file, some people had powers of attorney in place with no consents on record, some consent forms had been signed some time ago for example in early 2022 and there was no evidence of them being reviewed. The care consultancy had provided new consent forms however these had multiple consents on each page and were not clear for people to understand. The provider had commenced using these in order to review all consents. In addition, one consent was ‘indefinite’ in its duration but stated people could withdraw consent should they wish. We found 9 peoples care records had some inaccuracy or omission in consent.