Glencairn Residential 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

We reviewed 8 Quality Statements in this key question. We found the service did not always have sufficient systems and practices in place to keep people safe from environmental risks. While medicines management had significantly improved, there was still more to be done to meet requirements and therefore the provider remained in breach of Regulation 12.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they felt safe at Glencairn Residential Home, however did not make specific comments on this theme.

Staff reported an open culture where they felt safe to speak up without fear of reprisal should they have concerns. They told us they would speak with the acting manager, a senior care assistant or the nominated individual and were certain they would listen and act. Most staff had adapted well to the changes to the management team and in how the service was run. They had participated in supervision with a senior staff member, in training courses, and had been given opportunities to enrol in additional training in order to gain qualifications. Some staff had been offered opportunities to progress in their careers.

There had only been 3 safeguarding incidents since our last assessment. These had been referred to the local authority safeguarding team and records maintained. There was no log to provide an overview of safeguarding incidents, the acting manager told us they would add a safeguarding log. Maintaining an overall log of events enables themes and patterns in incidents to be seen. A handover meeting was held at shift changes in the morning and evening. These were recorded to ensure all staff working could access shared information. The acting manager was introducing a daily ‘stand up’ for department leads to share information they would cascade to their teams.

People did not comment specifically on their involvement in assessments and care plans, however they all felt engaged with staff and service provision and confirmed care was delivered as they wanted it to be.

We identified some people had no pre-admission assessments, care plans or risk assessments at our last assessment. Since we were last at the service, there had been no new admissions however we looked at assessments and care plans for the people who had no information previously and these were completed and had been reviewed. Referrals had been made to relevant services such as for speech and language therapy (SALT) safe swallowing assessments. The provider had also worked with the local authority improvement team to ensure appropriate assessments and plans had been put in place.

During the morning of our assessment, we spent time in the living room of premises. Staff were constantly in and out of the room and made a point of speaking with people and ensuring they were OK. We saw staff supporting people when they were seated in the lounge. Staff ensured people had everything they needed and were happy and safe. We were assured people were not being left for extended periods without staff input.

Assessments were much clearer and all in place. We reviewed pre-admission information which was detailed and contained suitable information. There had been no new admissions since our previous assessment enabling the provider to make necessary improvements.

People felt safe, and free to speak up should they feel unhappy or concerned about something. One person told us, “I would feel comfortable to complain. If I was not happy, I would tell them, and they would act and do something about it for sure.”

Staff felt free to express concerns without fear of consequences. Staff were encouraged to speak up by the management team. A staff member told us, “I feel I can speak up now and they [current management team] would listen, before that it was hard. My training is up to date, and I feel have all the training I need to support residents. Things are improving at Glencairn definitely. Atmosphere is much better. It was very unsettling before but now we support each other as a team.” Staff were confident concerns regarding potential abuse would be heard and acted upon by the management team. They told us, “If I had any concerns about residents or safeguarding, I would go to [acting manager] or a senior staff member. If they were involved, I would go to the [nominated individual].”

During the morning of our assessment, we spent time in the living room of premises. Staff were constantly in and out of the room and made a point of speaking with people and ensuring they were OK. We saw staff supporting people when they were seated in the lounge. Staff ensured people had everything they needed and were happy and safe. We were assured people were not being left for extended periods without staff input.

There was a clear safeguarding process in place and we reviewed the 3 safeguarding cases that had happened since our last inspection. We requested a safeguarding log but there was not one in place. The acting manager is compiling one, however at the time of assessment this had no impact as there were so few safeguarding referrals and there were no patterns or themes to check for. There were Mental Capacity Act 2005 assessments and best interest decision in place for some people. Deprivation of Liberties Safeguards assessment applications had been completed for some people, we saw 1 authorisation.

We saw care plans that had been written with people which were person centred. People told us they were supported to be safe. For example, a person said they were now supported between floors by staff using the lift as they were no longer able to use the stairs.

Staff told us the service had improved since we last inspected. They told us there were care plans to access on the eCare system that were better than previous plans, and staff worked to support each other. We highlighted there was no risk assessment for paraffin-based emollients. The acting manager addressed this as soon as we bought it to their attention.

Staff were aware of peoples whereabouts and maintained supervision as needed. Care was taken when supporting people with mobility and when offering them meals and drinks.

People had current risk assessments in their care records. These had all been reviewed and updated since we last inspected. Work was ongoing to ensure assessments and care plans were accurate and reflected how best to meet the person-centred needs of people.

People told us staff kept the ‘home well’. They were happy with how the service was cleaned and maintained.

The acting manager assured us the provider was responsive should improvements be needed within the care environment to improve safety.

We checked the communal areas of the premises and accessed 2 residents’ rooms. One was vacant, the other occupied by a person living with dementia who had been at high risk of absconding. We saw a Velux roof window had no restrictor in the occupied room, there was a chair immediately below it that could potentially be used as a means of accessing the window. In the same room, we noted the second window was restricted and safe. The radiator cover cabinet was not well attached to the wall and should someone use it to steady themselves could very easily come free of its fixings. In both rooms we noted the furniture, which was of a heavy, high quality, solid wood style, did not have wall anchors. These are necessary for items such as freestanding wardrobes and chests of drawers to prevent them tipping should someone use them when ‘furniture walking’. In one of the bathrooms additional maintenance and cleaning was needed to improve the hygiene and safety. The hoist had patches of rust and there was visible limescale present. There were also bottles of shampoo and shower gel left in the room. In the corridors, there were side / consul tables where staff could charge hoist batteries and store items such as hair dryers. These were low tables, however, again high quality and heavy and had no wall anchors. We expect the newly recruited maintenance person will address the issues we have raised on commencing in their role.

We saw records of equipment tests including the fire alarm system, emergency lighting, water hygiene flushing and temperature checks however these were regular until May when the maintenance person left the service. Checks from this time are sporadic and do not meet requirements. For example, the fire alarm should be sounded each week to meet British Standard BS 5839. There had been a maintenance person recruited and clearances were in progress and they would commence at the service within the following 2 weeks. They had already spent time with the nominated individual, learned about systems, and familiarised themselves with the premises. However, there was no contingency for the absence of the maintenance person. When they take annual leave, a plan must be in place to cover required tasks and maintain premises safety.

People understood there were problems in recruiting staff to this, and most care services. They told us staff were friendly and helpful and if they needed support and used their call bell it might take 5 minutes for staff to arrive.

Recruitment was underway for a number of positions and there were multiple new staff awaiting final clearances before commencing in their roles. One staff member told us they had not participated in supervision yet. However, when we asked the acting manager, they had almost completed all supervisions with staff apart from staff who worked only a few hours each week. The acting manager had scheduled these to take place at the earliest opportunity.

We saw appropriate levels of staffing during our assessment. In addition to an activities person there were care staff available for activities such as nail painting throughout the day. We observed staff frequently chatting and spending quality time with people as well as supporting them with their essential needs.

There were several staff midway through the ‘onboarding’ process at Glencairn. They had been offered posts subject to pre-employment checks and clearances, mostly Disclosure and Barring Service (DBS) checks were awaited. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. We saw 2 of 3 staff records reviewed did not have complete employment histories. These staff had not yet commenced in post and the acting manager contacted them to obtain a full employment history on the day of our assessment.

People confirmed staff wore appropriate personal protective equipment, PPE. They told us staff kept their home clean and fresh. When asked if the home was clean and maintained, one person told us, “Oh yes, to a point of boredom (laughed). If I drop anything it's picked up immediately. It's spot on!”

Staff told us they thought there were sufficient housekeeping staff however this meant a care assistant had to complete laundry for the service meaning at times they were not available to complete care duties.

The premises were mostly very clean and tidy and there were no malodours. However, there were some areas that were very dusty and cluttered. On the upper floors, there were chargers on lower shelves of consol tables, there was a lot of dust over these and there was an accumulation of dust beneath the tables. One of the staircases was noted to also be very dusty, other stairs looked as though they were not vacuumed. The acting manager told us she had devised a new infection prevention and control, (IPC) audit that would help address these concerns.

A new IPC audit was being introduced and the outcomes would be used to populate a service improvement plan. The provider had advertised for additional housekeepers but had yet to appoint to the positions. There were just 2 housekeepers working at Glencairn, this meant monthly deep cleans of rooms as part of ‘resident of the day’ were not possible at this time.

People told us they were happy with the support staff gave them with their medicines. Some people had medicines administered, another person had problems remembering their 7am medicine, so staff supported them by waking them in time to take it.

Staff told us medicines practice had improved. A staff member said, “We don't run out of medication now. We were told how to order [medicines on new pharmacy system], everything works much better. All the training I need regarding medicines was given by [a temporary clinical lead]. I feel well supported.”

There had been significant improvements in medicines management since we last assessed the service however, further improvements were still needed. Liquid medicines were not consistently labelled with the opening date. We found 4 medicines without labels amongst those we checked without opening dates, which had to be disposed of. The provider had a new supplying pharmacy, so medicines administration records (MAR) were supplied prepopulated with medicines information. Though a person taking a specific blood thinner was no longer using the service, we saw 2 people with daily aspirin doses where MARs did not have warnings about blood thinning medicines or that the medicine needed to be taken with or after food. A second medicine lacked specific guidance on the MAR. It needed to be taken on an empty stomach and for the person to remain sitting up for a period. Staff were aware of this requirement, however it needed to be added to the MAR. Following the assessment, the acting manager advised the supplying pharmacy to add these warnings to the MARs. There was a new homely remedies policy in place and individual plans had been compiled and were with the GP to be checked and signed. A person who self-administered their medicines had a risk assessment in place to ensure this practice was safe. Medicines were now safely signed in by 2 staff members and with additional weekly checks, there had been no incidents of medicines running out. We observed medicines storage had been changed from cabinets around the service, to a single medicines room which had been updated with kitchen type storage cabinets, worksurfaces, a new controlled medicines cabinet and air conditioning. This ensured medicines were safely stored at a suitable temperature. At the time of our assessment site visit there had been no direct impact on people of the continuing concerns in medicines however there remained a breach in Regulations.