Glenroyd

Updated 4 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Three inspectors took part in the inspection process.

Service and service type

Glenroyd is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Glenroyd is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals at the local authority who had been working with the service. We used information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 2 people living at the home and 10 relatives about their experience of the care provided by Glenroyd. We spoke with 18 members of staff including the registered manager, the deputy manager, 2 regional managers, the activities coordinator, nurses and carers. We walked around the home to check it was safe and fit for purpose. We observed people’s interactions and the care they received. This helped us understand experiences of people who could not talk with us.

We reviewed a range of records, policies and procedures including 4 people’s care records and recruitment information for 3 carers. We looked at records relating to the management of the service such as audits, meeting minutes, records of complaints, accidents, and incidents.

We looked around the building, at the environment, equipment, and cleanliness. We observed how medicines were being managed.

Following the inspection

Following the inspection we sought additional clarification from the management team around staffing levels, incidents, supervision and training and reviewed evidence received.

Updated 4 July 2023

About the service

Glenroyd is a residential care home, providing accommodation for persons who require nursing or personal care. The service provides support for up to 78 people including younger adults, older people, and people living with dementia or physical disabilities. At the time of inspection 70 people were using the service.

The property has 4 distinct units over 3 floors with lift access to upper floors. There were communal areas on each floor, multiple shared bathrooms and an accessible rear garden. Aids and adaptations were in place to meet people's individual needs.

People’s experience of using this service and what we found

Relatives told us people were safe and staff were able to meet people's basic care needs, but deployment was not always effective. We received feedback about low staffing levels and the impact of this. Measures were in place for health and safety, IPC and fire safety. However, risks were not consistently managed around people’s dietary needs or incidents. Medicines shortfalls had been identified prior to inspection but the home was working with the local authority and improvements had been made. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff received in-depth induction, but there had been delays providing training to meet some people’s needs. There was no evidence of periodic supervision to monitor staff competence and we received mixed feedback around managerial support. We observed people were not always supported to wear their hearing aids, dentures or glasses. Communal areas were comfortable and fit for purpose and bedrooms were personalised. There was a positive dining experience and food looked and smelled good.

Some concerns were identified around privacy, but we observed caring interactions and staff spoke about people with dignity and respect. People and their relatives praised the standard of care and were complementary about management and staff. One relative told us, “The staff are outstanding, I couldn’t ask for better. Staff all treat [person] with respect.” Another said, “The team work hard looking after people. I have a great deal of comfort, knowing they have things under control.”

Personalised care promoted choice and control and communication needs were considered. We received feedback from relatives about people’s health and well-being improving because of responsive staff. End of life wishes were recorded, and appropriate training in place. There was a busy timetable of social activities and special events. Relatives spoke positively about how they felt welcome at the home, efforts made by the team and the good atmosphere. One relative said, “It always feels like a happy place.”

There was feedback about low staffing levels and the impact this had. One staff member said, “Because of staffing, I feel deflated when we can’t do what the team wanted to achieve.” However, staff worked hard, and good teamwork and communication attributed to a positive culture. Meetings were held at different levels and there was a ‘resident of the day’ initiative in which relatives were prompted to raise concerns. Audits and clinical governance systems helped identify shortfalls and analyse concerns.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 15 February 2022).

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Glenroyd on our website at www.cqc.org.uk.

Why we inspected

The inspection was prompted due to concerns received about staffing, falls and dignity. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to staffing and safe care and treatment.

We identified evidence that some systems and processes were not fully embedded.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.