Glengariff Residential Home

We found the following examples of good practice.

At the time of our visit the service was at the end of an outbreak of Covid-19 infection. The service was working closely with the local authority, Public Health England and the Clinical Commissioning Group (CCG) infection control team to ensure their infection prevention practice was safe and people’s needs were met. There was adequate access and take up of testing for staff and people using the service.

National guidance was being followed on the use of personal protective equipment (PPE). There was clear signage on the correct use PPE and handwashing techniques. There was a plentiful supply of PPE and staff had received training in infection prevention and control.

Screening measures and visiting arrangements were in place to protect people from the spread of infection. A testing hub was set up and accessed from the car park where temperature and rapid lateral flow Covid-19 tests were taken prior to entering the premises. Visiting was pre-arranged.

Arrangements were in place for relatives to visit people and be with them at the end stage of their life. For others a glass pod with telephone intercoms had been purpose built within the smaller lounge accessed by visitors from the back of the building. The pod enabled a named visitor to have communication and a safe view of life inside the home. Alternative arrangements to visiting in person included video or telephone calls and weekly updates from the manager.

During the outbreak, isolation zones were implemented effectively using the third floor and a ground floor wing with dedicated staff. This enabled the outbreak of Covid-19 to be contained and prevent it from spreading throughout the service.

Clear procedures were in place from point of entry for admissions or return to service from hospital. People were not admitted without a negative test for Covid-19 and they are isolated for 14 days.

Staff wellbeing had been supported by home manager. For example, the introduction of a drop-in 'good to talk time' for staff with tea and cake to talk about anything other than work. Positive outcomes for some staff have arisen from the sessions. Feedback from staff found this very helpful and a decision has been made for it to continue.

People’s experience of using this service:

People told us and we observed that they were safe and well cared for and their independence was encouraged and maintained.

The service had made improvements since our last inspection. People who used the service and staff told us that the changes made had improved the service.

Maintenance work had been undertaken on the premises to ensure it was safe. Extensive refurbishment, internally and externally, was planned for 2019. We made a recommendation that further involvement of people in the redecoration of the service and good practice guidance about environments for people with dementia be explored.

The premises were clean and practices for the prevention of infection were in place. Medicines were managed and administered safely.

There were sufficient staff with the right skills and knowledge to carry out their roles and care for people effectively.

Assessments of people’s capacity to make their own decisions had been carried out with the involvement and agreement of their legal representatives. Applications to deprive people of their liberty had been completed appropriately and the relevant authorities informed.

People had a good meal time experience with food which was home made and provided a balanced diet.

Staff were kind and friendly and provided a warm and caring atmosphere in the service.

Care plans were person centred and comprehensive. There was sufficient detail in the documentation that enabled staff to provide responsive care. The service worked alongside professionals to provide joined up care.

Processes were in place to measure, document, improve and evaluate the quality of care. Management had clear oversight of the service. People's complaints were dealt with appropriately.

Rating for this inspection: The service met the characteristics for a rating of ‘Good’ in all key questions.

More information about our inspection findings is in the full report.

Rating at last inspection: The service was rated as ‘Requires improvement’ in all key questions and was in breach of Regulations 9 person centred care, 11 consent, 12 safe care and treatment and 17 good governance. The report was published on 5 February 2018.

Why we inspected: All services rated as ‘Requires improvement’ are re-inspected within one year of our prior inspection. This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received and the improvements made.

Follow up: We will continue to monitor the service through the information we receive.

Glengarrif residential home 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.

Glengarrif residential care home accommodates up to 54 people in one adapted building over three floors. On the day of inspection 47 people were living at the home, some of whom were living with dementia.

A long standing registered manager was in place at the home. ‘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.’

We found that the service required improvement across all domains. All staff observed at this service knew the people living there well. Responses to people receiving care were kind. However, staff did not always demonstrate that engagements with people was meaningful, nor did they demonstrate how people’s independence was promoted. We found that care for people living with frailty and older age was good, however, for those living with dementia or receiving end of life care, care needed to be more person centred and based on current best practice.

Systems in place to monitor the safety and quality of the service and the oversight of all these systems was poor. However, the registered manager took actions to address some of the concerns found during the inspection, and consequently we have made recommendations for improvements needed at the service, and we have also breached the provider in four areas. You can see the actions we took at the end of the report.

Following the inspection the registered manager immediately began to address some of the concerns found during the inspection. In addition the registered manager had set up, and was providing good support networks and links with other care managers in the area in order to share good practice and future learning. This should support the service to continue to develop and improve.

We will inspect the service again within 12 months of this reports publication, to assure ourselves that initial improvements made have been sustained.

During our inspection we spoke with people who told us they liked living in Glengariff Residential Home Residential Home. A relative told us they were happy with the standard of care. We saw that people were comfortable with staff and others living in the home and there was a relaxed atmosphere.

People enjoyed the lifestyle in the home and people made positive comments about the food, the social activities and the support they received from staff. People felt safe in the home and were confident that any concerns would be listened to and something would be done.

We saw that staff understood the needs of people living in the home, treated them with respect and provided care in ways that people preferred and that met their needs.