Glyn Thomas House

Glyn Thomas House is a residential care home providing personal care to up to 37 people, some of whom may be living with dementia. The service was supporting 26 people at the time of the inspection.

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

The provider had not always informed the Care Quality Commission (CQC) of incidents that they are required to by law. The registered manager lacked knowledge in this area.

The provider had systems in place for oversight and monitoring and generally this resulted in action plans and drove forward improvement within the service. Some minor areas of improvement were identified during the inspection including records in relation to risks, and medications. The registered manager took some actions during the inspection to address these.

People and their relatives were happy with the care being provided and told us they felt safe. People were supported to remain safe. Staff knew how to report allegations and concerns of abuse and understood their roles clearly and what was expected of them. People’s medicines were managed safely. Safe recruitment and selection processes were in place.

People and relatives knew the registered manager well and felt they were approachable and would immediately address any concerns they may have.

People were supported to have maximum choice and control of their lives and staff supported in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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

Rating at last inspection

The last rating for this service was good (published 16 March 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements. Please see the well-led section of this full report. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Glyn Thomas House is residential care home which was providing personal for 31 people at the time of the inspection. The service can support up to 37 people. The provider has added the regulated activity of personal care to this location following the last inspection. Provision of personal care in the community was not undertaken.

Care Homes

Glyn Thomas House accommodates up to 37 people in one adapted building across five wings called, Ivy, Bluebell, Buttercup, Lavender and Cherry Blossom. The service can provide care for people living with dementia.

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

People were safeguarded from abuse. Staff were aware of the action they must take if they suspected abuse was occurring. People had risk assessments in place to inform staff how to protect their wellbeing. Action was taken to reduce risk and maintain people’s independence and choice. There were enough staff provided to meet people’s needs. Incidents and accidents were monitored, and corrective action was taken to prevent re-occurrence. Recruitment was robust. Minor issues with recording of medicines were addressed.

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.

Training was provided for staff to develop and maintain their skills. Staff were supported through supervision and appraisal.

Staff were caring and provided encouragement and guidance to people. Information was provided in a format that met people’s needs.

People’s nutritional needs were assessed, monitored and reviewed. People were encouraged to maintain their independence. People’s wellbeing was monitored by staff and relevant health care professionals were contacted for help and advice.

Information about how people could raise a complaint was displayed. Issues reported were investigated and discussed with the complainant. A programme of activities was provided in line with people’s hobbies, preferences and interests. End of life care was provided at the service.

The management team were available for people to speak to. The views of people, staff and visitors to the service were sought through surveys and meetings. Feedback received was acted upon. Data security was maintained.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 04 March 2019) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Glyn Thomas House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Glyn Thomas House provides accommodation for up to 37 people who do not require nursing care. The service is located in Immingham.

There was a registered manager in place at the service. 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.

Relatives signed people’s care records without having the legal authority to do so.

The service was not well-led. We found issues with infection control, health and safety, monitoring people’s care records, the deployment of staff, maintaining accurate records and with the quality monitoring of the service by the management team. Policies and procedures also needed reviewing and implementing.

The service was not always safe or well-led. There was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 11, need for consent and of Regulation 17, good governance. You can see what action we told the provider to take at the back of the full version of the report.

We found issues with infection prevention and control and monitoring the safety of the environment. Action was taken to address the issues found. However, further monitoring of the environment was required by the management team to ensure people's health and safety continued to be protected. Accidents and incidents were monitored and corrective action was taken to prevent their re-occurrence.

Staffing deployment was reviewed during the inspection. Laundry duties were re-allocated to domestic staff which allowed care staff more time to spend with people.

The environment required improving for people living with dementia. We have made a recommendation about this.

Records of staff supervision required reviewing and more supervisions and all the appraisals were planned to take place.

Some people’s care records were not reviewed in a timely way. People with diabetes required care plans and risk assessments to be put in place. Guidance for staff about one medicine to be taken 'as required' was created during the inspection.

The provider's complaints policy and procedure was not displayed or known by people living at the service. However, we found complaints raised were acted upon.

Information was not always provided to people in a format that met their needs. Pictorial menus were being created to help people living with dementia understand what was available for them.

Staff understood how to protect people from potential abuse. Issues raised were acted upon.

Staff undertook training in a variety of subjects to maintain and develop their skills. People were supported to eat and drink, where necessary. People’s dietary needs were monitored and corrective action was taken if there were concerns.

Information was shared with people and their relatives about what the service could provide. People made their own decisions about their care and support.

Staff were caring and kind and respected people’s privacy and dignity. People’s care needs and risks to their wellbeing were recorded. People lived the life they chose and staff gave people choices.

People living at the service and staff were asked for their views and feedback received was acted upon to maintain or improve the service.

This is the first time the service has been rated Requires Improvement.

Further information is in the detailed findings below.