Glennie House Care Home Service Adults William McComb Court Auchinleck Cumnock KA18 2HH

Transcription

1 Glennie House Care Home Service Adults William McComb Court Auchinleck Cumnock KA18 2HH Type of inspection: Unannounced Inspection completed on: 10 December 2014

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 11 4 Other information 28 5 Summary of grades 29 6 Inspection and grading history 29 Service provided by: Countrywide Care Homes Limited Service provider number: SP Care service number: CS If you wish to contact the Care Inspectorate about this inspection report, please call us on or us at enquiries@careinspectorate.com Glennie House, page 2 of 31

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 4 Good Quality of Environment 5 Very Good Quality of Staffing 4 Good Quality of Management and Leadership 5 Very Good What the service does well There was continued evidence of resident and carer involvement within the service, which had led to feedback being used to improve the service. This included involvement in care needs, how the service was run and in the planning of activities. Residents have strong, positive relationships with a staff team who demonstrated good knowledge of each resident's needs. A strong management team continues to lead and develop staff practice to achieve positive outcomes for residents. What the service could do better Continued development of the role of keyworkers would enhance how information is obtained and used to promote the quality of life for residents. Quality assurance systems could be improved through involvement of residents and their families. Careplan documentation should more specifically reflect the needs of residents, using language with less jargon. Glennie House, page 3 of 31

4 What the service has done since the last inspection Inspection report continued The service has an effective audit process which has supported continued improvement in the care and support being provided. A range of community based activities has allowed residents to remain actively involved in family and friends. Conclusion The team at Glennie House remains responsive to meeting the needs of residents. Staff had a good knowledge and understanding of residents and their care needs. Effective communication and positive relationships with families assisted in the provision of good quality care. The team at Glennie continue to engage very well with people, respect their values and ensure they strive towards achieving the aims and objectives of the service. Glennie House, page 4 of 31

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at This service registered with the Care Inspectorate on 31 October Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve, we may make a recommendation or requirement. * A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service but where failure to do so will not directly result in enforcement. Recommendations are based on the National Care Standards, relevant codes of practice and recognised good practice. * A requirement is a statement, which sets out what is required of a care service to comply with the Public Services Reform (Scotland) Act 2010 and Regulations and Orders made under the Act or a condition of registration. Where there are breaches of Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Inspectorate. Countrywide Care Homes Limited has been registered as the owner of Glennie House Care Home Service. Glennie House is registered to provide care to a maximum of 53 older people, which may include 5 respite care places. At the time of our inspection, 37 people were resident within the service. Glennie House is a purpose-built care home for older people. The service is located in the town of Auchinleck, East Ayrshire. Accommodation is provided over two floors and connected by a passenger lift. Accommodation comprises of 50 single and 2 double rooms, all with ensuite shower facilities. People who use the service have access to a range of communal facilities including lounge areas, dining rooms, hairdressing room, coffee area, and an enclosed garden. The service's stated aim "is to provide care for all residents to a standard of excellence which embraces fundamental principles of good care practice, which is evidenced and evaluated through the practice, conduct and control of quality within the home". Country Wide Care Homes Limited stated objective is that "residents shall live in a clean, comfortable, happy and safe environment, and be treated with privacy, dignity, respect and sensitivity to their individual needs, abilities and human rights. Staff will be responsive to the individual needs of residents and provide the optimum degree of care to ensure that the highest possible quality of life is maintained". Glennie House, page 5 of 31

6 Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 4 - Good Quality of Environment - Grade 5 - Very Good Quality of Staffing - Grade 4 - Good Quality of Management and Leadership - Grade 5 - Very Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. Glennie House, page 6 of 31

7 2 How we inspected this service The level of inspection we carried out In this service we carried out a medium intensity inspection. We carry out these inspections where we have assessed the service may need a more intense inspection. What we did during the inspection We wrote this report after an unannounced inspection that took place on 9 December between 16:30 and 21:00 and 10 December between 10:00 and 17: The inspection was carried out by one Care Inspector. The focus of this inspection was to see how the service had sustained or improved on the practices detailed within the previous inspection report. As requested by us the service submitted an annual return and a self assessment. We took account of the 6 questionnaires returned from the 25 we sent to relatives before the unannounced inspection. We also received 6 completed staff questionnaires. During the inspection process we spoke to a number of residents and some family and friends of residents. We reviewed evidence we had looked at during the previous inspection from various sources including the relevant sections of the policies, procedures, records and other documents including: Resident personal and careplans Minutes of residents meetings Minutes of relatives meetings Staff and Management meeting minutes Quality Assurance System Documentation Accident and Incident records Staff rotas Insurance Certificate Certificate of Registration Previous Inspection Report Communication systems Medication Systems and records Service brochure which included aims and objectives of the service Staff training records Complaints records Maintenance records Participation strategy Service feedback mechanisms Glennie House, page 7 of 31

8 Policies and procedures manual We conducted a tour of the premises and observed staff interactions with residents and carers family/visitors. We also spoke with: Care and nursing staff Housekeping staff Admin staff The depute manager The manager Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at Glennie House, page 8 of 31

9 What the service has done to meet any recommendations we made at our last inspection Actions taken on outstanding recommendations is discussed within the relevant quality statement. The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The service submitted an appropriately completed self assessment within the allocated timeframe. The Self Assessment reflected the findings of this inspection. Taking the views of people using the care service into account Residents we spoke with during the inspection were complementary about the service they received. Some comments included "I like it fine." "People are nice.. they look after my legs." "I like it here. They look after you. The girls are good." "I am happy with things in here." "Things are much improved. The food has improved greatly, we have new providers of fresh food." Glennie House, page 9 of 31

10 Taking carers' views into account Carers we spoke with and feedback from questionnaires indicated relatives were happy with the service being provided. All relatives confirmed that they knew who the keyworker was for their relative although they stated that all staff were knowledgeable and approachable should they have any questions. All relatives felt that the home provided a safe, secure environment. Communication was felt to be positive. Comments included: Inspection report continued "I am happy I moved my relative here. There is good communication relating to health needs. That puts my mind at rest." "I am happy my relative gets treated with respect and I have overheard staff interacting with residents, singing to them and encouraging them to join in." "I have nothing but praise for the staff. Staff are skilled and knowledgeable and understand how to interact with someone who live with dementia. I can relax now and be a family member. I have trust and confidence in the staff, no need to oversee and co-ordinate care now." Glennie House, page 10 of 31

11 3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths The grade awarded during the previous inspection was 5 - Very Good. The evidence that we sampled at this inspection maintained the grade of 5 - Very Good. We reached this decision after we read the participation strategy and saw evidence of how it was implemented, read residents records, and examined questionnaire returns. We also spoke with residents and families. The service continued to use a range of consultation methods including: Six monthly reviews of resident personal plans and service delivery Resident and relative meetings Questionnaires Complaints/ compliments/ suggestions procedures Daily discussions Keyworker meetings Wishing tree Internet use for Skype We observed positive relationships between residents and staff, which often led to laughter and conversations about family. Involvement continued within community groups to promote socialisation for residents. Residents told us of the visiting animals to the home that they were able to hold and pet and how this made them feel happy. Glennie House, page 11 of 31

12 Residents spoke of their involvement in preparing for Christmas, including the display to welcome visitors into the home and making their own Christmas Cards through craft work. Resident meeting minutes demonstrated resident involvement in activity planning including outings. Resident committee meetings supported discussion on specific areas for improvement within the home. Actions were taken to ensure the suggestions were implemented with the agreement of residents individually or collectively. Some trips in the service minibus included cinema visits. Other discussion topics included the food forum and feedback on performance of staff and management. Resident had requested additions to the range of fruit and, another a change to the type of milk provided for breakfast and tea. Relative meeting minutes reflected discussions with families with information being shared on developments within the home to obtain feedback and ideas for future development. Throughout the home, display boards were updated with photos taken during activities or events. Captions supported the story in the photo. Newsletters were issued quarterly with a news round-up of life within Glennie. Appropriate consent was provided to allow the display of the pictures. Wall murals continued to be painted throughout the home. Shop front windows, music and film themes and scenic pictures were painted on corridor walls. Residents told us that they were involved in the development and how they were happy that their ideas were used when deciding the paining. Advocacy was accessible for residents. Information was freely available for residents or their families in the foyer of the home. To obtain feedback from residents and relatives on how the service could improve, satisfaction surveys were issued. Evaluation of these surveys provided ideas for improvement which then was included in the service development plan. Areas for improvement A recommendation was made during the previous inspection which stated: The provider should continue to develop the role of keyworker within this service. Action taken: Staff confirmed they attended the six monthly reviews of their key clients and were actively involved in the review process. Staff spoke of how they had a good knowledge and understanding of the residents for whom they were the keyworker. Some staff demonstrated a clearer understanding on the role of the keyworker, however, there continued to be a lack of involvement by keyworkers in the care planning process. Information was being recorded as part of the life story work, which should be used Glennie House, page 12 of 31

13 to inform how residents preferred their care to be provided. Whilst we saw some evidence there was some improvement in the development of the keyworker role, this has not yet been fully This recommendation is NOT MET and is repeated for further monitoring. (See recommendation 1 of this quality statement) The management told us they had plans to improve questionnaires, to obtain more focussed feedback to improve specific areas of the service. The proposals included use of more open questions or use of themes. Whilst we saw good evidence of 6 monthly reviews of care plans, the service should continue to improve the process and record more detail of discussions at the reviews, including who attended and outcomes to be achieved through action planning. Some residents had communication difficulties in expressing their views. The service should continue to improve its range of methods to support residents to express their views. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. The provider should continue to develop the role of keyworker within this service. National Care Standards Care Homes for Older People, Standard 7: Moving in Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths The grade awarded during the previous inspection was 4 - Good. The evidence we sampled during this inspection maintained the grade of 4 - Good. We reached this decision after we had spoken with residents and carers, staff, manager, provide during the inspection process. We also reviewed a number of relevant documents and records and observed practice. 3 recommendations were made during the previous inspection which stated: 1. Appropriate nutritional training should be provided for staff, including those who work in the kitchen within the home environment. Glennie House, page 13 of 31

14 Action taken The assistant cook had undertaken appropriate training. Other kitchen staff had been provided with additional training including training on food allergies to ensure their understanding of the legislative requirement to provide detailed information on food provided. This recommendation is MET. 2. The service should ensure that all medication is administered consistently with policy and best practice guidance. Action taken Audit processes were being used to support safe practice in the administration of medication with recording in personal files of any changes. There had been some improvements in the use of the recording on the Topical MAR (medication administration record). The timings of medication administration could be more clearly identified to promote a more person centred approach. The medication policy and procedures had been updated to reflect up to date, best practice guidance was promoted for staff awareness and reference. The service used as required medication (PRN - pro re nata) protocols. These protocols outlined the circumstances in which as required medication should be administered to each individual resident. The service should continue to develop the information contained within the protocols to ensure clear detail and guidance for administration. This recommendation is MET. 3. The service should monitor the current medication ordering system through audit processes. Action taken The audit for monitoring the medication system had been amended to ensure inclusion of the ordering of medications. This recommendation is MET. Each resident had a personal plan, which detailed health needs and outlined information on how these needs were to be met with some evidence of resident likes and dislikes. Careplans had been signed by residents or carers who agreed with the interventions. A variety of assessment tools including tools to monitor malnutrition Glennie House, page 14 of 31

15 and tissue viability were used to promote health and wellbeing needs of residents were met and were supported by appropriate risk assessments. There was good evidence of ongoing relevant input and liaison with external health professionals. This continued to ensure the health and wellbeing needs of residents were met, including visits from GPs, District Nurses, Specialist Nurses, VisionCall, dentist and podiatry. Residents could retain the services of their family GP after admission or change to a new practice. This allowed continuation or development of relationships in promoting the health of residents. To promote guidance for staff to achieve appropriate care for residents, advice from specialist health professionals, such as the district nurse was reflected through the care plans. Families commented on the relationships between residents and staff within the home and how the contribution this made to positive mental and physical health for the resident and themselves. Staff continued to attend a wide range of training on how to support different health needs of residents including oral health, dementia, moving and handling. This had supported staff becoming champions in specific areas related to health to ensure best practice was used and shared. A pilot study in health promotion was being promoted within the home in conjunction with the NHS to improve the lives of people within the home. Areas for improvement We again observed meals being offered, without the accompaniment or offer of vegetables. We are aware that whilst the recommended quota of five portions of fruit and vegetables was offered, it did not support the nutritional intake of residents who refused meals at specific times. Each mealtime should offer fruit and vegetables to promote the health and wellbeing of residents. This recommendation is NOT MET. (See recommendation 1 of this quality statement) Inspection report continued The depute manager told us that pictures had been taken of meals to encourage residents to make decisions on their choice of meal. These pictures were not yet available. Whilst we saw information within personal plans and assessments of health needs, some attention should be given to how these needs were to be met for each Glennie House, page 15 of 31

16 individual resident, in accordance with their needs, preferences and wishes. There was a lack of information on what was to be achieved for each resident in the care plan. For example, risk assessments were jargonised and did not clearly identify the need for a care plan. (See recommendation 2 of this quality statement) Personal plans contained a lot of information. To ensure appropriate information is accessible in the event of an emergency, the format of care plans should be streamlined. (See recommendation 3 of this quality statement) A care plan audit tool was being used to identify missing information which was under review to include effectiveness of monitoring of the detail in quality of care planning alongside the inclusion of the appropriate documents. Staff had received training which improved their knowledge on different areas of resident health. The management should consider how this information could be more appropriately shared to promote the health and wellbeing of residents such as health champions. Whilst medication practices had significantly improved, consistency in recording dates when medication bottles were opened is good practice Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 3 Recommendations Inspection report continued 1. Development of the menus should ensure the provision of fruit and/ or vegetables at each meal. National Care Standards, Care Homes for Older People, Standards 13: Eating 2. Care plans should be written with the aims of the support written clearly detailed. This should be written in a manner that promotes the understanding of the resident. National Care Standards Care Homes for Older People, Standard 6: Support arrangements and Standard 8: Making choices 3. Legal documents within the personal plan should be clearly accessible to ensure appropriate decisions regarding treatment options are supported. Glennie House, page 16 of 31

17 National Care Standards Care Homes for Older People, Standard 14: Keeping well - healthcare and Standard 19: Support and care in dying and death Glennie House, page 17 of 31

18 Quality Theme 2: Quality of Environment Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the environment within the service. Service strengths The grade awarded during the previous inspection was 5 - Very Good. The evidence we sampled during this inspection maintained the grade of 5 - Very Good. We reached this decision after we had spoken with residents, relatives, staff and management during the inspection. We also reviewed relevant documents and conducted a tour of the environment. Within bedrooms, some residents had their own personal items of furniture and belongings to make the environment more homely. We considered this statement alongside the information in statements 1.1. Areas for improvement Whilst residents had a name plaque on their bedroom door, some residents did not recognise this as their room. Consideration should be given to how personalising the door would assist each resident to identify their room more easily. Ongoing feedback should continue to be sought from residents relating to how residents and families were involved in improving the quality of the environment Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 2 We make sure that the environment is safe and service users are protected. Service strengths The grade awarded for the previous inspection was 5 - Very Good. The evidence we sampled during this inspection maintained the grade of 5 - Very Good. We reached Glennie House, page 18 of 31

19 this decision after we had spoken with residents, relatives, the management, and staff members. We also referred to the previous inspection report and considered a number of relevant documents including policies and procedures and maintenance records. A secure door entry system promoted safety of residents and visitors were required to sign the visitors book which also acted as a fire register for visitors. A range of policies and procedures were reviewed on at least an annual basis to promote the safety and wellbeing of residents. A variety of contracts remained in place, to ensure the home and equipment was well maintained. A maintenance man attended to general repairs around the home and had positive interaction with the residents who also allocated him some tasks. General repairs were allocated through use of a maintenance log book,which monitored that issues were addressed in a timely manner. Fire safety was managed through the Fire and Rescue service. The maintenance person worked with the manager and provider to obtain support to ensure recommendations or requirements made by them were met. To continue to promote resident safety, fire drills and alarm testing was conducted in accordance with organisational policy. Risk assessments were completed, reviewed and updated regularly in accordance with the assessed level of risk to promote the health and safety of residents, visitors and staff. These were internal and external community risk assessments. Visits to local areas had been made to risk assess suitability for residents to visit which encouraged community links for residents. A contingency plan was in place to promote an ongoing safe environment for residents in the event of an emergency with easy access to phone numbers for service contractors. Each resident also had a personal emergency evacuation plan which detailed the level of assistance they required should the need to evacuate arise. The service clearly displayed their registration and insurance certificates in the foyer of the home. This provided assurances to visitors about the obligations of the service being provided. Staff had received ongoing training to enhance their understanding of policies and ability to provide support to residents including Adult Support and Protection, moving and handling and received regular supervision and support. Domestic staff worked hard to ensure a safe environment for residents which was clean and odour free. A secure garden was available for residents who told us they sat out in the sunshine Glennie House, page 19 of 31

20 in the good weather. Residents often provided oversight of the activities of the maintenance man in the upkeep of the garden which provided a sense of purpose for them. A dependency assessment of resident needs was carried out monthly which was used to determine the staffing levels required within the home. This often resulted in an increase to the minimum staffing levels set in the staffing schedule to a more appropriate level. Accidents and incidents were reviewed and care plans were updated to ensure resident needs were met. All staff had appropriate vetting prior to undertaking their role and monthly checks were undertaken by the manager to ensure appropriate registration of staff with their regulatory body such as Nursing Midwifery Council or Scottish Social Services Council. Areas for improvement Whilst the service had a contingency plan, the management should ensure this plan remains up to date and is located in an appropriate place. Each resident had a Personal Emergency Evacuation Plan. Consideration should be given to developing this plan, to ensure detail on the assessed needs and level of assistance is clearly detailed for each resident in the event of an emergency to promote their safety. (See recommendation 1 of this quality statement) The service had sufficient staff to meet their staffing schedule, which details the minimum staffing levels. A dependency assessment was completed on a regular basis to assess the level of need of residents within the home. However, it is unclear how this was being used to inform the staffing levels on the rota. The management should improve the use of the dependency assessment to support the staff rota and staff deployment. (See recommendation 2 of this quality statement) We note that the service have a system to minimise the risk of falls, staff deployment should be considered within this process. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Glennie House, page 20 of 31

21 Recommendations Inspection report continued 1. Personal Emergency Evacuation Plans should be clear on the level of assistance required for each resident in the event of an emergency. National Care Standards Care Homes for Older People, Standard 4: Your environment and Standard 9: Feeling safe and secure 2. The staffing levels should be determined by the level of supports required to meet the needs of residents. National Care Standards Care Homes for Older People, Standard 5: Management and staffing arrangements Glennie House, page 21 of 31

22 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service Strengths The grade awarded during the previous inspection was 5 - Very Good. The evidence we sampled during this inspection maintained the grade of 5 - Very Good. We reached this decision after we had spoken with residents, relatives, staff and management. We also reviewed a number of relevant documents and records and considered the information contained within the last inspection report. The strengths for this statement already include those already mentioned in Statement 1.1 and 2.1. Relatives told us how they continued to feel part of life at Glennie and felt supported by the team as much as their relative. The management told us of plans to involve residents and relatives in staff training. Residents told us how they took part in the interview process and provided their opinion on suitability of candidates. Areas for improvement Consideration should be ongoing as to how feedback from residents and relatives could be used in the recruitment, supervision and appraisal Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Glennie House, page 22 of 31

23 Service strengths Inspection report continued The grade awarded during the previous inspection was 4 - Good. The evidence we sampled during this inspection increased the grade to 4 - Good. We reached this decision after we had spoken with residents, relatives, staff and management. We also reviewed a number of relevant documents and records and observed practice. Keyworker roles were being redefined to enhance the involvement and responsibilities of the care staff. Staff meetings ensured appropriate and up to date information was shared to support staff within their employment. Action points arising from meetings were reviewed during the next meeting, which ensured issues were addressed within a set timeframe. There was good facilitation of staff training being scheduled in advance. This training equipped staff with an understanding on a range of topics to meet the health and wellbeing needs of residents. Examples include dementia with regard to the promoting excellence framework and Adult Support and Protection for all staff, end of life care/palliative care including anticipatory care planning, Parkinsons' disease and nutrition for nursing and care staff. Specific training for nurses included gastrostomy, catheterisation and tissue viability. Other resources include LearnPro which allows online learning for staff through the NHS library. Supervision was facilitated in accordance with the service policy, which was due for update. Supervision was based on objectives set during the staff annual appraisal and supported staff, to reflect on their practice and identify training and development needs. An additional wide range of training opportunities were available through NHS for staff such as stroke awareness and Motor Neurone Disease. Staff reported feeling empowered in their support of residents through this training. Many care staff had completed their SVQ in care, and were in process of registering with the Scottish Social Services Council (SSSC) the governing body for Social Care Workers. Nurses were appropriately registered with the Nursing and Midwifery Council, where they confirm they have up to date knowledge in best practice guidance through continuing professional development. We observed that staff had a good value base which was reflected in their clear understanding of each resident and their current needs. Interactions with staff demonstrated a positive relationship between staff and residents which residents describe as making them feel at home. Recruitment is undertaken with reference to the Safer Recruitment guidance issued Glennie House, page 23 of 31

24 by the Scottish Government to protect residents. All staff felt they provided a good service to residents and policies were implemented within the service to support them in their roles. Areas for improvement Individual supervisors had been identified for each staff member to promote a safe space for discussion. However, supervision should be used more as a developmental tool with reflective practice to enhance staff skills through identification of training opportunities. (See recommendation 1 of this quality statement) The keyworker role should continue to be developed and implemented. (See recommendation 1 in quality statement 1.1) During observation of support to residents, we noted that there was an opportunity for monitoring staff practice which was not being utilised. The management should consider the use of spot checks to monitor and observe staff practice to identify good practice and any training issues. (See recommendation 2 of this quality statement) Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 2 Recommendations Inspection report continued 1. Supervision should be provided on a regular basis with the emphasis on support and development of each individual staff member. National Care Standards Care Homes for Older People Standard 5: Management and staffing arrangements. 2. The management should consider how staff practice can be monitored to identify areas of good practice and highlight training and development needs. National Care Standards Care Homes for Older People Standard 5: Management and staffing arrangements. Glennie House, page 24 of 31

25 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths The grade awarded during the previous inspection was 5 - Very Good. The evidence we sampled during this inspection maintained the grade of 5 - Very Good. We reached this decision after we had spoken with residents, relatives, staff and management. We also reviewed a number of relevant documents and records. The management team were available to meet formally and informally with residents, relatives and any other visitors. A variety of methods were employed to seek feedback from all stakeholders to support improvements in the service. The management informed us of plans to involve residents and relatives in the quality monitoring within the home. The strengths for this statement already include those already mentioned in Statement 1.1, 2.1 and 3.1. Areas for improvement The service should provide information on outcomes to all stakeholders on evaluation of feedback obtained to improve the quality of the service. The management should consider implementation of their plans to involve residents and relatives in the quality assurance processes Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 4 Glennie House, page 25 of 31

26 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide. Service strengths The grade awarded during the previous inspection was 5 - Very Good. The evidence we sampled during this inspection maintained the grade of 5 - Very Good. We reached this decision after we had spoken with residents, relatives, staff and management. We reviewed a number of relevant documents and records, including the previous inspection report. We also observed staff practice and interactions with residents and relatives. A fully completed, comprehensive and reflective self assessment was submitted to the Care Inspectorate on request. The aims and objectives of the service are the guide by which staff work to ensure a good quality of life for residents. To support improvement, a variety of audits were conducted throughout the home in relation to the quality of care and support and environment. Social events were regularly held with residents, families and other stakeholders to attended which demonstrated current care provision and to invite ideas for development to support written questionnaires. Accidents and incidents were dealt with properly in accordance with policy and actions taken to prevent re-occurrence were evaluated at appropriate timescales. Policies and procedures were being updated with reference to Scottish Legislation and best practice guidance. These policies ensure staff received appropriate guidance and direction to perform their roles and support residents safely. A "you said, we did" board provided feedback to residents and relatives on actions taken on suggestions that had been made. A market research organisation for care homes provided a positive rating for the service. Areas for improvement A recommendation was made during the previous inspection which stated: Recommendations Inspection report continued 1. The quality assurance system should continue to be implemented to take account of the views of service users, relatives, staff and of other professional and agencies. The information gleaned from this should be used to make improvements to the Glennie House, page 26 of 31

27 service. Action taken: We found that a variety of quality assurance processes were used to assess and improve the quality of the service including audits. Feedback was used to improve the quality of service with specific consideration to activities for residents. This recommendation is MET. The service should continue to review and assess the effectiveness of the quality assurance system and amend and upgrade as required. This should include ongoing participation from external health professionals by actively allowing them to input into the quality assurance systems and processes. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Glennie House, page 27 of 31

28 4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in the Care Inspectorate re-grading a Quality Statement within the Quality of Management and Leadership Theme (or for childminders, Quality of Staffing Theme) as unsatisfactory (1). This will result in the Quality Theme being re-graded as unsatisfactory (1). Glennie House, page 28 of 31

29 5 Summary of grades Quality of Care and Support Good Statement 1 Statement Very Good 4 - Good Quality of Environment Very Good Statement 1 Statement Very Good 5 - Very Good Quality of Staffing Good Statement 1 Statement Very Good 4 - Good Quality of Management and Leadership Very Good Statement 1 Statement Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 16 Jul 2014 Unannounced Care and support 4 - Good Environment 5 - Very Good Staffing 4 - Good Management and Leadership 4 - Good 12 Dec 2013 Unannounced Care and support 3 - Adequate Environment 4 - Good Staffing 3 - Adequate Management and Leadership 3 - Adequate 5 Sep 2013 Unannounced Care and support 2 - Weak Environment Not Assessed Staffing 2 - Weak Management and Leadership 2 - Weak Glennie House, page 29 of 31

30 4 Mar 2013 Unannounced Care and support 1 - Unsatisfactory Environment 3 - Adequate Staffing 1 - Unsatisfactory Management and Leadership 1 - Unsatisfactory 19 Sep 2012 Unannounced Care and support 4 - Good Environment 5 - Very Good Staffing 4 - Good Management and Leadership 4 - Good 29 Feb 2012 Unannounced Care and support 3 - Adequate Environment 3 - Adequate Staffing 3 - Adequate Management and Leadership 3 - Adequate All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Glennie House, page 30 of 31

31 To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on This inspection report is published by the Care Inspectorate. You can get more copies of this report and others by downloading it from our website: or by telephoning Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: enquiries@careinspectorate.com Web: Glennie House, page 31 of 31