CQC report explained · a nursing home
What the CQC found at Glottenham Manor Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, safe medicines practices and suitable risk assessments. Infection prevention arrangements, including COVID-19 testing, PPE and visiting arrangements, were also found to be suitable.
- Effective?
- Good
- People’s food and fluid needs were assessed and monitored. Staff supported consent and decision-making, and worked with health professionals to meet people’s needs.
- Caring?
- Good
- People and visitors consistently described staff as kind, caring and respectful. Inspectors saw staff protecting privacy, supporting independence and involving people in daily choices.
- Responsive?
- Good
- Care plans reflected people’s preferences and communication needs. People were supported with activities, family contact, complaints and end of life care.
- Well-led?
- Requires improvement
- The management team was committed to improvement, but governance systems had not identified some gaps in care plans. Visitor procedures were not followed when inspectors arrived, and some areas needed redecoration.
What inspectors found, October 2021
Glottenham Manor Nursing Home was rated Good overall; inspectors found safe, kind and personalised care, but management systems still needed improvement.
Inspectors visited without warning on 14 and 17 September 2021. They spoke with people, relatives, staff and a health professional. They observed care and checked care plans, medicines, recruitment, training, staffing and management records.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found enough staff, safe medicines practices, suitable training, personalised care and kind treatment. People’s health, food, communication, activities and end of life needs were generally supported well.
Well-led was rated Requires Improvement. Some care plans did not explain people’s health conditions or the action staff should take. The visitors’ COVID-19 procedures were not followed when inspectors arrived, and some areas needed redecoration.
The overall rating improved from Requires Improvement at the previous inspection in October 2019. The three previous breaches had been addressed, and the provider was no longer in breach of regulations. However, inspectors said improvements to management systems still needed time to become established.
Enough staff
Inspectors found staffing levels had improved and were sufficient to keep people safe. Recruitment checks were also completed before staff started work.
“There were sufficient numbers of staff to ensure people's safety.” from the report
Safe medicines
Medicines were stored, administered and recorded safely. Nurses who gave medicines had suitable training and competency checks.
“Medicines were stored, administered and disposed of safely.” from the report
Kind and respectful care
People and visitors spoke positively about staff. Inspectors saw people treated with dignity, privacy and respect.
“People were treated with kindness and care by staff.” from the report
Personalised support
Care plans included people’s choices, routines, communication needs and personal care preferences. Staff were described as knowing people well.
“The care plans were individual and reflected a person-centred approach to care.” from the report
Care plan gaps
needs fixingSome care plans did not explain important health conditions or the action staff should take to reduce risks. The deputy manager corrected the identified gaps during the inspection, but a new care plan system was still being developed.
“Care plans were person centred but there was a lack of reflection of peoples' health conditions and how it impacts on their well-being and what action staff should take to mitigate risk.” from the report
Management checks
needs fixingThe provider’s governance systems had not identified the care plan shortfalls before the inspection. Inspectors said the improvements needed time to become established.
“The providers' governance systems had not identified the shortfalls found at this inspection.” from the report
Visitor procedures
needs fixingCOVID-19 visitor procedures were not followed when inspectors arrived. The report said an out of hours policy would help staff who are not present during normal visiting hours.
“When the inspectors arrived at the service, the visitors' procedures for COVID-19 were not followed.” from the report
Redecoration
minorSome areas needed redecoration. The work had been delayed, although the maintenance person was prioritising safety issues.
“The maintenance person acknowledged that redecoration had been put back and he dealt with each day prioritising safety as it presented.” from the report
- 01What changes have been made to care plans for people with diabetes, COPD or continued bed rest?
- 02How will you check that the new care plan system is accurate and kept up to date?
- 03How are visitor and COVID-19 procedures followed outside normal daytime hours?
- 04What is the timetable for redecorating the areas identified by inspectors?
- 05How do you monitor staffing levels when people’s care needs change?
This was a follow-up inspection prompted by the previous rating and other risk information; it reviewed all five key questions and infection prevention and control, with the previous overall rating having been Requires Improvement. This explanation was written from the published report of 6 October 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2019
Rated Requires Improvement; inspectors found serious concerns about staffing, medicines, hydration, skin care and management.
This was an unannounced inspection on 20 August 2019. Inspectors spoke with people, relatives, staff and health professionals. They observed care and medicines being given, and checked care plans, medicines records, staff files, incident records and quality checks.
The home was not always safe. People and relatives said there were not enough staff, and call bells were sometimes unanswered for long periods. One person's medicines were delayed, and records showed that some people received very little or no recorded fluid. Skin care and repositioning were also not always managed safely.
There were positive areas. Staff were trained and knew how to report abuse. People generally liked the food, had activities available and received support with communication, healthcare and end of life care. However, care plans and quality checks did not always identify or manage important risks.
The overall rating and all five question ratings were Requires Improvement. This means the service was not consistently providing safe, effective, caring, responsive or well-led care. The previous comprehensive rating was Good, so the ratings had deteriorated.
Staff training
Staff received essential and specialist training, induction and supervision. They told inspectors this helped them feel supported in their roles.
“Staff were provided with the training they needed to work effectively with people.” from the report
Safeguarding
Staff understood different types of abuse and knew how to report concerns. Recruitment checks were completed before staff started work.
“Staff demonstrated a clear understanding of their responsibilities for safeguarding people and knew how to raise concerns.” from the report
Activities and relationships
People had access to varied activities, one-to-one support, volunteers and trips outside the home. The service also supported contact with relatives.
“People were supported to follow interests and had a range of activities they could take part in.” from the report
End of life care
Inspectors found that people received compassionate end of life support. Care plans recorded people's wishes and staff worked with health professionals.
“People were supported compassionately at the end of their lives.” from the report
Clean environment
The home was clean and tidy, with cleaning and infection control checks in place.
“All areas of the service were seen to be clean, tidy and smelt fresh.” from the report
Staffing and call bells
seriousPeople, relatives and staff said there were not enough staff during the day and night. Inspectors saw call bells ringing for more than five minutes without a response.
“We observed two call bells ringing for over five minutes without response from staff.” from the report
Poor fluid monitoring
seriousFluid requirements were set at the same level for everyone and records were not reliable. Some people had very little recorded fluid, including one person with none recorded on one day.
“Two people were recorded on one day as receiving just 50ml of fluid and another person as receiving no fluid at all.” from the report
Skin care and repositioning
seriousA person's skin care and moving plans had not been completed. Records showed they were not repositioned every two hours on several days, increasing the risk of skin breakdown.
“Records of the person's moving and positioning were poor and showed that on a number of days they had not been repositioned every two hours.” from the report
Privacy and dignity
needs fixingSome continence products were left where they could be seen by other people, visitors and family members. This did not protect people's dignity.
“Some people had a range of continence products in their rooms either on the floor or on top of wardrobes.” from the report
Weak quality checks
seriousThe home's audits did not cover fluid monitoring and did not identify all the problems found during inspection. Management therefore could not be sure that some risks were being controlled.
“There were no auditing systems to check whether people were receiving enough fluids.” from the report
- 01How many staff and registered nurses are planned for each shift now, and how do you change this when people's needs or occupancy increase?
- 02How quickly are call bells answered, and can you show us recent records of response times?
- 03How do you calculate and record each person's individual fluid needs, and what happens when someone drinks too little?
- 04How do you make sure repositioning and skin care plans are completed and followed, including when agency staff are working?
- 05What actions have you taken after the CQC breaches, and how do your audits now check that these problems have been resolved?
This was an unannounced planned inspection covering all five key questions; all five ratings had deteriorated from Good at the previous comprehensive inspection. This explanation was written from the published report of 19 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Glottenham Manor Nursing Home
4 rated inspections over 5 years: the service has held its Good rating throughout.
- October 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Glottenham Manor Nursing Home →
- October 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Glottenham Manor Nursing Home →
- July 2017Goodstayed GoodSafe: Good
- January 2017GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 29 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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