Elderslie Care Home Care Home Service

Transcription

1 Elderslie Care Home Care Home Service 20 Fulbar Road Paisley PA2 9AP Telephone: Type of inspection: Unannounced Inspection completed on: 27 July 2016 Service provided by: BUPA Care Homes (Carrick) Limited Service provider number: SP Care service number: CS

2 About the service Elderslie Care Home provides care for up to 120 older people. The Care Home is purpose built and is situated in Paisley, near to local amenities. The accommodation is over two levels and in four individual units each with 30 single en-suite bedrooms. Each unit has a choice of lounge areas, a servery area, residents' kitchen and dining room. The home has pleasant garden areas for the use of residents and their families. The Philosophy of Care includes: "those who live in continuing care should do so with dignity, have the respect of those who support them and should live with no reduction of their rights as citizens." What people told us There was an Inspection Volunteer involved in the inspection. An Inspection Volunteer is a member of the public who volunteers to work alongside the inspectors. Inspection Volunteers have a unique experience of either being a service user themselves or being a carer for someone who has used services. The Inspection Volunteer role is to speak with people using the service being inspected and gathering their views. The Inspection Volunteer involved in the inspection spoke with residents and their relatives, comments included; "Everything is very nice here" "I was in another place in Paisley - I wasn't happy there but I came here and I like it" "Everything they do for you is good" "The nurse says it's your home and you can stay up late if you like." "As soon as I walked in here I thought this'll do me" "Food is very good" "I've been told to tell them what I want for dinner (after lunch) if there is not anything on the menu that I like" "In between meals they come round with a trolley and offer choices of drinks and snacks" "I've been to some activities - cookery, Bingo, Handicrafts" "I get my paper every day and after I've read it I pass it on" "I've been on two bus runs" "I get my hair done regularly - the hairdresser came yesterday" "It's never too noisy - we can always talk" "Staff are all nice and friendly" page 2 of 12

3 "They seem to know what they are doing - they're all very professional" "They're all very good - it doesn't matter who's on" "They're always very good at looking after my relative." There is further information about our observations regarding residents' care and support detailed throughout the report. Self assessment We received a completed self-assessment document from the service provider. The service had provided us with relevant information for each of the headings that we grade them under. The service identified what they thought they did well, some areas for development and any changes they planned. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership 5 - Very Good 5 - Very Good 5 - Very Good 5 - Very Good Quality of care and support Findings from the inspection During the inspection visit we observed staff practice and saw that staff responded to residents' requests promptly with kindness and respect. We saw many positive and meaningful interactions between staff and residents. We observed that staff supported residents living with dementia who became distressed with skill and patience. There was a diary of activities and events for residents to take part in. We saw that residents enjoyed taking part in a range of activities, this included group and one to one activities, supported by an enthusiastic team of activity workers. People we spoke with commented positively about the range of activities and outings available. We saw that all staff teams in the home joined in and supported residents' activities. We observed that mealtimes were well managed and that residents enjoyed their meals in a pleasant social atmosphere. People we spoke with commented positively on the menu and the drinks and snacks available. We spoke with care and catering staff who demonstrated a good level of knowledge about individual residents' dietary needs and their preferences. Nursing and care staff we spoke with demonstrated a good knowledge of local community healthcare links; there was good evidence that advice from visiting healthcare professionals was followed. page 3 of 12

4 We viewed personal plans for individual residents. We saw that the plans contained good information about how the care and support needs of the individual were being managed, informed by the preferences of the individual. The assessments of risk were up to date and informed care planning. We noted that the management team had an overview of how specific aspects of residents' care and support were being managed; this included assessment and monitoring of nutrition and skin integrity and minimising the risk of falls. We looked at the records of medication administration. The records indicated that residents' medication was being managed in line with best practice. There were systems in place to audit medication management. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 5 - very good Quality of environment Findings from the inspection We found that the ethos of the home was welcoming and friendly; visitors we spoke with commented positively about the friendly welcome they received when they visited. The home offers single bedrooms with en-suite facilities. Many of the bedrooms were personalised and reflected the taste of the resident. Each unit had a range of pleasant sitting rooms and dining areas that residents could access. There had been recent development of a café area in one of the units which people we spoke with commented positively about. The home are looking to further develop an area of the home for Namaste care, which is a comforting and person-centred approach to meaningful activities for people living with dementia. The home has well maintained garden areas that are accessible from the ground floor units. We saw residents enjoying use of the garden. The residents have a gardening club which is supported by the homes gardener and activities team. We saw that the home was clean and tidy, both residents and relatives we spoke with commented about the cleanliness of the home and how important that was to them. We looked at the systems in place to ensure the safety of the environment and the equipment used to support residents. We saw that records were up to date and appropriate systems were in place to monitor safety and cleanliness. page 4 of 12

5 We spoke with housekeeping and maintenance staff; they demonstrated a good knowledge of their role and responsibility to maintain high standards regarding the safety and cleanliness of the environment for everyone who uses the service. One of the areas of the home was malodorous. We noted that the housekeeping staff had carried out additional routine cleaning of this area. There was a need for further assessment as to how the malodours could be eliminated in this area. This will be the subject of a recommendation. See recommendation 1. Requirements Number of requirements: 0 Recommendations Number of recommendations: 1 1. The service provider should take measures to ensure that the environment of the care home is free from malodours. Standard 4 - Your environment - National Care Standards for care homes for older people. Grade: 5 - very good Quality of staffing Findings from the inspection We spent time during the inspection visit observing staff practice; we saw that staff were skilled in the care and support they delivered. We noted that staff demonstrated a good knowledge of residents' preferences and their lives before coming into the home; this helped to promote a person centred ethos to care and support. We spoke with a visiting healthcare professional who commented positively about the skills of the staff working in all the units of the home. From training records we saw that staff were up-to-date with their training. The home had embarked on the Promoting Excellence Framework for dementia learning and development. We will monitor the progress and impact of this programme of training at the next inspection. Staff we spoke with during the inspection commented that they found the training available was relevant to their role. Staff had access to regular supervision which helped to evaluate practice and plan training and development. Staff we spoke with commented that they felt supported by the management team and by their peers. page 5 of 12

6 We spoke with newly recruited staff who detailed the support they were receiving with induction to their role and the opportunity to 'shadow' more experienced staff. They commented that this had helped to introduce them to their posts in a supportive way. The service had a clear staffing structure with defined roles for staff. Staff we spoke with demonstrated a good awareness of their roles and responsibilities. This included their key worker roles to support individual residents maintain links with families and friends. We saw that staff were respectful to each other. This was evident when senior staff were directing their team and delegating tasks. We saw good work between staff teams including discussion of timing of aspects of staff tasks such as housekeeping and maintenance work to ensure that residents were unsettled as little as possible. Nursing and care staff had appropriate registration with regulating organisations such as the Nursing and Midwifery Council and Scottish Social Services Council. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 5 - very good Quality of management and leadership Findings from the inspection The management team used the providers Quality Assurance systems to gather information to help assess the quality of the service delivered. This included quality audits, group meetings with residents, relatives and staff and surveys. We saw that the information gathered was being used to inform action plans which were helping to further develop the service. We saw information on display about how the comments and suggestions from people who use the service had informed developments and improvements. This included the development of a café area. The manager and senior staff demonstrated a good level of knowledge about residents' care and support needs, staff development and training needs and health and safety matters. There was a monthly overview of residents' care and support needs which informed decisions regarding the management of care and staffing requirements. People we spoke with during the inspection knew who the manager was and commented that she was approachable. They all knew who they would talk to if they had concerns or complaints. page 6 of 12

7 Since the previous inspection there has been a recommendation made as the result of a complaint investigation. This was regarding the need to ensure systems were in place to ensure that equipment to support residents' care needs was ordered promptly. We noted that while there was a system in place it had not been correctly followed. This resulted in an item of equipment needed to support residents not being ordered. This was brought to the manager's attention and was acted upon during the inspection. There was a continued need for this system to be followed to ensure that appropriate equipment was in place to meet residents' support needs. This recommendation will continue in this report. See recommendation 1. Requirements Number of requirements: 0 Recommendations Number of recommendations: 1 1. The service provider should implement a system to ensure equipment is ordered promptly when this is required to meet assessed needs of residents. National Care Standards for care homes for older people - Standard 4. Your environment Standard 6: Support arrangements Standard 9: Feeling safe and secure. Grade: 5 - very good What the service has done to meet any requirements we made at or since the last inspection Previous requirements There are no outstanding requirements. page 7 of 12

8 What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 The service should ensure that they adhere to the Mental Welfare Commission of Scotland's guidance "Rights, Risks and Limits to Freedom" guidance when using equipment which could be regarded as being potentially restraining. This is to comply with NCS Care Homes for Older People, Standard 6.1 Support Arrangements. This recommendation was made on 7 May Action taken on previous recommendation We saw that assessments for the use of equipment that could be regarded as restraining such as bedrails and lap straps were in place and up to date. Staff we spoke with demonstrated a good level of knowledge regarding the use of this equipment and the best practice guidance regarding its use. We saw that there was a need for clarity regarding the confirmation of consent for the use of this equipment for some cases. This was discussed with the management team who detailed how they would address this issue. This recommendation has been implemented and we will monitor progress with the management of consent confirmation at the next inspection. Recommendation 2 The service should ensure that staff adhere to good practices through being mindful of the volume of radio and television to ensure that this does not have a negative impact on the experience of residents. The service should monitor that good practices are being adhered to. This is to comply with NCS Care Homes for Older People, Standard 4 Your. This recommendation was made on 7 May Action taken on previous recommendation We observed that staff were mindful of background noise in units and demonstrated an awareness of the impact excessive noise could have on residents living with dementia. This recommendation has been implemented Complaints Please see Care Inspectorate website ( for details of complaints about the service which have been upheld. page 8 of 12

9 Enforcement No enforcement action has been taken against this care service since the last inspection. Inspection and grading history Date Type Gradings 2 Nov 2015 Unannounced Care and support Management and leadership 30 Nov 2015 Re-grade Care and support Management and leadership 7 May 2015 Unannounced Care and support Management and leadership 8 May 2014 Unannounced Care and support Management and leadership 8 Jan 2014 Unannounced Care and support Management and leadership 15 May 2013 Unannounced Care and support Management and leadership 31 Dec 2012 Unannounced Care and support page 9 of 12

10 Date Type Gradings Management and leadership 29 Jun 2012 Unannounced Care and support Management and leadership 24 Jan 2012 Unannounced Care and support Management and leadership 3 Oct 2011 Unannounced Care and support 2 - Weak 2 - Weak Management and leadership 9 May 2011 Unannounced Care and support Management and leadership 18 Nov 2010 Unannounced Care and support Management and leadership 24 Aug 2010 Announced Care and support Management and leadership 3 Dec 2009 Unannounced Care and support Management and leadership 9 Jul 2009 Announced Care and support page 10 of 12

11 Date Type Gradings Management and leadership 25 Feb 2009 Unannounced Care and support Management and leadership 3 Oct 2008 Announced Care and support Management and leadership 8 Jul 2008 Unannounced Care and support Management and leadership 30 May 2008 Announced Care and support 1 - Unsatisfactory Management and leadership page 11 of 12

12 To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com Find us on Facebook Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 12 of 12