Inchmarlo House Care Home Service

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1 Inchmarlo House Care Home Service Inchmarlo Banchory AB31 4AL Telephone: Type of inspection: Unannounced Inspection completed on: 11 October 2017 Service provided by: Skene Enterprises (Aberdeen) Limited Service provider number: SP Care service number: CS

2 About the service Inchmarlo House is a care home situated in a retirement community at Inchmarlo on the western outskirts of Banchory. It is in extensive grounds with mature trees, wildlife and outstanding views over the surrounding countryside. It is registered to provide a care service to a maximum of older 52 people, with an integrated day care support service for up to eight people. The service aims 'to provide individualised care of a high standard in a homely environment in pleasant surroundings'. At the time of the inspection there were 48 people residing at Inchmarlo House. This service was registered with the Care Inspectorate on 1 April What people told us During the inspection we spoke with 16 residents and two residents' visitors, formally and informally. We received back 29 out of 36 Care Standards Questionnaires (CSQs) we sent to the service for random distribution to the residents and their relatives/representatives. All were very happy or happy with the overall quality of care provided to residents at Inchmarlo House. We provided the manager with a summary of the responses. Comments from people we spoke with and in questionnaires were positive and praised the efforts of the staff and management. Comments included: 'No words adequately describe the service and care we receive. The environment I find immaculate especially décor, carpets etc. The quality of care and support could not be better.' 'I am sure all staff are trained above average.' 'I find the environment pleasant and the outside front of the house scenery stunning. The have recently added a long fence to the garden area to keep residents within he grass at one end of the house. Paths leading from the dining rooms French windows, a paved area laid for wheelchair users to easily access the sensory garden. The chefs and his two lady assistant chefs prepare and cook a variety of meals to a high standards. Special requests are willingly granted.' 'If I had to be in a care home there is nowhere else I would rather be.' 'A lot of lovely staff. Very friendly. There are lots of different activities going on in and out of the home. The folk in the kitchen are excellent at making something for my specialist diet - working with me. The home is very clean and spotless. That carer is excellent.' 'I am very happy living here, the staff are kind and caring.' 'I always find all staff welcoming, friendly, polite and professional. I enjoy visiting and feel my mother has relationships with staff as well as other residents. I particularly find the nursing staff very caring and approachable and me and my family feel very reassured that our mother is receiving excellent medical care when she needs it as well as good practical care for her health and wellbeing to prevent the need for medical care where possible. For example, keeping her mobile, clean and mentally stimulated and encouraging her to eat well and be independent with toileting, never causing a fuss if there is an accident.' 'I get a lovely cooked breakfast every morning. The carers are super. They are really good. Helpful and kind. 'We just have to buzz and they are on the doorstep.' page 2 of 8

3 'The food is very good, I eat well. I enjoy my food. The cooking is excellent. The chef did lovely food for my birthday. The carers and ladies who clean are very friendly. The library van comes here.' 'There is always something going on. ' 'A very lovely environment for my (age given) mother. Lovely staff and management.' 'The food is very good. The chef caters for the digestion of elderly people.' 'I suggested a pool table. They got one.' 'The activities lady is great fun... I was trout fishing recently...we go outside when it's warm enough to sit out.' 'I enjoy watching all the activities.' 'The quality of the environment is excellent.' Less positive comments included: 'I am using a large room which is very nice. I find it difficult to communicate with some of the foreign staff. They don't understand what I am saying and I don't understand them.' There is a smell in a small area - this had been dealt with by the service. There was an issue with the laundry for a very short while - this had been dealt with by the service. We concluded that people were highly satisfied with the overall quality of care and support provided at Inchmarlo House. Self assessment We did not request a self assessment. The manager shared the service improvement plan with us. The service had clearly identified how they wished to improve the service and the plans to achieve improvement included timescales and who was responsible. The manager regularly reviewed the plan appropriately to ensure developments remained on track. 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 not assessed not assessed What the service does well The quality of care and support was very good and the quality of the staffing was of an excellent standard. People could be reassured that staff provided very good standards of care and support. One relative told us: page 3 of 8

4 '...me and my family feel very reassured that our mother is receiving excellent medical care when she needs it as well as good practical care for her health and wellbeing to prevent the need for medical care where possible. For example, keeping her mobile, clean and mentally stimulated and encouraging her to eat well and be independent with toileting.' We found excellent communication was used to ensure people were kept well informed. This helped to ensure very good standards of consistent care were provided. One relative wrote, '(my relative's) dedicated nurse (named) keeps me informed and we regularly discuss any issues regarding her health and care. In that I am very satisfied.' The dementia unit was being refurbished to ensure the already exceptionally high quality environment supported people who had dementia care needs. People were very much involved in the planning. A relative told us, 'The team has gone to great lengths to enrich the lives of the most vulnerable residents in the home with these new plans.' The enormous, newly enclosed garden was enjoyed by people and provided a safe, secure and independently accessed garden environment. Inchmarlo had a very good history of encouraging physical activity. We saw that people enjoyed an excellent range of activities they may have previously taken part in prior to moving to the home. These included: a walking group, chair dancing, carpet bowls, indoor golf course, trout fishing, outside to the garden, family members playing guitar to residents, residents playing piano to each other. The home was involved in the 'Care About Physical Activity' programme (CAPA) and promoted daily exercise for all. Improvement was recorded in peoples' abilities in the activities measured but we were also told of the improvement to people's confidence. People very much enjoyed influencing the activity program. Two examples included: a person suggested pool table and this was bought and, someone wanted to have a bible study group and this is about to be started, led by the resident. We found that excellent, safe recruitment and selection continued to be undertaken. Families and residents were very much involved in the recruitment processes, influencing the choices of the staff supporting and caring for them. An ex-family member was involved in some of the interviews and some interview questions had been set by residents and families. The senior staff or management formally sought resident's views about candidates when the residents met the candidates informally or over a coffee. This is excellent practice. We saw that staff were supported and encouraged to undertake an excellent range of induction, training and qualifications in care and leadership. Training was of an excellent mix of online, internal and external events. The training was in keeping with their roles and also to further develop their careers. Staff felt highly supported by the manager. We saw supervision, meetings and appraisal were regularly planned and carried out to ensure staff carried out high standards of care. A wide range of 'champions' in the staff group promoted best practice amongst the team in areas including moving and handling, dementia care, nutrition and hydration. For example, we saw many excellent examples of staff taking time to enable people to do as much as they could for themselves whilst using proper techniques to help people to move when needed. This ensures people retain as much independence as possible. We saw that there was an exemplary ethos of respect for people among the management and staff group. Staff clearly knew each resident's needs and what made a good day for each person. Staff aimed to always ensure they gave residents their full attention, in an unhurried way. Staff told us of their pride and commitment to providing the highest levels of care. They told us they got excellent levels of job satisfaction at Inchmarlo. Different relatives told us: 'Inchmarlo house is a wonderful place. Our mother is well cared for and extremely happy. page 4 of 8

5 The ethos of the service is beyond reproach. Staff are always happy and engaged with the residents. They are happy to help and we have never at any time seen any of the residents unhappy. The staff are patient and extremely helpful. The home manager is absolutely wonderful.' 'The quality of the care in this home is outstanding. The compassion and real caring of these country and other nurses is amazing. Care staff are respectful and those involved in creative arts have a real understanding and rapport with the interests and talents of their patients. The food is five star quality.' 'All staff show empathy with the residents and as I visit most days I have the opportunity to observe a large number of staff doing various roles.' The service was seen to be meeting its aims 'to provide individualised care of a high standard in a homely environment in pleasant surroundings'. What the service could do better The management were introducing updated and improved, streamlined care planning documentation. These would further highlight individualised and personalised outcomes for people. On reviewing wound documentation and care planning we saw that not all the photographs taken to monitor wounds were of a good quality. The management had already planned to review and update the documentation to ensure good quality photography was used and which also provided measurement of any wounds. Photography and body mapping of bruising should be considered to support accident reporting and monitoring of recovery. Staff were well supported to keep comprehensive training records. The senior staff were to further develop the support of staff to keep reflective accounts of their learning and practice to provide clear evidence of how their learning and experience has influenced their practice. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at page 5 of 8

6 Inspection and grading history Date Type Gradings 13 Oct 2016 Unannounced Care and support 5 - Very good 17 Dec 2015 Unannounced Care and support 5 - Very good 11 Feb 2015 Unannounced Care and support 5 - Very good 27 Mar 2014 Unannounced Care and support 5 - Very good 2 Nov 2012 Unannounced Care and support 5 - Very good 20 Jan 2011 Unannounced Care and support 16 Sep 2010 Announced Care and support 11 Mar 2010 Unannounced Care and support 5 - Very good 5 - Very good page 6 of 8

7 Date Type Gradings 6 Oct 2009 Announced Care and support 5 - Very good 5 - Very good 5 - Very good 5 - Very good 11 Mar 2009 Unannounced Care and support 4 - Good 4 - Good 12 Nov 2008 Announced Care and support 4 - Good 4 - Good 4 - Good 4 - Good page 7 of 8

8 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 8 of 8

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