Skye View Care Centre Care Home Service 1 Arran Drive Airdrie ML6 6NJ Telephone: 01236 762 242 Type of inspection: Unannounced Inspection completed on: 11 May 2017 Service provided by: Skye Care Limited Service provider number: SP2012011795 Care service number: CS2012307045
About the service Skye View is registered to provide a care service for 24 older people and people under 65 years who are diagnosed as living with dementia. The service is owned and managed by Skye Care Limited. The service is situated in a quiet residential area of Airdrie. There are local shopping facilities and public transport links. The accommodation is situated on two floors with lounge and dining areas on each floor. All bedrooms are single and have en-suite facilities. There is a pleasant front garden for resident use and parking facilities for visitors. The aims and objectives of the service state: 'We will endeavour to provide 24 hour holistic care to specialised dementia residents in a supportive and comfortable environment. It is our objective to promote independence and help each resident reach their maximum potential. We will ensure that their wellbeing, privacy and dignity are maintained at all times. We actively promote resident and relative participation in all aspects of our service. What people told us Prior to the inspection we sent out ten questionnaires to the manager to give residents and their families. We received eight completed questionnaires back. We spoke with several residents, relatives and visitors during the inspection. Everyone was overall happy with the care and support that they or their relative receives at Skye View. People spoke very positively about the staff and the manager and how approachable they were. Some comments included: - The food is always lovely...there's plenty of choice. - Staff are good at contacting the Doctor when needed. - I am always updated when there are any changes with my relative. Self assessment The Care Inspectorate is not currently requesting services to submit this. 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 We sampled personal plans and found that they contained a very good level of detail to guide staff on how best to care and support each resident. These included relevant risk assessments that were then used to inform care plans. We discussed introducing one page profiles at feedback. page 2 of 11
We found that six monthly reviews were being carried out and that residents and/or their family were asked to participate in these and any agreed outcomes were recorded and worked through. We heard about how people spent their day from residents, relatives and staff. We noted that staff recorded each day how the resident had spent their time and some of this mirrored past hobbies and interests. We were told about entertainers that visited and links with the local churches. We discussed with manager how this area could be developed to provide more variety for residents and signposted them to our Hub. We found that residents received their medications as prescribed. We found that lunch was well organised. Residents were supported at a pace suitable to them. They were offered plenty of choice as to where to have their meals, what to drink and to wash their hands before and afterwards. There were plenty of snacks and drinks offered in between meals too, including fruit and milkshakes. Resident's weight was monitored and the dietician was contacted when needed. We looked at the management of accidents and incidents, including falls. These were recorded on individual forms and any follow up was noted. Where required, these had been referred or notified to relevant authorities. Care plans and risk assessments took account of any changes needed. The manager had a very good overview. We noted that the home closely liaised with health care professionals as and when needed by each resident. We spoke with several visiting health care professionals during our inspection who told us that the service contacted them appropriately and carried out any instructions they advised. This meant that resident's health care needs were well supported. We observed residents to look clean and tidy. They looked relaxed and comfortable around staff. We spoke with visiting relatives who told us that this was always the case. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 5 - very good Quality of environment Findings from the inspection We found the care home to be clean, tidy and homely when we arrived. Resident's bedrooms were nicely personalised and relatives told us that they were encouraged to do this. This ensured some familiarity for residents. We noted that there was a range of equipment available to support residents including profiling beds, hoists and bedroom sensors. page 3 of 11
We looked at how the service ensured that the home was kept safe for residents and noted that in house maintenance checks were carried out including fire checks and hot water temperatures. External service checks were also carried out, including the fire and nurse call system, lifting equipment and gas safety. We heard that the service had recently purchased some new garden furniture and found that the garden was very well maintained. The garden is open plan, which meant that residents needed to be supported by staff or their visitors to use this, which they did. We found that the service had adopted some good practice guidance for people living with dementia, including contrasting toilet seats, handrails in corridors and signage. We noted that as part of the manager's development plan, they would be using the King's Fund Tool 'Is your care home dementia friendly?' to look at ways of enhancing this. We also signposted them to Thomas Pocklington Trust. We observed throughout the inspection that staff were very mindful of noise levels and creating a comfortable environment to reduce stress and distress for their residents. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 5 - very good Quality of staffing Findings from the inspection We sampled staff recruitment and found that residents could be assured that new staff had been selected using best practice guidance. We looked at training records and found that all staff had received their mandatory training which included moving and handling, fire safety and adult support and protection. We noted that staff had been supported to attend non-mandatory training including venepuncture, dementia and oral health. Some of this training had been provided by NHS healthcare professionals who told us that the home was very receptive to training and it was very well attended. We spoke with fairly new members of staff who told us they had been very well supported in their role. We found that an induction programme was on-going. We suggested that this be divided into an initial orientation to the service and then the on-going induction through each person's probation period. We spoke with staff who were very enthusiastic about working at the service. They told us that they felt there was good team working and that the management team were very supportive. They told us that they were encouraged to come forward with any ideas or concerns they may have and that they were listened to. page 4 of 11
We observed staff to know the residents well and support them in a caring manner. We noted that residents looked relaxed around staff and there was some friendly humour. We found that staff received regular individual supervision. We heard from staff that they found these very useful and could use them to discuss their work performance and training needs. This complimented the new competency checks that the service was implementing. We discussed how this could be best managed and signposted the service to the Scottish Social Services Council 'Step into Leadership'. We noted that there were regular staff meetings and again staff told us that these were open forums where they could receive information from the manager, but also offer any views that they had. We heard from relatives that staff were very good and very caring towards both them and their relatives. They told us that staff kept them up to date with relative's care and were very approachable. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 5 - very good Quality of management and leadership Findings from the inspection We read minutes from meetings with residents, relatives and staff and noted that these took place regularly and provided and opportunity for people to give the manager feedback about the service. Any agreed actions were noted and re-visited at the following meeting to track progress and make them meaningful. Quality assurance and monitoring systems were very effective. The overall performance of the service was closely monitored and there was a clear commitment to the maintenance of high standards and ongoing development. We asked the service to look at carrying out their resident, relative and staff survey on an annual basis as the previous one had provided them with good feedback to develop the service. The manager agreed with this and said that she would also include feedback from other people who visited the service. We found that the service had a system in place for managing complaint. There had not been any internal complaints since the last inspection. We looked at the manager's monthly audit which provided them with an overview of the care home and highlighted any areas to be worked through. This included key areas of care including accidents and incidents, falls and nutrition. We discussed that the self-assessment, we previously asked for, was now being replaced by the service's own development plan and asked the service to look at putting this in place. page 5 of 11
We observed staff to be very well organised and this meant that residents' care was delivered as reflected in their care plans. We heard how the manager was very visible around the home and encouraged people to come and speak to her about any ideas or concerns. We heard examples from staff and relatives and they told us that they had been listened to. From the evidence we have examined at this inspection we could see that there was an assurance to continually improve the quality of the service for the people who use it. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 5 - very good What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 By the 30 December the service provider must ensure that report writing carried out in relation to times whereby residents sustain accidents or incidents, with or without apparent injury at the time, contains as much detail as possible. This relates to care plan recording, any referral made to Social Work and notifications to the Care Inspectorate. In addition to the information that is made available to residents' representatives. This is in order to comply with The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011/210, Regulation 4 (1)(a) Welfare of service users - a requirement that a provider must make proper provision for the health and welfare of service users. Regulation 5(2)(b)(ii) Personal Plans. This requirement was made on 14 February 2017. Action taken on previous requirement Please see information under quality theme 1 of the report. Met - outwith timescales page 6 of 11
Requirement 2 By the 30 December 2016 the provider must ensure that all residents have their personal plan reviewed at least once in every six month period whilst the service is in receipt of the service. This is in order to comply with The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011/210, Regulation 5(2)(b)(iii) - Personal plans This requirement was made on 14 February 2017. Action taken on previous requirement Please see information under quality theme 1 of the report. Met - outwith timescales What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 The provider should continue to develop the consultation methods used at the service to ensure that all residents including those who find it more difficult to express their views are consulted. This takes account of the National Care Standards, Care Homes for Older People, Standard 8 - Making Choices and Standard 1 - Informing and Deciding. Please see information under quality theme 1 of the report. Recommendation 2 It is recommended that the provider develop the content of residents and respite residents support plans to ensure all aspects of the care to be provided is recorded including but not limited to the management of falls, social activities and aspirations, managing stress and distress. Support plans should be updated when care needs change or new information becomes available following reviews or incidents. Risk assessments should be updated after accidents or when circumstances change. This takes account of the National Care Standards, Care Homes for Older People, Standard 6 - Support arrangements. Please see information under quality theme 1 of the report. page 7 of 11
Recommendation 3 The service should carry out regular evaluation of staff practice to ensure they are competent to carry out their roles and responsibilities. This takes account of the National Care Standards, Care Homes for Older People, Standard 5 - Management and Staffing Arrangements. Please see information under quality theme 3 of the report. Recommendation 4 It is recommended that systems are put in place to demonstrate that residents' nutritional needs are accurately assessed, monitored and met. Maintain accurate records of residents' dietary needs. Ensure an overview of all residents' nutritional status is maintained. Proper measures are put in place to support residents at risk of unplanned weight loss, review anything that may affect resident's ability to eat and access advice. When food and fluid charts are used these are monitored and used to influence residents' nutritional needs. This takes account of the National Care Standards, Care Homes for Older People, Standard 13 - Eating Well. Please see information under quality theme 1 of the report. Recommendation 5 It is recommended that staff with supervisory responsibility, are given education opportunities to develop their leadership and managerial skills. This is in accordance with the National Care Standards, Care Homes for Older People, Standard 5 - Management and staffing arrangements. The home has sourced courses for staff, but as yet these had not started. This recommendation had not been met. Recommendation 6 It is recommended that the provider ensures that new staff are supported and not left unsupervised with residents until assessed as capable. This is in accordance with the National Care Standards, Care Homes for Older People, Standard 5 - Management and Staffing Arrangements. page 8 of 11
Please see information under quality theme 3 of the report. Recommendation 7 It is recommended that the manager implement the quality assurance effectively to assess and monitor the quality of all aspects of the service. Keep a record of what areas for improvement were identified, timescales for the actions to be completed and the person with overall responsibility for ensuring the necessary improvements are achieved. Review the audit information to inform how the service is improving, or where further improvements are necessary. This is in accordance with the National Care Standards, Care Homes for Older People, Standard 5 - Management and Staffing Arrangements. Please see information under quality theme 4 of the report. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. Enforcement No enforcement action has been taken against this care service since the last inspection. page 9 of 11
Inspection and grading history Date Type Gradings 25 Jan 2017 Unannounced Care and support Environment Staffing Management and leadership 29 Jun 2016 Unannounced Care and support Environment Staffing Management and leadership 14 Dec 2015 Unannounced Care and support Environment Staffing Management and leadership 30 Apr 2015 Unannounced Care and support 4 - Good Environment 4 - Good Staffing 4 - Good Management and leadership 4 - Good page 10 of 11
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 www.careinspectorate.com Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 Find us on Facebook Twitter: @careinspect 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 11 of 11