Anam Cara Care Home Service Dementia Resource Centre Stoneyholm Road Kilbirnie KA25 7JE Telephone: 01505 684371 Type of inspection: Unannounced Inspection completed on: 16 October 2017 Service provided by: North Ayrshire Council Service provider number: SP2003003327 Care service number: CS2008177877
About the service This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April 2011. Anam Cara is managed and operated by North Ayrshire Council. It is located in Kilbirnie, North Ayrshire and provides a respite service for up to 14 older people who have dementia. All service users are referred to as guests, which will be reflected in this report. The service is located near the town centre with good access to transport links, local services and amenities. The premises are decorated and furnished to a good standard offering single ensuite accommodation for all guests. There is a choice of pleasant sitting areas and areas where meals can be taken. There is access to all areas of the garden. The aim is to provide high quality, person centred care to the older person with dementia, whilst allowing the carer to have a break from their caring role. What people told us We spoke with five relatives/carers during the inspection. As found in previous inspections, they continued to speak very positively about the quality of service provided. They told us that staff were very welcoming and always made them feel confident and happy about leaving their loved ones with them. They told us 'this is a brilliant place', 'It is such a help to us'. They continued to tell us how crucial the service was to support them in their caring role. We spoke with five guests who told us they were well cared for and that staff were very friendly. One guest told us that she enjoyed the company and meeting different people. Another said that there was always something to do. Comments about the food were very positive. We were told that there were 'wonderful choices' and there were particularly good comments made about the afternoon tea served on a Sunday. We had asked the service to distribute care standards questionnaires on our behalf, which they did. We received one completed questionnaire from a relative, who made very positive responses to the statements and also 'Strongly Agreed' with the statement 'Overall I am happy with the quality of care my relative/friend receives at this home'. The following additional comment was made: 'My father and family are all delighted by the service provided at Anam Cara. He looks forward to his visits. Without Anam Cara my mother could never cope with all my father's complex needs. The staff are excellent. They are genuinely interested and have made real efforts to help. We cannot praise Anam Cara enough'. Self assessment The service had not been asked to complete a self-assessment in advance of the inspection. The provider had an improvement plan which identified areas of improvement. page 2 of 8
From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership not assessed not assessed What the service does well The provider continued to place great importance in seeking the views of guests and carers on the quality of all aspects of the service. The service regularly evaluated the methods used and made changes were required, to ensure they were appropriate for both guests and carers. One guest told us 'we are always asked our opinion about things and they listen to what we say'. The carers' forum continued to make a meaningful contribution to the development of the service. Guests and carers were involved in the assessment and care planning process, to identify individuals' care needs and how these needs should be met. Care plans were, in the main, person led, with clear examples of positive outcomes for individuals. We saw that community health professionals were involved whenever required. The service had made good improvements in the way that individuals' medication was managed and the checking procedures with GPs prior to guests' admission. The requirement and recommendation made in the last report regarding this matter had been met. Kitchen staff received information about guests' dietary needs and preferences. We also saw that specific food items continued to be purchased from local shops where guests stated preferences for specific food items or brands. All of the guests we spoke with continued to tell us that the food was good. One guest told us 'There is food available all day we just finish a meal and the tea and cakes come out'. We saw very positive interaction between guests and staff throughout the inspection. Some of this was in group activities chosen by the guests, or in one to one engagement. One guest told us about her trip to the shops in the mornings with a member of staff to buy papers. The service encouraged guests to make full use of community amenities and resources and encouraged local schools and businesses to be involved in the service. The Twitter account showed very good examples of guest, carer and community involvement. The participation methods used to seek the views of guests and relatives informed the service's quality assurances processes. A recent example of this was where guests had participated in a meaningful way in the appointment of a new member of staff and had influenced a change to the Sunday lunch menu. The manager and senior care staff continued to be supported, to enhance their training and development in management and leadership. Since the manager's completion of 'My Homelife' training a further three staff were now participating in training from 'My Homelife'. There were identified lead staff/champions in dementia, continence, oral health, infection control and nutrition. The recommendation relating to compiling a service development plan had been met. We saw that the views of page 3 of 8
guests, carers and other stakeholders had influenced this plan, in addition to the findings from the last inspection. The development plan was comprehensive and identified the improvements required and timescales for completion. Guests and relatives were provided with information on how to make a complaint. This included contact information for the Care Inspectorate. No complaints had been made to the service. The issues identified at the last inspection relating to the admission process had been addressed. The manager and senior manager of the service were receptive to our suggestion on how this could be further improved. Staff told us that they were encouraged by management to make suggestions on how improvements could be achieved in the service. This was reflected in a recent staff survey carried out by North Ayrshire Council to gauge the level of engagement with the staff group from an organisational and service level perspective. What the service could do better We made a recommendation in the last inspection about care plans not always reflecting changes in individual need. We found this was still the case. We discussed with the manager the issues we found and where there were omissions in care plans and gaps in recording which made it difficult to evidence that some individuals care needs were being fully met. These were significant and influenced the grade awarded to Quality Theme 1. (See recommendation 1) Some improvements had been made to quality audit systems. These were most effective in the improvements made to how individuals' medication was managed. Further improvements were required to audits of care plans and associated records to ensure that any deficits were identified and improvements made. (See recommendation 2) A recommendation was made in the last inspection report to review the induction training policy and procedure, to reflect a more structured approach to induction. Although a new induction training programme had been compiled there were some parts of the training which were not achievable within the timescales stated. We made some suggestions on how improvements could be made. The recommendation was not met. (See recommendation 3) We noted that the service was not always submitting formal notifications to the Care Inspectorate when required. We provided the manager with a copy of the guidance document 'Records that all registered care services (except childminding) must keep and guidance on notification reporting'. (See recommendation 4) Requirements Number of requirements: 0 page 4 of 8
Recommendations Number of recommendations: 4 1. The provider should ensure that changes in individuals' presentation and care needs are reflected in care plans. National Care Standards for Short Breaks and Respite Services - Standard 7: Starting to use the service, Standard 12: Lifestyle, Standard 13: Eating well and Standard 14: Keeping well - healthcare. 2. The provider should review the content of quality audits particularly for care plans to ensure they identify any deficits and where improvements are required. National Care Standards for Short Breaks and Respite Services - Standard 5: Management and staffing arrangements. 3. The provider should review the induction training policy and procedure to reflect a more structured approach to induction. This should include evidence of completing training in key areas within a stated timescale and confirmation of competency in completing tasks related to the individual's role. National Care Standards for Short Breaks and Respite Services - Standard 5: Management and staffing arrangements. 4. The provider should ensure that formal notifications are made to the Care Inspectorate as outline in the guidance document. 'Records that all registered care services (except childminding) must keep and guidance on notification reporting.' National Care Standards for Short Breaks and Respite Services - Standard 5: Management and staffing arrangements. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. page 5 of 8
Inspection and grading history Date Type Gradings 31 Oct 2016 Unannounced Care and support 5 - Very good Management and leadership 27 May 2015 Unannounced Care and support Management and leadership 13 Oct 2014 Unannounced Care and support 2 - Weak Management and leadership 17 Apr 2014 Unannounced Care and support 3 - Adequate Management and leadership 10 Apr 2013 Unannounced Care and support 3 - Adequate 3 - Adequate Management and leadership 28 Jun 2012 Unannounced Care and support Management and leadership 13 Dec 2010 Unannounced Care and support Not assessed Not assessed Management and leadership Not assessed page 6 of 8
Date Type Gradings 17 May 2010 Announced Care and support Management and leadership page 7 of 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 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 8 of 8