Antonine House Care Home Service 16 Roman Road Bearsden Glasgow G61 2SL Telephone: 01463 795050 Type of inspection: Unannounced Completed on: 9 July 2018 Service provided by: Antonine Care Limited Service provider number: SP2010010916 Service no: CS2012310887
About the service Antonine House is located in a residential area of Bearsden, East Dunbartonshire. The service provider Antonine Care Limited is part of Meallmore Ltd. Antonine House provides a care service to a maximum of 81 older people, with: - 14 bedrooms on the lower ground floor for frail older people - 27 bedrooms on the ground floor for frail older people - 27 bedrooms on the first floor for older people with dementia - 13 bedrooms on the upper floor of the care home. All bedrooms were single with en-suite toilet and shower facilities. The care home benefited from a variety of sitting and dining areas. There was also a cinema room which residents could use if they wished to do so. An enclosed garden area and outdoor sitting area has also been developed. The service's information brochure states that: 'Care is individually tailored to the residents' needs and wishes, though we strongly encourage people to stay as independent as possible.' There were 80 people living in the home during the inspection. What people told us Prior to the inspection we issued fifteen Care Inspectorate questionnaires to people using the service and fifteen to carers or relatives of people using the service. We received three completed Care Inspectorate questionnaires from people using the service and three from carers or relatives. All of the people who responded agreed or strongly agreed that they were happy with the service overall. We spoke to several people using the service on a one to one basis and in small groups. 'Staff are welcoming and friendly'. 'It feels like an extended family'. 'It's inclusive and welcoming'. 'Staff are very caring and motivated'. 'Don't know their names'. 'Would like some plainer choices of food'. 'Food not always great, can be cold'. 'Plenty going on, can take part if I want to'. 'I love the garden'. 'Home from home'. page 2 of 7
Self assessment The Care Inspectorate did not request a self assessment from service providers this year. 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 3 - Adequate What the service does well The atmosphere in the home was bright and welcoming. Bedrooms were personalised with items from home and people told us they liked their rooms. Someone said 'It's very comfortable to live in'. There was access to the very well maintained garden and outside spaces on every floor. Many people told us 'I like the garden'. Access to outside space is important to promote choice, dignity and respect. Staff approached people with kindness and consideration and used opportunities to make the most of time with people. Relatives told us 'All the staff make it feel like an extended family when we come in'. Personal support plans contained information to keep people safe. Assessment of risks such as falls, nutrition and mobility were in place and these were updated when required. However, the recommendation made at the previous inspection about medication management had not been met and has been repeated. Please see section about previous recommendations later in the report. When people's health and wellbeing needs changed, staff were responsive. Positive working relationships with other health and social care professionals meant people could rely on their comfort and safety being promoted. Staff used safe infection control and moving and assisting practice to promote dignity and respect. People were supported with meals and drinks which helped maintain physical and emotional wellbeing. While independence was encouraged, appropriate support was given to those who needed additional assistance Relatives told us that staff were good at keeping them up to date with any changes which 'Gives peace of mind'. A range of social and recreational activities were available. There were established community networks including local nurseries and churches which helped people keep personal connections and supported personal choice and wellbeing. Quality assurance methods included a range of meetings to allow people's voices to be heard. This is important for staff and people using the service to be able to contribute their ideas to shape the service going forward. Registers of accidents, incidents and complaints demonstrated the service was responsive to events that impacted on people. An open door management policy and visible senior staff helped give people confidence. Someone said 'Oh you always see the managers' on the floor'. The staff structure provided opportunities for professional development. This motivated staff who told us they page 3 of 7
felt supported in their roles. Staff had recently been involved in a project to support palliative care to ensure their practice was current and based on recent evidence. What the service could do better We found that some staff did not have the appropriate registration status with the Scottish Social Services Council (SSSC) and some were not registered. Quality assurance systems to ensure staff were equipped to perform their roles were not robust enough. It is important to ensure the workforce is appropriately registered to uphold public trust in social services. The service took immediate appropriate action to safeguard people during the inspection. We have made a recommendation about this (Recommendation 1). Medication management was not as effective as it should be especially for people prescribed as required medicines for pain or distress. Consistent use of assessment tools including pain and behaviour assessments in conjunction with prescribed medication would ensure care is responsive. Use of relevant best practice tools would optimise health and wellbeing benefits to people. Existing quality assurance methods had not identified these areas for improvement. A recommendation made at the last inspection about medication management has not been met and is repeated (see previous Recommendation). Personal support plans contained up to date information. However records could contain greater detail to provide clearer direction for staff supporting people. Systems to identify when legal powers including Adults with Incapacity were due for review were not always effective. To safeguard the rights of people living in the home we discussed with the service provider how this could be improved. The mealtime experience would benefit from review to ensure the experience remains calm and pleasant for everyone. People told us they didn't always like food choices and food could be warmer at times. Someone said 'I keep telling them I would like plainer choices'. We discussed with the service provider how to address these issues and recognise that there were plans to respond to this feedback. Some environmental features could be made more dementia friendly. For example, to help people remain orientated and find their way around the home, directional signage could be clearer. This would help people living with dementia to retain their independence. Supervision is an important method of staff support that helps staff provide responsive care and support in accordance with Health and Social Care Standards. A good approach to supervision that involved face to face supervision as well as observation of practice was in place. However the frequency and consistency of supervision could be improved to ensure company policy was being implemented and all staff benefitted from this. We encouraged the service provider to further develop this approach to help provide consistent feedback to staff about their practice. Regular observed practice can help identify individual training and support needs which can increase staff competence and confidence. This in turn can raise standards of care. The service provider was responsive to feedback and initiated an action plan to address the identified issues during the inspection. Requirements Number of requirements: 0 page 4 of 7
Recommendations Number of recommendations: 1 1. The service provider should ensure that care and support is consistent with Health and Social Care standards which state 'I benefit from a culture of continuous improvement, with the organisation having robust and transparent quality assurance processes (HSCS 4.19), and 'I have confidence in people because they are trained, competent and skilled, are able to reflect on their practice and follow their professional and organisational codes'(hscs 3.14). The service provider should develop a more robust system to monitor staff who are registered with a professional body such as Nursing and Midwifery Council (NMC) or Scottish Social Services Council (SSSC). A plan should be devised to monitor staff on an ongoing basis to ensure registration remains current and appropriate to specific staff roles. Staff should understand their personal accountability towards their registration and any conditions related to registration. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. Inspection and grading history Date Type Gradings 26 Jul 2017 Unannounced Care and support Not assessed Not assessed 9 May 2016 Unannounced Care and support 24 Jun 2015 Unannounced Care and support 24 Nov 2014 Unannounced Care and support page 5 of 7
Date Type Gradings Not assessed 21 May 2014 Unannounced Care and support page 6 of 7
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 7 of 7