Auchinlea Care Home Care Home Service 10-12 Scott Street Largs KA30 9NU Telephone: 01475 673500 Type of inspection: Unannounced Inspection completed on: 20 September 2017 Service provided by: Bertinaley Care Limited Service provider number: SP2006008166 Care service number: CS2006116406
About the service The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at www.careinspectorate.com This service registered with the Care Inspectorate on 1 April 2011. Auchinlea Care Home is a care home for older people who require residential care. The service is privately owned under the company name of Bertinaley Care Limited and is situated within a residential area in the coastal town of Largs, North Ayrshire. This service has been registered since 2006. The accommodation is homely and welcoming. It is over two floors and consists of single bedrooms, most have an en suite toilet. There is a lift to get to the first floor. There is a lounge and a lounge/dining area. There are assisted bathing facilities and a well maintained garden. Auchinlea can provide a service for up to 20 older people, including a maximum of 4 places for respite care. At the time of the inspection there were 19 people using the service. What people told us An inspection volunteer was involved in this inspection. This is someone who uses, or has used services or an unpaid carer, who volunteer to take part in inspections. They talk to people who use the service, relatives and friends and make observations based on their own personal experience. This information is used by the inspector to report on the service and award grades. The volunteer inspector spoke positively about the homely feeling within Auchinlea. For this inspection, we received views from 24 of the people using the service and relatives and carers. We received 16 care standards questionnaires from service users and relatives. They indicated satisfaction in the quality of care at Auchinlea. The following additional comments were made: "I am very happy with the care provided at Auchinlea. The staff are wonderful. The staff always have time for the residents. Although they're always busy, they always have time to make tea/coffee for visitors and residents. There is a comfortable homely feel to the place - not like an institution. I am kept up to date with everything that is going on with my mum. My family are happy with our decision to choose this particular home." "Lovely lounge, nice garden, glad I came" "More than expected. No complaints." "Settled and happy. Can't imagine going back home". "Very happy with room + lounge. Enjoy garden." "Very happy = good care and support given". "Clean/tidy. Enjoy the lounge area". "Yes, if not I would not stay = great care" [in response to question asking if they were happy about the quality of care]. "Enjoy being here. Happy" "Nice place very homely" "Happy to be here." "Care + support very good couldn't do without it". "Very clean and tidy. No complaints No smells" "Very good quality of care provided." page 2 of 12
"Good care - feel supported no complaints". Although not my own previous house I have settled well - staff work hard to keep me safe and secure" "Very happy + content." "Good care given to me. No complaints". More than happy with my room/garden/lounge. No complaints. Very happy good service provided." "I am very happy to know that I have staff there for me all day every day" Cosy clean, love the lounge for TV and chat". "Although not my home I have been made to feel at home." "Very comfortable. No complaints. Love my room and TV lounge. Great service." People we spoke with confirmed that staff were kind and helpful. Their wishes and preferences were taken into account. Positive comments were made about the accommodation, meals and particular activities, including musical entertainment and pet therapy. One relative thought their family member may like to go out more. The manager agreed to follow this up. Self assessment The provider was not asked to submit a self-assessment prior to this inspection. Areas where developments were planned were reflected in the staff training plan and an environmental refurbishment schedule. An overall service development plan may be beneficial. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership 4 - Good 4 - Good 4 - Good 4 - Good Quality of care and support Findings from the inspection Auchinlea is a homely and welcoming service. There was a stable staff team who knew the residents in their care well. Throughout the inspection we observed positive interactions and a good staff presence. This allowed staff to monitor and respond to the resident's needs. Formal risk assessments were used to monitor aspects of health. Personal plans gave detail of each individuals support needs and how they like them to be met. Daily notes of people's well-being and presentation and a brief handover note were made. This helped keep staff informed of the needs of the residents. Records showed that residents had been referred to a range of health professionals. The manager advised that they were well supported by the local GP, nurse practitioner and community nurses. Anticipatory care plans were being reviewed. This helped ensure individual's heath needs were met. page 3 of 12
The manager maintained a register of legal documents including Power of Attorney, Guardianship Orders, Section 47 consent to treatment certificates in accordance with best practice guidance. The service employed an activity coordinator who planned a range of group and individual activities. Residents spoke positively about this. Nutrition was well-managed. The catering staff knew people's dietary needs and accommodated their preferences. Weights were monitored and records were kept to monitor the dietary intake of individuals who were causing concern. We saw that mangers had worked hard to improve medication management and recording. However, we were concerned that one individual's medication records did not appear to be accurate. The management agreed to look into this issue. We repeated a recommendation relating to this. (See recommendation 1) Requirements Number of requirements: 0 Recommendations Number of recommendations: 1 1. To promote health and wellbeing and comply with best practice guidance. Medication records must be improved to accurately reflect when prescribed medication has been administered and the reason for any omission. National Care Standards, care homes for older people - Standard 6: Support arrangements, Standard 5: Management and staffing and Standard 14: Keeping well - medication. Grade: 4 - good Quality of environment Findings from the inspection The care home was friendly and relaxed creating a warm and welcoming atmosphere. This helped make Auchinlea a pleasant place to live. All bedrooms were single. Most had an en suite which promoted privacy and dignity. We saw that residents were encouraged to personalise their bedrooms to make them more homely. Domestic and maintenance staff worked well to ensure that the accommodation was appropriately maintained, nicely presented and odour free. Equipment was serviced and checked to promote safety. There was a range of equipment to support the needs of the resident group. This included a call system, alert mats, a passenger and stair lift, pressure reliving mattresses and cushions. To promote comfort the provider had purchased new seating, additional profiling beds and moving and assisting equipment. page 4 of 12
To promote a pleasant living environment the provider had supplied a new lounge carpet that residents had chosen. Improved lighting and redecoration had brightened up the lounge space. The provider planned to improve the assisted bathing facilities. There was a small, secure and well maintained garden area. The management team acknowledged that communal space was limited. Most residents chose to use the main lounge area. This area was crowded at times. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good Quality of staffing Findings from the inspection There was a stable staff team at Auchinlea. This helped promote continuity of care. Through discussion it was clear that the staff knew the residents needs and preferences well. Training records showed that staff had access to a good range of training opportunities appropriate to the needs of the resident group. This included an ongoing SVQ training programme. The manager used a training matrix to highlight any gaps in training. These were being followed up with the individuals concerned. Staff meetings were held to communicate information to the staff team. Annual appraisals and regular one to one supervision sessions took place to support staff development. The manager planned to review the supervision policy to introduce some group supervision to target specific areas of practice. Recruitment records showed that safe recruitment procedures were followed. There was a staff induction programme to support new staff in their role. The manager checked that staff were appropriately registered with the Scottish Social Services Council. Staff returned questionnaires to us. These indicated that the staff felt well supported by the manager and there were no unmet training needs. Overall, we noted an improvement in staff morale. We found staff were attentive to the needs of the residents. Residents and staff engaged positively. Interactions were kind and caring. page 5 of 12
Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good Quality of management and leadership Findings from the inspection Since the last inspection the managers had worked hard to improve record keeping. Overall, this was more organised. The manager continued to complete a range of audits to monitor standards across all areas of the care home. The external manager was involved in completing and reviewing audit material. We suggested that quality assurance processes be reviewed to ensure that checks remained relevant and were being used to inform practice. The managers accepted that improvements could be made in this area. There was a good system of recording, receipting and auditing money that the service held securely on behalf of service users. The manager attended meetings with other managers within the company and had established links with peers in the local area. This provided an element of support and promoted sharing of good practice. An open door policy and a regular meeting schedule with residents, relatives and staff facilitated effective communication channels. It was evident that the manager enjoyed a good rapport with residents and relatives. This helped the manager to resolve any issues promptly and ensure ongoing satisfaction. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good page 6 of 12
What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 Personal plans must record how to suitably manage behaviour that may be challenging in order to safeguard the service users. To do this, they must: Implement the policies to ensure that they reflect best practice in relation to a planned and consistent approach to care. Take account of triggers and interventions to de-escalate distressed reactions. Include any current medication used to manage the care need and its criteria for use in that individual and any monitoring required following administration of prescribed medication. This is to comply with:the Social Care and Social Work Improvement Scotland (Requirements for Care Services) regulations (SSI 2011/210). Regulations 4 (1) (a). Timescale: to commence within 24 hours and be completed by 31 March 2015. This requirement was made on 21 November 2016. Action taken on previous requirement At previous inspections this requirement could not be evaluated as none of the residents presented with distressed reactions or behaviour that may be challenging. This remains the case. The manager acknowledged that limited public space impacted on their ability to meet the needs of individuals who present with distressed reactions. The manager has taken this into account when conducting pre admission assessments. The staff team have attended training in dementia and in managing challenging behaviour. Further training was scheduled. On balance, we have discontinued this requirement. We will follow this up during the course of future inspections. Met - outwith timescales page 7 of 12
What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 Records used to monitor individuals fluid and dietary intake and positional changes should be accurately completed and contain good detail. National Care Standards, care homes for older people - Standard 13: Eating well. This recommendation was made on 21 November 2016. Action taken on previous recommendation We found that positional changes, food and fluid records overall, were well maintained. This recommendation is: met. Recommendation 2 Medication records should be improved to accurately reflect when prescribed medication has been administered and the reason for any omission. National Care Standards, care homes for older people - Standard 6: Support arrangements, Standard 5: Management and staffing and Standard 14: Keeping well - medication. This recommendation was made on 21 November 2016. Action taken on previous recommendation This recommendation is: not met and therefore, repeated. Please see the care and support theme. 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 8 of 12
Inspection and grading history Date Type Gradings 23 Mar 2017 Unannounced Care and support Management and leadership 6 Oct 2016 Unannounced Care and support Management and leadership 26 Nov 2015 Unannounced Care and support Management and leadership 29 May 2015 Unannounced Care and support 4 - Good 4 - Good Management and leadership 29 Jan 2015 Unannounced Care and support Management and leadership 4 - Good 23 May 2014 Unannounced Care and support 4 - Good Management and leadership 4 - Good 24 Jan 2014 Unannounced Care and support Management and leadership 5 Nov 2013 Unannounced Care and support 1 - Unsatisfactory 1 - Unsatisfactory page 9 of 12
Date Type Gradings Management and leadership 2 - Weak 23 Apr 2013 Unannounced Care and support Management and leadership 29 Nov 2012 Unannounced Care and support Management and leadership 4 - Good 25 Oct 2012 Re-grade Care and support Management and leadership 7 Jun 2012 Unannounced Care and support 2 - Weak Management and leadership 15 Nov 2011 Unannounced Care and support Management and leadership 4 - Good 9 Jun 2011 Unannounced Care and support 4 - Good 2 - Weak Management and leadership 4 - Good 12 Jan 2011 Unannounced Care and support 4 - Good Management and leadership 6 Jul 2010 Announced Care and support 4 - Good page 10 of 12
Date Type Gradings Management and leadership 5 Feb 2010 Unannounced Care and support 4 - Good Management and leadership 21 Aug 2009 Announced Care and support 4 - Good 2 - Weak 4 - Good Management and leadership 4 - Good 9 Mar 2009 Unannounced Care and support Management and leadership 4 Sep 2008 Announced Care and support 2 - Weak Management and leadership 2 - Weak page 11 of 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 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 12 of 12