Castle View Nursing Home Care Home Service 200 Castlegreen Street Dumbarton G82 1JU Telephone: 01389 764 700 Type of inspection: Unannounced Inspection completed on: 14 November 2017 Service provided by: HC-One Limited Service provider number: SP2011011682 Care service number: CS2011300851
About the service The provider is HC-One Limited and the service first registered with the Care Inspectorate on 31 October 2011. Castle View is a purpose built two storey care home situated in a quiet residential area of Dumbarton. The home is set within its own grounds with ample parking facilities to the front and spacious garden areas surrounding the home. All bedrooms have en-suite facilities and there is a variety of lounges, quiet sitting areas and dining areas available to residents. It is close to local amenities and transport. The home provides nursing care for a maximum of 60 people, namely 11 people under the age of 65 with physical disabilities; 19 frail older people on ground floor; and 30 older people living with dementia in two units upstairs, split into a 20 bed unit and a 10 bed unit. The service has one respite bed in their dementia unit to provide a short stay respite facility. There were 58 people using the service during our visit plus one person on a respite break. The stated aim of the service is: 'Our aim at HC-One is to have the kindest homes in the UK with the kindest and most professional staff. We are a company founded on the principles of involvement, accountability and partnership'. What people told us We met 18 residents and 12 relatives during our visit. With the exception of one resident, all other residents expressed very positive feelings about the staff and care provided. The one resident who was unhappy said they were bored but declined to participate in the activities programme. Comments from residents included: 'I am very lucky here it's great' 'You can ask them anything and they'll help you' 'It's great here. Food is very good too' 'I'm happy here staff are all so nice' 'I am fine here no problems. I've got a lovely room with a view of the garden'. Some of the residents were full of praise for the maintenance operative who they said was very nice and had helped them in a number of ways. With the exception of one relative who was unhappy with some elements of their loved one's care other relatives gave very good feedback. The relative who was unhappy gave permission for us to discuss their concerns with management which we did. Management will arrange to meet with this relative. Comments from relatives include: 'They are great here. They helped my husband to get to our grandson's wedding' page 2 of 7
'Mum's settled in really well. She loves it' 'The staff are excellent and friendly and very good for my wife. She can't communicate verbally but the staff always know what she wants by her actions. I have always been content that my wife is getting looked after very well in the home' 'Staff are approachable, helpful and kind any concerns are quickly addressed and resolved'. Self assessment The Care Inspectorate did not require services to submit a self assessment for this year's inspection. 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 5 - Very Good not assessed What the service does well The manager always spends time when they are on duty speaking to residents and relatives to make sure they are happy with the care provided. Families can meet with management at weekends or evenings if that is their preference to discuss any concerns they may have. There is a robust complaints procedure in place to help resolve any matters which may arise. Throughout our visit we experienced a calm relaxed atmosphere. Staff were skilled at comforting and calming people who were distressed offering very good support. Residents told us staff cared for them with compassion and respect and they had confidence in staff. Residents were included in discussions regarding their care needs and could contribute to their care plan. The service regularly consulted with residents and relatives regarding service development. Good nutrition is essential to residents' wellbeing. There were regular opportunities for residents to give feedback regarding: meal quality, choice and portion size. A good range of snacks and drinks were readily available. Staff provided good support and encouragement to residents who required help to have their meal. A new activity coordinator was due to start to complement the current activities programme. A comprehensive and varied activities programme supported residents to pursue their hobbies such as gardening, enjoy music, singing and dancing. Regular visits from local nurseries and schools kept residents engaged with their surrounding community. The service had its own mini bus therefore residents were able to attend local community events. We were impressed by how well staff interacted with residents encouraging them to be active and meaningfully engaged in daily life. This promoted physical and mental wellbeing. Residents were able to spend more time outdoors now that the garden was improved. Residents who enjoyed gardening were helping tend flower and plants thus keeping them active and healthy. page 3 of 7
Each resident had regular risk assessments undertaken to help staff monitor residents' progress. Staff liaised closely with other health professionals to make sure residents got all the care they needed. The provider offered a good range of staff training. This includes appropriate levels of dementia training to support staff working with people living with dementia. The new nursing assistant role is proving beneficial in that it frees up nurses time to deal with more complex medical issues. What the service could do better The service is currently without a depute manager. Two nursing staff were given time off the floor to assist the manager. Once the depute manager is in post staff supervisions and appraisals will be brought up-to-date. One resident had a serious pressure ulcer when they first came to the home. Good nursing care had proved successful and the ulcer had now healed. Staff need to ensure they record information accurately as the documentation did not reflect the grade of ulcer seen. Following discussion with management they agreed in future to maintain photographic records of the healing process to evidence the progress achieved. Some residents required positional changes to protect their skin. Staff should ensure accurate records for positional changes are recorded. Where 'as required medication' (PRN) is given staff had not always recorded the effect the medication had. Staff should ensure this is recorded in the medication record. One person was prescribed pain relief on an as required basis but had it administered daily. This suggested the need for a GP medication review. We discussed this with the manager to take forward. Staff should ensure that medication protocols are signed and dated by the GP and reviewed yearly. Staff should also ensure the information in the protocol is accurate. Staff daily recordings overly focused on physical tasks and should be more person centred focusing on achieving good outcomes for residents. The manager will arrange training for staff on outcomes focused recording. Management had agreed to improve their auditing of care plans to better evidence resident participation in activities and ensure issues raised at reviews are being addressed. The service has robust quality assurance systems in place. However, some medication audits identified instances where staff had not properly signed off on medication given or coded correctly if not given. The manager will revisit this issue with all staff who administer medication. Some issues had arisen recently for people on short respite breaks. Part of the problems seemed to stem from the service not having been given fully up-to-date care assessments by social work. It is important that prior to admission the service has a fully up-to-date holistic assessment of the person's care needs. Management will discuss this matter with social work to ensure assessments reflect a person's full range of care needs. The Young Physically Disabled unit is caring for a number of people who are long term residents and growing older. Their medical conditions are often complex and their ability to participate in previously organised physical and social activities is now more limited. The service is considering installing sensory equipment. See Recommendation 1. page 4 of 7
Requirements Number of requirements: 0 Recommendations Number of recommendations: 1 1. The provider should undertake a full review of the Young Physically Disabled (YPD) unit to ensure that people living there have the support they need to achieve their maximum potential. National Care Standards - Care Homes for Older People - Standard 5 - Management and staffing arrangements - and - Standard 14 - Keeping well healthcare - and Standard 17 - Daily life. 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 16 Aug 2016 Unannounced Care and support 5 - Very good Not assessed Not assessed Management and leadership 5 - Very good 8 Oct 2015 Unannounced Care and support 5 - Very good 5 - Very good 5 - Very good Management and leadership 5 - Very good 3 Mar 2015 Unannounced Care and support 5 - Very good Management and leadership 10 Oct 2014 Unannounced Care and support page 5 of 7
Date Type Gradings Management and leadership 11 Feb 2014 Unannounced Care and support 5 - Very good 5 - Very good Management and leadership 5 - Very good 8 Feb 2013 Unannounced Care and support 5 - Very good Management and leadership 20 Aug 2012 Unannounced Care and support Management and leadership 27 Mar 2012 Unannounced Care and support Management and leadership 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