Castle Lodge Nursing Home Care Home Service Kirkburn Inverbervie Montrose DD10 0RS Telephone: 01561 361206 Type of inspection: Unannounced Completed on: 18 June 2018 Service provided by: Thomas Dailey trading as Kennedy Care Group Service provider number: SP2003003646 Service no: CS2007158513
About the service Castle Lodge Nursing Home is registered to provide nursing care to up to 21 older people. The service is part of the Kennedy Care Group and has been registered with the Care Inspectorate on 1 April 2011. The home is situated in the seaside town of Inverbervie, near to local amenities, and is convenient for local services and public transport. Accommodation is provided from a two-storey building which holds a prominent position overlooking the seafront, offering spectacular views to the beach and out to the sea. The home is accessible via a passenger lift to all areas. The aims and objectives for the service were: "We aim to develop the highest quality of care for residents in the safest and most efficient way." What people told us We received back 18 out of 20 Care Standards Questionnaires (CSQs) we sent to the service to randomly distribute to service users and their families and friends. We asked their views on 25 quality statements about the service's care, environment, staffing and management. Most returns highlighted that people strongly agreed that the quality of care was of a good standard. We spent time speaking with people at the service and relatives during the inspection. We also received eight questionnaires from staff, who said felt very supported by the management team. Comments and feedback in these CSQs and in person included: From people in the service: - it's very comfy here - I like it here, everyone is so nice - no complaints - the staff are very good - I'm treated with respect by everyone - I would like to do more gardening - the food is very nice, always a choice - always something to do - staff are kind - I love the view from my bedroom. From relatives: - the quality of care is excellent - it was a relief to find a nice care home - everyone is just like an extended member of the family - the staff interact with everyone really well - it's a smashing place - it seems things are on the up - I can speak to any of the staff if I had a concern. page 2 of 11
From staff: - it's much better - everyone works together - it's a happy place to work now - the training is very good - I feel supported by the manager - it's a great place to work, really friendly - very friendly team, which impacts on residents - manager is exceptionally approachable, always visible, always around. - I think it's' a great home and everyone seems happy here, the manager and depute are always happy to help with any questions I have. - I am very happy for the residents and staff that we now have a new manager, who we all find supports us all and had made a very good job in making the home a happy place for all; also have a deputy who is very good with all aspects of work, keeping everyone motivated. Self assessment Every year all care services must complete a 'self-assessment' form telling us how their service is performing. A self-assessment was not required to be completed at this inspection, however the service spoke about their goals and aspirations for the forthcoming year. The service was presently further developing an improvement plan which was discussed at the 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 not assessed not assessed Quality of care and support Findings from the inspection We found the performance of the service for quality theme care and support to be good. Staff were familiar with people as individuals and delivered their care in a way that respected their personal preferences and choices. People were supported to be independent and to make choices, according to their abilities. Where people could not express their wishes clearly, we saw that staff took time to understand what they wanted. Interaction with others was encouraged and family and friends were welcomed into the home. People knew that they could approach the manager at any time to discuss any concerns or to make suggestions about the service. Resident and relatives' meetings had continued to provide a forum for people to get together and discuss the service, what was going well and what people would like to see change. page 3 of 11
The minutes of meetings reflected that people who lived at Castle Lodge were encouraged to express their views. We saw where suggestions had been made, that these had been acted upon and changes made. People were involved in the planning and reviewing of their support. Some people had been appointed a guardian or power of attorney to help and advice about decisions that may impact on their welfare. It was clear in care plans where there were restrictions on peoples' independence, control, choices, and the agreements made with legal representatives. People could choose from a range of activities arranged within the home if they wanted to. Some of these were group activities but we heard that staff took time to spend time with people on an individual basis if this was preferred. People were encouraged to play a part in the community, and helped to support a community shop. The service is looking at further developing meaningful interests for the mens' group. This development continues. Through speaking with staff and observing practice, we saw that staff demonstrated a good understanding of the individual needs of people. Care plan records highlighted the assessment, planning and evaluation of care. Care plans were very personal centred, making it easier for staff to understand how to support people. People felt that the support they received was meeting their needs. What the service can do better: The service has progressed well and the team are striving to make improvements across the service. However, there is a need to continue with this approach, and ensure the successes and improvements continue, and are embedded and sustained. The manager said: "there was still work to be done, and that the team were looking forward to further developing and implementing their house improvement plan". Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good Quality of environment This quality theme was not assessed. Quality of staffing This quality theme was not assessed. page 4 of 11
Quality of management and leadership Findings from the inspection We found the performance of the service for Quality Theme Management and Leadership to be good. People had confidence that the service was being well-led and managed. The new manager had been in post since our last inspection, which was helping to drive forward improvements in the service. We saw that the entire team was working well together to provide better outcomes for people. Residents, relatives and staff told us they had seen improvements. levels had improved, the teams worked better, communication had improved, training was good and staff said they felt more confident in their role. Staff said they felt more valued as individuals and as a team. We saw that staff now actively played a part in suggesting ideas for the service. Training was better evaluated, supervision was more meaningful and staff were reflecting more about practice and the difference their approach could make to outcomes for people at Castle Lodge. Staff were very familiar with the Scottish Social Services' (SSSC) Codes of Practice. We saw that all staff and management were registered with the appropriate professional body and the provider followed safe recruitment procedures. Quality assurance was enabled through the undertaking of a number of audits. These were used to identify areas of good practice or development actions needed. Examples included: care records, accident/incident, observation of practice and medication. We discussed with staff and management various best practice initiatives including accessing websites such as the Care Inspectorate 'The Hub', Social Services Knowledge Scotland, 'Step into Leadership pathway', 'The badges scheme', Supervision Learning resource and other Scottish Social Services Council literature. We asked the management to share these good practice guides with the team and left information. What the service can do better While we evidenced improvements across the service, there is a need to continue with this approach, and ensure the successes and improvements continue, and are embedded and sustained. The manager said that there was still work to be done and the team were looking forward to further developing and implementing their house improvement plan. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good page 5 of 11
What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 The provider must ensure the needs of the service users guide and direct staff practice. In order to achieve this, the service must introduce planned strategies to ensure support plans are used to influence staff practice and that these: (i) Accurately reflect the assessed need and the required care and support to be delivered by staff to meet that assessed need. (ii) Use all available information to inform and influence these support plans. For example, nutrition, falls, pressure, and continence assessments. (iii) Be outcome-focussed, highlighting the strengths and abilities of service users. This is in order to comply with: The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011, (SSI 210/2011) Regulation 4(1)(a): Welfare of Users; and Regulation 5(1): Personal Plans. This requirement should also take account of: National Care Standards care homes for older people. Standard 5: management and staffing arrangements; standard 6: supporting arrangements; standard 11: expressing your views. Timescale for completion - 30 October 2017. This requirement was made on 13 September 2017. Action taken on previous requirement We evidenced a marked improvement in the detailing of care plans. They were more person-centred and evaluative. Plans were better detailed in highlighting assessed need and how to support people. We saw that there was much clearer direction by the provider and management team and the entire team were working better together. There was an improvement plan in place to audit the service and an action plan to ensure improvements continue. Staff practice was clearly monitored and reflective accounts were encouraged after training or practice sessions. This requirement has been met. Met - outwith timescales page 6 of 11
Requirement 2 The provider must ensure that quality assurance systems are fully implemented for the effective monitoring of the service provision. Any deficiencies highlighted should be fully recorded and include an action plan of how these are to be addressed, by whom and when they are to be completed by. This is in order to comply with: The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011, (SSI 210/2011) Regulation 4(1)(a): Welfare of Users. Timescale for completion - 30 October 2017. This requirement was made on 13 September 2017. Action taken on previous requirement The provider, manager and staff team have implemented quality audit systems for the effective monitoring of the service provision. We saw that the systems in operation were meaningful, and measurable. An improvement plan was in operation to address any issues. The plan was also used by the service and team to highlight successes and achievements. Although this requirement has been met, the service recognises that there is a need to further develop some systems and has developed an action plan to make further progress. Met - outwith timescales What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 It is recommended that care planning is reviewed and updated to ensure records reflect the choices and preferences of the people being supported. Plans should be sufficiently detailed to guide staff on the interventions required to support and improve agreed outcomes. Plans should also include, where appropriate, detailed strategies to support residents who displayed stress or distress reactions. National Care Standards, Care Homes for Older People. Standard 6: supporting arrangements. This recommendation was made on 13 September 2017. Action taken on previous recommendation We saw a clear improvement in the detailing of care plan. They were more person-centred, highlighted assessed needs and how staff would support such needs. Plans were now regularly reviewed by the team and an audit system was in place to monitor documentation. Although this recommendation has been met, there is a need to ensure this practice continues. page 7 of 11
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. Inspection and grading history Date Type Gradings 10 Nov 2017 Unannounced Care and support 22 Jun 2017 Unannounced Care and support 1 Dec 2016 Unannounced Care and support 2 - Weak 22 Feb 2016 Unannounced Care and support 18 Sep 2015 Unannounced Care and support 5 - Very good page 8 of 11
Date Type Gradings 20 Mar 2015 Unannounced Care and support 5 - Very good 5 - Very good 19 Jun 2014 Unannounced Care and support 17 May 2013 Unannounced Care and support 24 May 2012 Unannounced Care and support 5 - Very good 26 Oct 2011 Unannounced Care and support 5 - Very good 5 - Very good 18 May 2011 Unannounced Care and support 29 Sep 2010 Unannounced Care and support 19 May 2010 Unannounced Care and support 2 - Weak page 9 of 11
Date Type Gradings 7 Oct 2009 Announced Care and support 11 May 2009 Unannounced Care and support 26 Nov 2008 Unannounced Care and support 16 Jun 2008 Announced Care and support 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