Seaton Grove Care Home Service Adults Seaton Road Arbroath DD11 5DT Telephone:

Seaton Grove Care Home Service Adults Seaton Road Arbroath DD11 5DT Telephone: 01241 873733 Inspected by: Timothy Taylor Type of inspection: Unannounced Inspection completed on: 18 September 2012

Contents Page No Summary 3 1 About the service we inspected 4 2 How we inspected this service 6 3 The inspection 10 4 Other information 21 5 Summary of grades 22 6 Inspection and grading history 22 Service provided by: Angus Council Service provider number: SP2003000043 Care service number: CS2003000362 Contact details for the inspector who inspected this service: Timothy Taylor Telephone 01382 207200 Email enquiries@careinspectorate.com Seaton Grove, page 2 of 24

Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 5 Very Good Quality of Environment 6 Excellent Quality of Staffing 6 Excellent Quality of Management and Leadership 5 Very Good What the service does well This is a good all-round service which provides residential care and high dependency care for older people. Staff are well liked by residents and provide a relaxed and professional environment. What the service could do better The service should ensure that staffing levels in the high dependency units remain high at all times and that they assess service users needs and use this to adjust staffing levels when necessary. What the service has done since the last inspection Plans have been approved to extend the social areas of the high dependency units as well as some re-utilising of existing rooms to make better use of them. The daycare part of the home will also be re-modelled. The current manager is retiring soon. Conclusion This is a high quality service. Who did this inspection Timothy Taylor Seaton Grove, page 3 of 24

1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Prior to 1 April 2011, this function was carried out by the Care Commission. Information in relation to all care services is available on our website at www.careinspectorate.com. The Care Inspectorate will award grades for services based on findings of inspections. Grades for this service may change after this inspection if we have to take enforcement action to make the service improve, or if we uphold or partially uphold a complaint that we investigate. Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve its service, we may make a recommendation or requirement. - A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service but where failure to do so will not directly result in enforcement. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reforms (Scotland) Act 2010 and Regulations or Orders made under the Act, or a condition of registration. Where there are breaches of the Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Inspectorate." Seaton Grove is a 48 bedded unit for older people with residential needs. It provides a warm and friendly environment where service users are encouraged to have their say and participate in the day to day activities of the home. It caters for respite long term and high dependency service users. Seaton Grove, page 4 of 24

Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 5 - Very Good Quality of Environment - Grade 6 - Excellent Quality of Staffing - Grade 6 - Excellent Quality of Management and Leadership - Grade 5 - Very Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website www.careinspectorate.com or by calling us on 0845 600 9527 or visiting one of our offices. Seaton Grove, page 5 of 24

2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care. What we did during the inspection This report was written following an unannounced inspection that took place on 18 September 2012. During the inspection evidence was gathered from a number of sources including: Informal discussion with service users. Informal discussion with relative/carers. A review of service users personal plan documentation. Discussion with staff. Observation of staff interaction with residents. Observation of the environment. Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Seaton Grove, page 6 of 24

Fire safety issues Inspection report continued We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org Seaton Grove, page 7 of 24

The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. A comprehensive self assessment was submitted by the service. Taking the views of people using the care service into account On the day of inspection 4 service users were spoken with in regard to the service. The views they expressed were all very positive. Here are some of the comments made:- I have no complaints whatsoever. The food is great and there are plenty of choices. The staff always knock on my door before coming into my room. The staff are lovely - they always treat me with respect. I have made a lot of friends here. Seaton Grove, page 8 of 24

Inspection report continued Taking carers' views into account On the whole views expressed about the service where very positive. 11 care service questionnaires were received by the Inspectorate from relatives/carers and on the day 2 visitors were spoken with. Here are some of their comments. I cannot praise Seaton Grove enough. Since coming to Seaton Grove I can honestly say that my mother is happier than she has been for years. The care home has a warm friendly feel. The range of activities offered are excellent. The staff are quick to respond to any noticed need. Very high standard of care. Her (my mother's) keyworker is a very pleasant caring person who understands my mother and her needs. The staff are brilliant, the place is spotless and grounds well kept. The staff are kind and supportive to family members. Sometimes I feel that the unit (high dependency) could have an extra member of staff. Seaton Grove, page 9 of 24

3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths The service provides residents with a high level of participation. The forums it provides are applicable to getting feedback on quality of care. Here are some examples of strengths:- Service users and carers participate in reviews, assessments, meetings and personal plans all relating to the care they would like to receive. Staff all undertake SVQ assessment which places an emphasis on choices and rights for service users. Service users participate in a self-evaluation focus group which contributes to the home's self evaluation as submitted to the Care Inspectorate. The home is developing the Talking Point tool which asks stake holders for their views on what they would like to see the service doing. There is a newsletter which has stakeholders on its editorial group. There are regular resident's meetings. Consultation is part of how the home operates on all levels. The home has a suggestions box as well as a complaints procedure. Residents can participate in the running of the home if they choose. On the day of inspection residents were folding napkins for lunch and were enjoying themselves. Care managers who have helped situate service users in the home are consulted on their views of the service. The service has developed an action plan to record issues and set dates for completion. Seaton Grove, page 10 of 24

Areas for improvement The service should continue to promote the high standard of participation by stakeholders that it has achieved. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Inspection report continued Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths The service provides a good level support for resident's health and wellbeing. Here are some of its many strengths:- All residents have risk assessments done for falls, nutrition and any other needs that they might have. The home has developed a final care plan designed to best support residents who are dying. Residents are given access to outside agencies i.e. GP,district nursing services,chiropodist, dentist, physiotherapist, dietitians and the community mental health team. All staff that administer medication are trained to do so. Individual care plans detailing health and wellbeing needs are in place for each resident. A random check of care plans showed them to be easy to read and to be individualised for each person. Staff have had training in dementia,continence care,palliative care, visual awareness, food hygiene,moving & handling, activities, oral hygiene for the elderly, deafness, and other relevant courses. Observation of practice within the home showed a staff group who knew each person's needs. There was evidence of trips out, musical events, exercise classes and activities such as quizzes, church services and cooking. There was evidence of assistance with physical exercise - walks and exercise classes. Fresh fruit and drinks were available throughout the home and throughout the day. The catering staff are aware of service user's dietary needs. Feedback from residents and carers was very positive in relation to the care that people receive in the home. Seaton Grove, page 11 of 24

Inspection report continued Areas for improvement Several members of staff and one person in a questionnaire which was returned to the Care Inspectorate commented on the staffing levels in the high dependency units - which were felt to be too low on occasion. These units where observed and it was noted that when staff were on a break that this could leave only one person in the unit to see to the needs of people high levels of dependency. Although there are designated floating members of staff in the home who can cover if asked for they are not always automatically there. The service should review how its covers breaks to ensure staffing levels in the high dependency units do not fall too low. See requirement 1. Related to the above issue is the question of dependency scores. The home does carry out an exercise to measure the dependency level of each service user but it is not clear what happens with this information. The current staffing schedule reminds the service that the provider shall ensure that the needs of service users are being met at all times. This may require an increase in staffing at given times... It is suggested that the home uses the information it gathers form its dependency scores to review staffing levels in the high dependency units to see if they feel they need adjusting. This should be done in an ongoing way so that the service can demonstrate that its staffing levels meet the current needs of its service users. See recommendation 1. Grade awarded for this statement: 4 - Good Number of requirements: 1 Number of recommendations: 1 Requirements 1. The service should review how its covers breaks to ensure staffing levels in the high dependency units do not fall too low. The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 Staffing 15. A provider must, having regard to the size and nature of the care service, the statement of aims and objectives and the number and needs of service users- (a)ensure that at all times suitably qualified and competent persons are working in the care service in such numbers as are appropriate for the health, welfare and safety of service users. Timescale: With immediate effect. Seaton Grove, page 12 of 24

Recommendations Inspection report continued 1. It is suggested that the home uses the information it gathers form its dependency scores to review staffing levels in the high dependency units to see if they need adjusting and that this be a continual regular process. See NCS 5 Care Homes for Older People - Management and Staffing Arrangements. 7 You are confident that at all times the number of staff who are trained and who have the necessary skills will be sufficient to meet your support and care needs. Seaton Grove, page 13 of 24

Quality Theme 2: Quality of Environment Grade awarded for this theme: 6 - Excellent Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the environment within the service. Service strengths The service provides residents with a high level of participation. The forums it provides are applicable to getting feedback on quality of environment. Here are some examples of strengths:- Service users and carers participate in reviews, assessments, meetings and personal plans all relating to the care they would like to receive. Staff all undertake SVQ assessment which places an emphasis on choices and rights for service users. Service users participate in a self-evaluation focus group which contributes to the home's self evaluation as submitted to the Care Inspectorate. The home is developing the Talking Point tool which asks stake holders for their views on what they would like to see the service doing. There is a newsletter which has stakeholders on its editorial group. There are regular resident's meetings. Consultation is part of how the home operates on all levels. The home has a suggestions box as well as a complaints procedure. Residents can participate in the running of the home if they choose. On the day of inspection residents were folding napkins for lunch and were enjoying themselves. Care managers who have helped situate service users in the home are consulted on their views of the service. The service has developed an action plan to record issues and set dates for completion. Areas for improvement The service should continue to promote the high standard of participation by stakeholders that it has achieved. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Seaton Grove, page 14 of 24

Statement 2 We make sure that the environment is safe and service users are protected. Service strengths Inspection report continued The service provides a very good level of security and protection for service users. Here is some evidence of its strengths:- Policies are in place for recording accidents and incidents. The manager monitors these using a risk assessment tool. Staff have all the healthcare and infection control equipment they need for working with vulnerable older people. Staff interviewed confirmed that there were always enough protective gloves and aprons available. The home has a restraint policy which involves risk assessment. The home has regular health and safety audits done to ensure the environment is safe for its users. Call system alarms are attached to all external doors so that staff are aware when an outside door has been opened and can investigate to ensure the safety of residents. The home is covered by public liability insurance. The home has regular fire service checks and all staff are trained in fire evacuation drills. Each service user has their own evacuation plan. On the day of inspection the fire alarm system was being tested and serviced. Residents have a call system in their room should they need assistance. When interviewed residents stated that they felt safe within the home and that when staff assisted them with personal care it was done in a professional and secure manner. Observation of the environment of the home showed it to be clean, bright and well maintained. There were safe and well maintained areas of the grounds where residents could walk and sit. Areas for improvement The service should continue to seek ways to improve safety within the environment of the home. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Seaton Grove, page 15 of 24

Quality Theme 3: Quality of Staffing Grade awarded for this theme: 6 - Excellent Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service Strengths The service provides residents with a high level of participation. The forums it provides are applicable to getting feedback on quality of staff. Here are some examples of strengths:- Service users and carers participate in reviews, assessments, meetings and personal plans all relating to the care they would like to receive. Staff all undertake SVQ assessment which places an emphasis on choices and rights for service users. Service users participate in a self-evaluation focus group which contributes to the home's self evaluation as submitted to the Care Inspectorate. The home is developing the Talking Point tool which asks stake holders for their views on what they would like to see the service doing. There is a newsletter which has stakeholders on its editorial group. There are regular resident's meetings. Consultation is part of how the home operates on all levels. The home has a suggestions box as well as a complaints procedure. Residents can participate in the running of the home if they choose. On the day of inspection residents were folding napkins for lunch and were enjoying themselves. Care managers who have helped situate service users in the home are consulted on their views of the service. The service has developed an action plan to record issues and set dates for completion. Areas for improvement The service should continue to promote the high standard of participation by stakeholders that it has achieved. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Seaton Grove, page 16 of 24

Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Inspection report continued The service has a very good level quality in its workforce. Here are some points of evidence of their strengths:- Angus council supports its staff through the provision of physiotherapy, stress management and counselling services. They are also an accredited Investors In People employer. Staff are encouraged to undertake work shadowing other staff with different roles to further their skills and knowledge. The members of staff who were interviewed had received a lot of training. Several were on a 12 week dementia course. Those who dispensed medication had all been trained in administration of medication. Other training quoted, and recorded in the home's training records, were:- infection control, moving and handling, palliative care, nutrition awareness, food hygiene and first aid. Observation of staff practice showed a high level of interaction with residents and the offering of choices. It was clear that staff respected residents and acted to enable them to do what they wanted to do. Staff were reported by residents to always knock on bedroom doors before entering. This was also observed. The home has a rolling programme of staff undertaking SVQ qualifications. Most had a level 2 or 3 SVQ in care. Staff confirmed they had regular staff meetings at which they could make suggestions about improving care. Examples of this were given. Staff meetings take place soon after residents meetings so that any issues raised at them can be discussed and actioned. All staff interviewed confirmed that they had received annual appraisal which looked at how they could develop their skills as care workers. Staff were aware of the values contained within the National Care Standards (NCS) and felt they carried them out. Residents who were interviewed felt their privacy and dignity were respected by staff. Observation showed that staff appeared happy and relaxed in their roles and enjoyed good relationships with residents. The manager of the home attends a monthly network meeting with other home managers. This allows for sharing of knowledge and support. Seaton Grove, page 17 of 24

Areas for improvement The service should continue to invest in its staff who are of a very high standard. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Seaton Grove, page 18 of 24

Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths The service provides residents with a high level of participation. The forums it provides are applicable to getting feedback on quality of management. Here are some examples of strengths:- Service users and carers participate in reviews, assessments, meetings and personal plans all relating to the care they would like to receive. Staff all undertake SVQ assessment which places an emphasis on choices and rights for service users. Service users participate in a self-evaluation focus group which contributes to the home's self evaluation as submitted to the Care Inspectorate. The home is developing the Talking Point tool which asks stake holders for their views on what they would like to see the service doing. There is a newsletter which has stakeholders on its editorial group. There are regular resident's meetings. Consultation is part of how the home operates on all levels. The home has a suggestions box as well as a complaints procedure. Residents can participate in the running of the home if they choose. On the day of inspection residents were folding napkins for lunch and were enjoying themselves. Care managers who have helped situate service users in the home are consulted on their views of the service. The service has developed an action plan to record issues and set dates for completion. Areas for improvement The service should continue to promote the high standard of participation by stakeholders that it has achieved. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Seaton Grove, page 19 of 24

Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide. Service strengths Inspection report continued The service has a good quality assurance system. Here are some of the strengths:- The home has an integrated set of quality assurance mechanisms in relation to budget, risk, recruitment, training of staff and participation. Environmental health do regular checks of the kitchens. A record is kept of staff training and any refresher courses they need to complete. Staff attend regular staff meetings, get supervision and get annual appraisals. Staff who are required to - are registered with the SSSC. Records of accidents and incidents are kept and monitored by the manager. regular environmental risk assessments take place as well as fire drills and fire training. The service has a very good participation process which ensures residents and relatives have a say in the quality of the home. Care planning for residents is comprehensive and individualised. Relatives, representatives and service users have a say in their care at review meetings. The home's external manager monitors a variety of aspects of the provision such as:- SVQ training for staff, repairs, Fire Service reports, environmental reports and does a health and safety visit to the home on a regular basis. Each year the manager of the home produces a management report which outlines the developments made by the service, the feedback it has gained form all the agencies that inspect and regulate it, outlines of staff development and training and future plans to develop the service. Areas for improvement The service should continue to ensure that quality is monitored throughout all areas of their practice. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Seaton Grove, page 20 of 24

4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information None noted Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1). Seaton Grove, page 21 of 24

5 Summary of grades Quality of Care and Support - 5 - Very Good Statement 1 Statement 3 6 - Excellent 4 - Good Quality of Environment - 6 - Excellent Statement 1 Statement 2 6 - Excellent 6 - Excellent Quality of Staffing - 6 - Excellent Statement 1 Statement 3 6 - Excellent 6 - Excellent Quality of Management and Leadership - 5 - Very Good Statement 1 Statement 4 6 - Excellent 5 - Very Good 6 Inspection and grading history Date Type Gradings 21 Jan 2011 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed 9 Sep 2010 Announced Care and support 6 - Excellent Environment 6 - Excellent Staffing Not Assessed Management and Leadership Not Assessed 23 Feb 2010 Unannounced Care and support 6 - Excellent Environment Not Assessed Staffing 5 - Very Good Management and Leadership Not Assessed Seaton Grove, page 22 of 24

30 Jul 2009 Announced Care and support 6 - Excellent Environment 6 - Excellent Staffing 5 - Very Good Management and Leadership 6 - Excellent 26 Jan 2009 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 3 Jun 2008 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Seaton Grove, page 23 of 24

To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on 0845 600 9527. This inspection report is published by the Care Inspectorate. You can get more copies of this report and others by downloading it from our website: www.careinspectorate.com or by telephoning 0845 600 9527. Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: 0845 600 9527 Email: enquiries@careinspectorate.com Web: www.careinspectorate.com Seaton Grove, page 24 of 24