Stobhill Nursing Home Care Home Service 70 Stobhill Road Glasgow G21 3TX Telephone: 0141 558 8500 Type of inspection: Unannounced Inspection completed on: 23 March 2017 Service provided by: Tamaris (RAM) Limited, a member of the Four Seasons Health Care Group Service provider number: SP2007009152 Care service number: CS2003010429
About the service we inspected Stobhill Care Home is registered to provide a care service to a maximum of 60 Older People. The home is run and managed by Tamaris (RAM) Limited, a member of the Four Seasons Health Care Group and has been registered with the Care Inspectorate since April 2002. The home is situated in the north of Glasgow in a residential area a short drive from the city centre. It is purpose built over two floors with a large enclosed garden area to the rear of the building. It has separate lounge/dining areas on each floor with a cafe/bar on the ground floor and a hairdressing room and small living room on the first floor. The service's stated aims are to provide the highest possible standards of care, with residents treated as individuals, with respect and dignity in a safe, comfortable and homely environment providing stimulation and encouraging independence. How we inspected the service We wrote this report following an unannounced inspection. Two inspectors carried out a visit to the home on Thursday 23 February 2017. A further visit was carried out to continue the inspection on Friday 3 March 2017. We gave feedback to the external and internal manager on Thursday 23 March 2017. During this inspection, we gathered information in different ways. We spoke with people living in the care home as well as visitors and staff who were on shift throughout our visits. We observed various aspects of people's experiences, staff practice and also the internal environment of the care home. We also looked at a range of records including care plans and related records such as, food and fluid charts, staff training and registration records and audits of the service. We used this information to assess what progress had been made on the requirements and recommendations made in the last inspection report. Taking the views of people using the service into account We received a range of feedback via care standards questionnaires and talking with people during the inspection process. " It is very good." Taking carers' views into account We received a range of feedback via care standards questionnaires and talking with people during the inspection process. It was clear that there were a number of areas which people felt needed to be improved such as, staffing levels, staff morale and staff turnover. There were also some concerns raised about some aspects of direct quality of care and support and about the laundry service. At the time of our inspection, some people were keen to express their view that they could see that the new management team were beginning to have a positive impact on service provision and that staff were working hard: page 2 of 9
"marked improvement since Debbie on board." "some staff are very good." What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 The provider must make sure that all residents have a regular assessment of their needs in relation to eating and drinking. Care plans should contain clear detail about the type and level of assistance the person needs, how this is to be provided. Processes should be in place to make sure that everyone receives the right care and support throughout each meal time. Clear records of individual outcomes should be kept. Robust monitoring processes need to be introduced to make sure that any gaps or issues are identified and that prompt action taken as necessary. This is in order to comply with SSI 210/2011: Regulation 4(1) welfare of service users and Regulation 5(1) personal plans. Timescale: work to begin immediately on receipt of this report and to be completed within four weeks of receipt of this report. We saw staff working hard and helping people to have a relaxed and dignified mealtime experience. Some people were enjoying their meals and having a positive dining experience and there was choice in where people could eat. The managers were supporting staff to improve the records in personal plans to make sure that people were receiving consistent care according to their needs and wishes. However, we saw that the mealtime for people upstairs was quite chaotic and disorganised and there were delays for some people who needed help to eat and drink. Some people were not assisted to sit in a dining chair at mealtimes and some people looked uncomfortable in their chairs. Seating assessments were needed to improve this. We saw that some people had signs that they may be dehydrated such as, sleeping during a meal time and having dry lips. Food and fluid charts were in use however, they were not always promptly completed and therefore we could not clearly determine that people had enough to eat and drink over the course of the day. We were unable to see that this requirement had been fully met therefore it will remain in place. Requirement 2 The provider must review and improve the opportunities available for residents to have access to meaningful activity which is purposeful to them throughout each day. This includes the need to review the way in which staff are able to support people and to improve the range of practical resources available within the home. page 3 of 9
Effective ways need to be found of monitoring the impact of any activity on the health and wellbeing outcomes for residents. This is to comply with The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI2011/210), Regulations 4 (1) (a). Timescale: work to begin immediately on receipt of this report and to be completed within eight weeks of receipt of this report. There were now two PALS working in the home and we received feedback about the positive impact of this on outcomes for people living in the home. Links had been made with local community resources and, for example, nursery school children visited regularly and people living in the home visited the nursery on a regular basis. We acknowledged that the manager was relatively new to their post and that they were working hard alongside the staff team and external managers to find ways of continuing to improve outcomes for people. However, we saw that several people spent a lot of time sleeping or walking around and becoming distressed in the dementia unit and more work was needed, this requirement will remain in place. Requirement 3 The provider should make sure that the staffing levels, skill mix and the way in which staff are deployed throughout each shift is reviewed and improved so that positive outcomes for residents can be assured. This is to comply with The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI2011/210), Regulations 4 (1) (a). Timescale: work to begin immediately on receipt of this report and to be completed within eight weeks. We acknowledged that the management and staff team had a positive commitment to making improvements and were continuing to address this. As reported elsewhere in this report, we saw that outcomes for people in relation to specific areas such as, eating and drinking, meaningful activity and support with distress needed to be improved. We also had to intervene to ask staff to help people at times because staff were busy and not available, this requirement will remain in place. Requirement 4 The provider must make sure that adequate investigation takes place in relation to every fall to determine any trigger and/or cause. Prompt action should take place after each fall to review whether any change to care and support is needed. Record keeping must be improved to demonstrate that information collected and kept is accurate, sufficiently detailed and reflects the care planned or provided. There should be clear and accountable processes in place to make sure that appropriate monitoring takes place in relation to outcomes for each person. page 4 of 9
Staff require training in relation to their role in falls prevention, falls management and also their responsibility to keep clear, accurate and up to date records. This is in order to comply with SSI 210/2011 Regulation 4(1) (a) health and welfare of service users & Regulation 5(1) personal plans & Regulation 15(b)(i) staff training. Timescale: work to begin immediately on receipt of this report and to be completed within eight weeks. We acknowledged that the fairly new management team were committed to continuing to improve the way in which people were supported in relation to the risk of falls. However, we found that people continued to have recurrent falls and we were unable to see that care plans, risk assessments and reviews were carried out promptly to prevent further accidents and improve outcomes, this requirement will remain in place. Requirement 5 The provider must carry out an analysis of individual staff training needs in line with their roles and responsibilities to make sure that outcomes for residents are improved. A particular focus is needed on improving person centred planning and supporting people with dementia in line with Promoting Excellence: A framework for all health and social services staff working with people with dementia, their families and carers. There should be a clear effective process to evaluate the impact of training on staff practice and outcomes for people living in the home. This is to comply with The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI2011/210), Regulations 4 (1) (a). Timescale: work to begin immediately on receipt of this report and to be completed within 12 weeks of receipt of this report. We were told that a comprehensive evaluation of staff roles and responsibilities was being carried out. Work was also underway in assessing staff competencies to make sure that staff practice and outcomes for people was improved where this was needed. Managers had also identified the need to review the skill mix. Given that this was still in progress, this requirement will remain in place. Requirement 6 The provider must make sure that there is a consistent and accountable approach taken to the way that complaints are recorded, responded to and acted upon. This is in order to comply with SSI 2010/210 Regulation 18 - complaints. page 5 of 9
Timescale: work to begin immediately on receipt of this report and to be completed within four weeks of receipt of this report. We saw that there was much improvement in terms of the responsiveness of the management team when a complaint was raised. We saw examples of meetings being held with people who had raised issues to help sort out what action was needed. People told us that they felt that they were listened to and that there were clear improvements happening. Met - within timescales What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations There are no outstanding recommendations. Complaints Please see Care Inspectorate website (www.careinspectorate.com) for details of complaints about the service which have been upheld. Enforcement No enforcement action has been taken against this care service since the last inspection. page 6 of 9
Inspection and grading history Date Type Gradings 10 Nov 2016 Unannounced Care and support Management and leadership 2 - Weak 31 Mar 2016 Unannounced Care and support Management and leadership 2 Oct 2015 Unannounced Care and support Management and leadership 2 - Weak 30 Mar 2015 Unannounced Care and support Management and leadership 18 May 2015 Re-grade Care and support Management and leadership 2 - Weak 21 Nov 2014 Unannounced Care and support Management and leadership 8 Oct 2013 Unannounced Care and support Management and leadership page 7 of 9
Date Type Gradings 27 Sep 2012 Unannounced Care and support 5 - Very good 5 - Very good 5 - Very good Management and leadership 5 - Very good 26 Jan 2011 Unannounced Care and support 5 - Very good Management and leadership 14 Aug 2010 Announced Care and support Management and leadership 22 Mar 2010 Unannounced Care and support Management and leadership 7 Aug 2009 Announced Care and support Management and leadership 11 Mar 2009 Unannounced Care and support Management and leadership 31 Jul 2008 Announced Care and support Management and leadership page 8 of 9
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 9 of 9