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Archived: Ayrshire House Good

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Inspection report

Date of Inspection: 22 May 2013
Date of Publication: 21 June 2013
Inspection Report published 21 June 2013 PDF

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 22 May 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with staff, reviewed information given to us by the provider and talked with commissioners of services.

Our judgement

There were not enough qualified, skilled and experienced staff to meet people’s needs.

Reasons for our judgement

The people we spoke with talked positively about the care workers, owner and the registered manager. One person told us, “(Name of the owner) and (name of registered manager) take us to appointments like the doctors.”

People were able to name their key workers. A key worker is a named care worker who has additional responsibility for a person who uses the service. The people we spoke with told us they could talk to their key worker, owner or the registered manager if they felt sad or anxious about anything.

We asked people who used the service if they felt there were enough care workers available to support them. One person told us, “We could do with an extra member of staff.”

We spoke with a visiting professional on the day of our inspection. They told us they had been visiting the home since March 2013. They talked positively about the communication with the home. They said that they felt confident the registered manager followed their instructions and that if they had any concerns they could easily raise them. They also said that they found generally the care workers were helpful.

We spoke with two care workers who told us a part of their role and responsibility included providing care and support, cooking, cleaning and laundry tasks. They also told us generally there were two care workers on during the day and a waking night care worker and a sleep in care worker at night. They said the owner visited the home regularly and supported people with attending health appointments and with social activities. They also said that the registered manager was included in the rota when they were not having an ‘office day’.

We asked the care workers we spoke with about their experience about providing care and doing the daily domestic tasks. One person told us, “There are two care workers on during the day, we have to cook, clean and care. It’s more difficult now (name of person who uses the service) needs have increased and the changes with day services means we can have all the residents at home.” And, “Sometimes (name of person) can need two care workers to assist, especially late afternoon and evening, this then means others are not supervised. Since the changes with day services, people’s behaviours have increased.”

This person also advised that they regularly transported up to 11 people to attend a social club using the homes mini bus on their own and this causes them some concerns about safety. We did not see a risk assessment had been completed for this activity.

Another care worker said, “It can be a little bit much and not safe if two care workers are on and (name of person) needs two of us to support her.” This person also confirmed that since the changes with the local authority’s day services, people were at home more and there had been an increase in some people’s behaviours.

We asked the registered manager how often they had ‘management days’. The registered manager told us they had one day a week in the office and that they liked to work along side care workers as they thought this was good practice. We had concerns that the registered manager did not have sufficient management time available to them, to fully meet the requirements of the role and responsibilities of a registered manager.

We asked the owner and registered manager how they had assessed the dependency levels of people who used the service, and how this had informed what staffing levels were required. The owner and registered manager told us they had not used a particular assessment or formula to determine staffing levels but had asked staff and had done observations.

We asked the owner and registered manager about staffing levels and shared with them what care workers had told us. The owner and registered manager told us there were always three care workers on duty. We received information after our inspection from the provider stating they had told us there were two or three care workers on duty. We looked at the staff rota with the reg