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Inspection report

Date of Inspection: 9 March 2013
Date of Publication: 18 April 2013
Inspection Report published 18 April 2013 PDF | 92.72 KB

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 9 March 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 and talked with staff.

Our judgement

There were not sufficient numbers of staff consistently on duty to meet people’s care needs.

Reasons for our judgement

People who used the service told us that staff were kind and helpful to them and that they were satisfied with the care they received. People did not make comments directly relating to the numbers of staff on duty, although one person said if they needed help staff usually responded quickly. Another person commented that sometimes they had had to wait for assistance when they pressed their call bell. We noted that during the afternoon of our inspection the call bells rang frequently and at times for periods of time for up to six minutes. We noted that staff were busy during our inspection.

During the inspection, we saw the staff provided care and support to people who used the service in a kind manner.

We observed that people who lived at Langholme asked staff for assistance if they needed it. Staff stopped what they were doing and helped people when requested or when they noticed people required support.

On the day of our inspection there were four carers and a senior carer on duty during the morning. In the afternoon / evening shift there were three care workers initially with another recently employed member of staff coming on duty at 5pm. One member of staff who was due on at 2 – 9pm had cancelled their shift and up until the time we completed our inspection at 4.30pm this shift had not been covered by another member of staff. We spoke with the staff and registered manager and we were told shifts were covered by existing staff working additional hours. The registered manager told us staff could request agency staff but they were not clear whether the agency had been rung by the senior carer who had tried to cover the shift during the morning. At the time of our discussion this person had gone home. We were told that there were two waking members of night staff due to work that night.

We discussed the staffing arrangements with the registered manager and were told the ration of staff was determined by one member of staff for every eight people who used the service. One member of staff told us that since some rooms had become empty the number of staff had decreased and this had meant there did not seem to be enough staff on duty to spend sufficient time with people, This did not ensure that the dependency and complexities of people’s care needs were considered.

We spoke with staff members regarding the staffing levels and they expressed concerns regarding the numbers of staff on duty. Staff told us and we evidenced from care plan documentation that a number of people who lived at Langholme required assistance from two members of staff in order to meet their care needs. Staff also commented that on occasions people with dementia care needs required one to one assistance for their safety and / or that of others. One member of staff said it was upsetting when they could not support people as they wanted to and the people needed. We were told how sometimes staff did not have time to bath people as the care plans instructed. We saw from care plans that it was planned for people to have a weekly bath. One person’s daily records identified their bath had been missed due to insufficient staff on duty and the staff being too busy.

We saw from daily records that the staffing levels had affected the care and wellbeing of people who used the service. Comments included ‘ X rang the bell and was very cross as had to wait for ten minutes for us to get to them’ and ‘X rang for comfort but couldn’t stay as other bells were ringing’. This did not ensure that the care needs of people who used the service were met.