Gairloch Residential Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of the legal regulation in relation to consent.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing their care needs. A relative told us the admission process for their family member had been smooth and they had been actively involved. They told us, “I asked questions, I was there [Gairloch Residential Care Home] for 2 to 3 hours and was made to feel welcome, everything was organised.”

Most people spoken with indicated to us both verbally and through non-verbal cues they were happy with the care and support provided by staff. People told us staff were kind and caring. People told us they had enough to eat and drink and enjoyed the meals provided. Comments included, “The food is very good”, “It is plain ordinary everyday food, something for everybody. There is always plenty of fruit and vegetables” and “If [person using the service] does not like the menu, they [staff] will make them something else.” The dining experience was not as positive as it should be for people using the service. Staff did not showcase food choices through ‘show plates’ by allowing people to choose their meals at the point of service. Staff did not routinely explain to service users what the meal provided was, despite many people living with dementia. Some members of staff were observed to be distracted while supporting individuals to eat. For example, by initiating support and then carrying out another task without explaining to the service user being supported, what was happening. These actions were not person-centred and were undignified as they can negatively impact a person’s dining experience. People’s nutrition and hydration needs were assessed and recorded within their care plan. However, fluid intake records required improvement as these showed people's fluid targets were not always met. No information was recorded to demonstrate how this was being monitored and addressed.

Information demonstrated the service worked with others, for example, the Local Authority, healthcare professionals and services to support people’s ongoing care provision. However, although Local Authority partners said they worked well with the service they did not always find them proactive enough where improvements were identified and required.However, although Local Authority partners said they worked well with the service they did not always find them proactive enough where improvements were identified and required.

The provider supported people to manage their health and wellbeing. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People had access to healthcare services when they needed it and confirmed their healthcare needs were met. A person using the service told us they had attended a dentist appointment within the last 6 months. A relative told us when their family member had an accident, the person attended the local hospital for treatment. Relatives told us they were kept informed of their family member’s healthcare appointments and needs. A relative told us their family member had seen an Occupational Therapist and were “fully involved” about the plans and recommendations suggested and implemented.

The provider did not always routinely monitor people’s care and treatment effectively to continuously improve it.

Although there were arrangements in place to monitor people’s weights, food and fluid intake, records relating to the latter were not always consistent with targets set within their individual care plan. The fluid intake for some people were below recommended quantities, either because people had not received sufficient fluids or because the monitoring system was not accurately reflecting what had been given by staff.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The Mental Capacity Act 2005 [MCA] provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards [DoLS].

Staff did not demonstrate sufficient knowledge and understanding of the key requirements of the MCA and how this affected people using the service. Where people had an authorised DoLS order in place with conditions imposed, there was no evidence to demonstrate these had been reviewed and actioned to ensure compliance with the Mental Capacity Act. Not all DoLS had been renewed in a timely manner prior to them expiring.

The records for MCA assessments viewed were confusing. For example, a person was assessed as having capacity, meaning they were able to make their own decisions. However, rather than discontinuing to complete the form, staff persisted to complete the best interest document.

The service had CCTV in place for monitoring communal areas. Although the provider confirmed the use of the CCTV had been discussed with people using the service, relatives and staff, evidence of consent had not been sought and recorded.