Gairloch Residential Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

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

This meant people’s needs were not always met.

The service was in breach of the legal regulation in relation to person centred care.

This service scored 54 (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 did not always make sure people were at the centre of their care and treatment choices.

Not all people using the service had a plan of care detailing all of their care and support needs and how this was to be delivered by staff. Not all care plans accurately reflected people’s current care needs. This meant there was a risk that relevant information was not captured for use by staff to demonstrate appropriate care was being provided and delivered in line with people’s support needs.

None of the care plans viewed recorded people’s individual social care needs, wishes and how this was to be provided and delivered by staff. Where people were at risk of dehydration and were unable to maintain an adequate fluid intake, this was not routinely reflected within their care plan. The care plan for 1 person recorded they required full assistance from staff to drink. However, during our assessment we observed the person to drink independently. The care plan for another person recorded they did not need adapted crockery whilst eating and were assessed as needing a normal diet. However, this was not accurate as the person was observed using adapted crockery and requiring a thickening agent to be added to their drinks. Thickening agents play a vital role in managing dysphagia [difficulty swallowing].They can modify the consistency of liquids to make them easier and safer to swallow, therefore reducing the risk of aspiration.The latter was not recorded within their care plan.

Not all care provided by staff was observed to be person-centred. Clothes protectors placed on people at breakfast were not removed until late morning. Not all staff when speaking to people, gave them enough time to process and respond to conversations held. People within a communal lounge were not offered the opportunity to sit at the dining table to have their lunchtime meal. The same people experienced long periods of immobility without being offered the opportunity to change their position or to have their comfort and personal care needs met. For example, 3 people remained in their chair from 9.00am to 2.45pm on day 1 of our assessment.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported continuity.

Staff worked with other services and involved people’s relatives to provide care and support to people. People received care from the same staff so they experienced continuity of care as many members of staff had been employed at the service for some considerable time.

The provider did not always supply appropriate, accurate and up to date information in formats that were tailored to people’s individual needs. Though people’s communication needs were recorded, the Accessible Information Standard [AIS] was not fully implemented within the service. For example, although a written and pictorial activities programme was displayed, a full week’s activities was recorded which some people, particularly those living with dementia, may find it difficult to decipher and understand. The menu was not pictorial and although written on a board, the writing did not stand out and some people could find it difficult to interpret and follow.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. However, where areas for improvement were communicated and recorded, there was no information detailing the actions being taken based on peoples’ feedback.

The provider and manager told us they encouraged people who used the service, those acting on their behalf and staff to share feedback about the quality of the service provided, and what it was like to work at Gairloch Residential Care Home. Quality assurance surveys were forwarded to individuals, inviting them to provide feedback and suggestions for improvement.

The provider made sure people could access the care, support and treatment they needed when they needed it.

Discussions with people using the service and those acting on their behalf implied they had not experienced discrimination or inequality. Care records demonstrated people were able to access services, including a range of external healthcare services and professionals throughout the day, including out of normal hours and in an emergency. There was no evidence to suggest people experienced delays in healthcare provision. We observed a person being actively supported by staff as their physical health declined, with appropriate external healthcare professionals being requested in a timely manner.

The provider had not always included people or discussed whether there were alternatives to the activities available at the service.

Whilst we saw some people were occupied with activities provided by staff, others were left for long periods of time to watch television with minimal staff interaction. We observed limited opportunity for some people to participate in meaningful social activities that met their needs. This was despite the service having an assigned member of staff responsible for facilitating social activities.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

However, where people were judged to be at the end of their life, there was a lack of detail record within their care plan relating to their decisions about their preferences for end-of-life care. For example, the information was generic and provided no specific information as to how they wished to be cared for so as to receive a comfortable, dignified and pain-free death.

Where appropriate, ‘Do Not Attempt Cardio-Pulmonary Resuscitation’ [DNACPR] orders were recorded. The service worked in partnership with other professionals, such as the local palliative care team to ensure people received appropriate end of life care. Not all staff had completed end of life care training.