Gairloch Residential Care Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Inadequate. This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high quality care.

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

This service scored 36 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Provider systems and processes designed to monitor the quality of the care provided was not always effective. The provider and manager did not always understand the challenges and the needs of the people being supported.

The provider and manager did not recognise deficits in their governance and monitoring systems. We found the learning and improvement culture was not as robust and embedded within the service to make sure all risks were managed and minimised.

Staff meeting minutes referenced the providers shared vision, strategy and values and these were shared with staff. However, when we spoke with staff, they were unable to clearly demonstrate an understanding of the provider’s ethos and values or confirm where this information was located.

The provider and manager did not always have the skills, knowledge and experience to lead effectively.

The provider and manager identified outcomes for people that needed improvement via their Service Improvement Plan and action plan following the Local Authority’s assessment of the service. The Service Improvement Plan and action plan recorded an inaccurate picture of achievements attained. For example, the action plan provided to the Local Authority documented mental capacity assessments were now completed in line with the MCA code of practice. Care plans were accurate and included information relating to risk to people’s safety and wellbeing. Meaningful and stimulating activities were now being offered to people using the service. This did not concur with the findings from our assessment as highlighted within this assessment report.

The service had a manager who was in the process of registering with the Care Quality Commission. The manager told us they felt supported by the organisation.Staffs’ comments about the manager were positive and included, “The manager is very nice” and “I do feel I can talk to the manager.”

The provider fostered a culture where people felt they could speak up and their voice would be heard. Arrangements were in place for gathering peoples’, relatives’ and staffs’ views relating to the quality of the service provided at Gairloch Residential Care Home. However, there was no analysis of the data or an action plan where corrective areas for improvement were highlighted and recorded. For example, in relation to staffing levels and improvements to staff interactions with people using the service. There were systems in place to enable staff and others to speak up when something was wrong. Staff understood this and told us they felt confident doing so. Staff we spoke with knew they could raise concerns with the provider, manager, Local Authority and safeguarding team.

The provider and manager valued diversity in their workforce. However, not all staff employed at the service felt there was a fair culture at the service.

There was a diverse workforce at the service, with staff employed from a wide range of backgrounds, cultures, and experiences.The provider and manager were unable to provide examples of how they developed and supported a compassionate, collaborative, and inclusive culture at Gairloch Residential Care Home for all staff. Staff confirmed there were few opportunities to discuss their development through formal supervision and appraisal. Not all staff felt there was good teamwork at the service and mainly attributed this to cultural and diversity differences within the existing staff team. The manager told us they were aware of the latter and were in the process of exploring ways to manage this.

The provider did not always have clear responsibilities, roles and systems of accountability or good governance arrangements.

The quality assurance and governance arrangements in place were not effective in identifying shortfalls found at the service as part of this assessment. As stated within this assessment report, this referred to non-compliance with the Mental Capacity Act. Risks to people’s safety were not routinely identified and recorded. Care plans were not routinely accurate or recorded all of a person’s care and support needs. Not all care provided by staff for people using the service was person-centred. Whilst the provider and manager implied, they were aware of the above, they had not taken enough action to address this and to mitigate the potential risks of people receiving inappropriate care.

Senior staff were not available to provide support and guidance to staff to enable them to effectively carry out their roles and responsibilities. Staff did not recognise their responsibility and accountability to identify and question poor practice with colleagues when this was evident. For example, where staff exhibited poor moving and handling practices or where staff failed to initiate activities with people living at the service.

Relatives were generally positive about the overall management of the service. Relatives told us, “I would recommend them [Gairloch Residential Care Home], [Name of family member] is safer here than at home”, “New management took over about 12 months ago, management had put a lot of things in place, all the staff are kind and caring. I would recommend [Gairloch Residential Care Home] now” and “Really good to see how much it has improved.” However, some less favourable comments were made related to concerns about staff of different ethnicities and the impact this had on the service, such as language barriers and cultural differences in communication. Staff said they felt supported.

Services that provide health and social care to people are required to inform the Care Quality Commission [CQC], of important events that happen in the service. This enables us to check that appropriate action had been taken. The provider had submitted statutory notifications to the Care Quality Commission as required.

The service collaborated and worked in partnership with other services so as to promote effective joint working to meet people’s needs. Information demonstrated the service worked with others, for example, the Local Authority, healthcare professionals and services, such as the local Dementia Intensive Support Team to support care provision.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always actively contribute to safe, effective practice and research.

The manager had not engaged with local forums and networks to learn and improve the service and share good practice. There was no evidence that staff had the opportunity to be debriefed following incidents or that reflective practice was actively encouraged.