Archived: Ailsa House Residential Care Home

Ailsa House Residential Care Home is a care home providing personal and nursing care. The service can support up to 18 people, in one adapted building across two separate floors. On the ground floor there were living facilities including kitchen, dining room and living rooms. At the time of the inspection 11 people were living at Ailsa House.

People’s experience of using this service and what we found

We observed some examples of poor practice, where staff were not putting on and taking off the personal protective equipment (PPE) correctly, whilst supporting people with personal care and moving around the home. The management noted the improvements needed and booked staff to attend training.

Staff told us staffing levels were not always adequate. The provider completed a staffing dependency tool to determine the staffing levels. However, people living at the service told us there were occurrences where they had to wait a considerable about of time for assistance. The call bell logs corroborated that people had to wait over the desired time frame specified by the management team.

Medicines were managed through an electronic system. The MAR records had been completed correctly and were clear to read. However, we identified some discrepancies, where data had been incorrectly entered into the system, which resulted in someone not receiving their medicine. Lessons were learnt from this occurrence and the manager informed us they would put measures to ensure all entries were checked.

Quality monitoring processes were in place and the management team were able to demonstrate they were gathering the information, auditing and analysing the findings. However, we found some instances where actions were not identified from these findings and completed. Following the inspection, the new manager produced an action plan detailing where improvements were required.

Staff training records showed that some of the training had expired, however staff felt they had the right training to complete their role. Staff had competency assessments completed. The management team acknowledged the shortfall in staff training and actions were put in place to review all training needs.

Care plans were detailed and offered information on people’s preferences and how they would like to be supported. Relatives said they were involved in their family members care plans and felt that the staff knew them well and supported their family member in a kind way.

The service demonstrated they understood the importance of close links with external stakeholders and agencies. Working in partnership in such an open and positive way meant that people received the overall care they needed.

People were supported to have choice and control of their lives and support. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 25 April 2019).

Why we inspected

We received concerns in relation to the outbreak of COVID-19, medicines, staffing and food and fluids. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Ailsa House Residential Care Home provides accommodation with personal care for up to 18 older people, including people living with dementia. The service does not provide nursing care. At the time of our inspection, 17 people were living at Ailsa House.

People’s experience of using this service:

People received safe care. Risks to people had been assessed and managed. Staff knew what to do to keep people safe from avoidable harm. Systems were in place for the safe management of medicines.

Recruitment systems ensured people were supported by staff who had been appropriately employed and there were enough staff to help keep people safe and ensure their care and support needs were met.

On-going training, supervision and observations of staff competence was undertaken to support staff and check they had the skills and knowledge to be competent in their job role and support people safely and effectively.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to eat and drink enough to ensure they maintained a balanced diet.

Staff supported people to access health and community care services.

Staff knew people well, and they were kind and sensitive to people’s needs and respectful of people’s privacy, dignity and independence. People received person centred care. A holistic approach was taken to assessing, planning and delivering care and support. Staff had access to up to date information and care and support was provided in line with people’s preferences and needs. There was a complaints system in place.

People had the opportunity to participate in activities, however, not everyone was happy with the activities provided. An activities coordinator had recently been recruited and improvements were planned to ensure activities were more responsive to people’s needs and wishes.

Staff embraced the provider’s visions and values to deliver a high-quality person-centred service. People were encouraged to express their views on the service they received.

There were effective quality assurance systems to monitor the service and drive continuous improvement.

Rating at last inspection:

At our last inspection in March 2018, the service was rated ‘Requires Improvement’ (report published on 14 May 2018). At that inspection, we found one breach of the Regulations. This related to safe care and treatment.

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The registered provider was no longer in breach of the Regulation we identified at our last inspection. At this inspection, the service has made sufficient improvements to be rated ‘Good’.

Follow up:

We will continue to monitor this service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Ailsa House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 18 older people and people living with dementia in one building. At the time of the inspection, there were 16 people living at Ailsa House.

Ailsa House is a large detached house situated in a quiet residential area in Westcliff on Sea and close to all amenities. The premises are set out on two floors and there are 12 single and three double bedrooms. Adequate communal facilities are available for people to make use of within the service.

At the last inspection on the 14 December 2015, the service was rated ‘Good’. At this inspection, we found the service was rated ‘Requires Improvement’. This is the first time the service has been rated ‘Requires Improvement’.

Although the registered provider’s company name has recently changed in 2018 and a new registered manager appointed, the majority of staff employed at the service have remained the same. There was therefore no impact on the delivery of care for people using the service.

Our key findings across all the areas we inspected were as follows:

Improvements were required to the service’s arrangements to assess and monitor the quality of the service. The quality assurance arrangements had failed to identify the issues we found during our inspection to help drive and make all of the necessary improvements.

Some aspects of medicines management required further development to ensure people received their medication as they should and in line with the prescriber’s instructions. Not all staff who administered medication had up-to-date medication training. Staff recruitment practices required strengthening as these were not robust and not all newly employed staff had received an appropriate induction.

People were protected from abuse and avoidable harm. People living at the service confirmed they were kept safe and had no concerns about their safety and wellbeing. Policies and procedures were being followed by staff to safeguard people.

Risks to people were identified and managed to prevent people from receiving unsafe care and support. Minor improvements were required to ensure these clearly recorded how risks to people were to be mitigated. People were protected by the provider’s arrangements for the prevention and control of infection. Arrangements were in place for learning and making improvements when things go wrong.

People were treated with care, kindness, dignity and respect. People received a good level of care and support that met their needs and preferences. Support plans were in place to reflect how people would like to receive their care and support, and covered all aspects of a person's individual circumstances. Staff had a good knowledge and understanding of people’s specific care and support needs and how they wished to be cared for and supported. Social activities were available for people to enjoy and experience.

Comments about staffing levels from people using the service and staff were positive. The deployment of staff across the service was observed to be appropriate and there were sufficient staff available to meet people’s needs to an appropriate standard at all times.

People’s nutritional and hydration needs were met and they received appropriate healthcare support as and when needed from a variety of professionals and services. The service worked together with other organisations to ensure people received coordinated care and support.

Staff understood and had a good knowledge of the Deprivation of Liberty Safeguards [DoLS] and the key requirements of the Mental Capacity Act [2005]. Suitable arrangements had been made to ensure that people’s rights and liberties were not restricted. Staff supported them in the least restrictive way possible and people were routinely asked to give their consent to their care, treatment and support and people’s capacity to make day-to-day decisions had been considered and assessed.

Information about how to make a complaint was available. People confirmed they knew how to make a complaint or raise concerns.