Background to this inspection
Updated
11 March 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection consisted of two Inspectors and one Expert by Experience.
An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Ailsa House Residential Care Home 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.
At the time of the inspection the service did not have a registered manager. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report. We used all the information to inform our inspection.
During the inspection
We spoke with five relatives about their experience of the care provided. We spoke with five members of staff including the manager, care workers and the chef.
We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who have was involved in the service.
Updated
11 March 2021
About the service
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.