Tigh-A-Rudha Residential Home Care Home Service
Total Page：16
File Type：pdf, Size：1020Kb
Tigh-a-Rudha Residential Home Care Home Service Scarinish Isle of Tiree PA77 6UH Telephone: 01879 220407 Type of inspection: Unannounced Completed on: 17 August 2020 Service provided by: Service provider number: Argyll and Bute Council SP2003003373 Service no: CS2003000462 Inspection report About the service The Care Inspectorate regulates care services in Scotland. Information about all care services can be found on our website at www.careinspectorate.com The service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April 2011. Tigh-a-Rudha Residential Home is owned and managed by Argyll and Bute Council. It is located in the village of Scarinish on Tiree and has very attractive views of the sea towards Mull. The home is located close to the local shop and the island has a 'dial-a-bus' service for anyone wishing to travel. The home provides a care service to 12 older people, including respite accommodation. All accommodation is on the ground level and all bedrooms are for single occupancy. Residents have easy access to a well designed and dementia friendly sensory garden for recreation and activity. The philosophy of the service is: "To provide a caring, comfortable and homely environment where older residents are encouraged, through appropriate support and stimulation to maximise their physical, intellectual, emotional and social potential." This was a focussed inspection to evaluate how well people were being supported during the COVID-19 pandemic. We evaluated the service based on key areas that are vital to the support and wellbeing of people experiencing care during the pandemic. This inspection was carried out by inspectors from the Care Inspectorate. What people told us As part of our inspection we spoke to several relatives and residents as well as external health professionals. The feedback we received for the service was very good. People were particularly happy with the good relationships between residents and staff and families and felt generally confident about the standard of care. Comments included: 'Staff are very good at keeping in touch'. 'They are very caring and there is very good communication'. 'I feel very confident that staff know my mum. There is a real warmth about the place'. 'Staff have been tremendous through COVID'. From this inspection we evaluated this service as: In evaluating quality, we use a six point scale where 1 is unsatisfactory and 6 is excellent How good is our care and support during the 3 - Adequate COVID-19 pandemic? Further details on the particular areas inspected are provided at the end of this report. Inspection report for Tigh-a-Rudha Residential Home page 2 of 10 Inspection report How good is our care and support during the 3 - Adequate COVID-19 pandemic? 7.1 - People's health and wellbeing are supported and safeguarded during the COVID-19 pandemic. People who use care services should feel confident their health and wellbeing will be supported and safeguarded during the COVID-19 pandemic. During this inspection we found some strengths that had a positive impact on people's experiences and outcomes and outweighed any areas for improvement. We saw that staff interacted with residents in a warm and compassionate manner. Residents we spoke to felt safe and relaxed. People told us about the good relationships between staff, residents and families. They also felt confident that staff knew each esidentr very well. We saw several examples of staff using their knowledge of people's life history and preferences to facilitate good outcomes for them. This meant that residents experienced person-centred care in a familiar and homely environment. Residents benefitted from very good connections with family and friends. Staff found creative ways to support people to stay in touch. This included the use of innovative technology as well as adapting traditional ways to communicate, for example by laminating letters. Families told us that they were kept well informed of the impact of COVID-19 on their relatives in a caring and sensitive manner. Despite having to spend most of the time in their bedrooms to enable appropriate social distancing, people were regularly engaged and interacted with by staff. Staff also enabled individual residents to make use of the communal spaces whilst ensuring social distancing. Safe garden visits were taking place and the service was also prepared to facilitate individually risk assessed indoor visits in line with current guidance. Staff were able to demonstrate a good understanding of symptoms associated to COVID-19. The service had very good links with external healthcare professionals. Examples showed that staff responded quickly to individuals' changing healthcare needs, including symptoms associated with COVID-19. People could therefore be confident that COVID-19 symptoms would be identified and appropriate health professionals would be involved to facilitate testing and treatment as needed. Since our last inspection, the new management team made progress in ensuring that people's personal risk assessments were complete and up to date. This work was based on detailed and regularly updated action plans. However, care plans did not yet always contain regularly evaluated descriptions of people's current support needs and clearly defined personal outcomes. This meant care and support may not be provided in a consistent, outcome focussed way that enabled regular, evidence-based evaluations of the care provided. To support their ongoing improvement work we encouraged managers to develop and implement new and improved quality assurance tools and processes. (See area for improvement 1.) People should be confident that they will experience very good care in the last days of their life and that their individual preferences were understood and respected. To ensure this we would expect residents to have anticipatory care plans (ACP) in place that contain their individual wishes, needs and preferences. We saw that the service had no ACP in place which meant that people could not be assured of care that reflects their needs and wishes at the end of life. (See area for improvement 2.) Inspection report for Tigh-a-Rudha Residential Home page 3 of 10 Inspection report 7.2 - Infection control practices support a safe environment for both people experiencing care and staff. We evaluated how well infection control practices support a safe environment for people experiencing care and staff. We concluded that there were several important strengths that had a positive impact on people's outcomes, with some areas to consider improving. We found that the service was clean and tidy. An effective enhanced cleaning schedule was in place and all staff worked together to carry out necessary cleaning and disinfection tasks. This included the cleaning of frequently touched areas at least four times daily and regular deep cleaning of communal areas. Sharing of care equipment was minimised and any shared equipment, like hoists, was cleaned immediately after each use. These infection control practices supported a safe environment for people experiencing care and for staff. There was appropriate and sufficient ersonalP Protective Equipment (PPE) available. Staff were competent in the use of wearing PPE in accordance with guidance which helped to keep everyone safe. An appropriate number of PPE stations were placed at key locations throughout the service. This made PPE, alcohol-based handrub and waste bins easily available near to the point of use. Handwashing facilities were available in each bedroom and there was a clearly marked handwashing station in a communal toilet. Staff supported residents with regular hand hygiene. We observed staff undertaking hand- hygiene in line with best-practice during this inspection, helping to reduce the risk of cross contamination. Managers supported this by implementing and encouraging regular peer observations of practice. There was appropriate separation of clinical and domestic waste. Staff knew what went where and the importance of securing potentially infectious waste, helping to keep everyone safe. Managers had started to make further improvements to the disposal and management of clinical waste prior to our inspection. This meant that the service was in the process of implementing improved, pedal operated clinical waste bins throughout the service. Regular COVID-19 testing was in place and staff understood the guidance on accessing tests for COVID-19, both for themselves, and those who live in the home. Staff were routinely wearing their own clothes when working in the service, but also had access to uniforms. We found that the service's approach to wearing and laundering uniforms or staff's own clothes lacked clarity and that this was potentially creating a risk of contamination. We discussed this with managers and encouraged them to clarify and strengthen their policies. 7.3 - Staffing arrangements are responsive to the changing needs of people experiencing care. Our focus in this inspection area was to evaluate if staff were competent, skilled and knowledgeable to support people in relation to COVID-19. We concluded that there were several important strengths that had a positive impact on people's outcomes, with some areas to consider improving. It was positive to see that training and guidance in relation to COVID-19 was readily available for staff. Staff told us that they were routinely updated with any changes to guidance and that they felt well informed. We found staff to be very competent and highly motivated to use their knowledge and skills to keep people safe. Staff demonstrated a high degree of resilience and motivation in the face of the challenges they encountered during the pandemic. This collective effort helped to maintain a high degree of staff continuity which created a Inspection report for Tigh-a-Rudha Residential Home page 4 of 10 Inspection report safe and familiar environment for people during these unsettling times. Staff told us that they felt well supported by managers.