Achvarasdal (Care Home) Care Home Service
Reay Thurso KW14 7RR
Telephone: 01847 811226
Type of inspection: Unannounced Inspection completed on: 20 September 2016
Service provided by: Service provider number: Church of Scotland Trading as SP2004005785 Crossreach
Care service number: CS2003008461 Inspection report
About the service
The inspection focused on standards of care for people living with dementia. We are using a sample of 150 care home services to look in detail at the standards of care for people living with dementia and this service is one of those selected as part of the sample.
The areas looked at were informed by the Scottish Government's Promoting Excellence: A framework for health and social care staff working with people with dementia and their carers and the associated dementia standards. It is our intention to publish a national report on some of these standards during 2017.
The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at www.careinspectorate.com
This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April 2011.
The service is provided by Crossreach, formerly Church of Scotland, and is registered to provide a care home service to a maximum of 28 older people. There were 13 residents living at the home at the time of the inspection.
The service is located in Achvarasdal, a former Victorian shooting lodge, in Caithness.
Crossreach's mission statement is "In Christ's name we seek to retain and regain the highest quality of life, which each individual is capable of experiencing at any given time."
Our aim is to create a homely environment with a welcoming atmosphere, where individuals are supported to do as much for themselves as possible and so promote their independence and fulfilment.
The objectives to enable us to deliver our aim include:
- To offer an individual, needs' led service to all within our care, regardless of gender, culture, social background or ability. - To maintain a safe and comfortable environment. - To promote choice in all aspects of daily life. - To offer opportunity for fulfilling activities and pastimes. - To maintain dignity and respect privacy. - To promote an individual's independence.
What people told us
For this inspection, we received views from 11 out of the 13 people using the service. Seven people gave their views via the care standards questionnaires and we spoke with a further four during the inspection. Individual comments from the questionnaires included:-
"Staff are very caring and supportive towards me"
"Very happy with all care and support and the staff are very good to me"
"Very happy with care and support. Sometimes need help through my buzzer, the girls are very busy"
Inspection report for Achvarasdal (Care Home) page 2 of 18 Inspection report
When we spoke with residents they appeared happy with the level of care and support and said that the staff were very helpful. They enjoyed the meals and said that there was always a choice. Rooms and the rest of the home were kept tidy and clean. Individual comments included:-
"I like it that the staff are spoken of in devotions and that they are excellent"
"I am worried about my wife as she had a fall and is still quite anxious. The care and support is very good and the staff are helpful"
"I have had no issues with the agency staff but I sometimes have to wait too long for the call bell to be responded to"
"The food is great and my room is spotless"
We were unable to speak to relatives during our inspection as none were visiting at the time. We gained the views of five who completed our questionnaires. Four of the people who responded indicated that they agreed with all of the questions that were asked of them. One felt, overall, that staff did not have the skills to care for their relative. Also they strongly disagreed that there were enough trained and skilled staff on duty at any given time.
Individual comments included:-
"All the staff are extremely helpful to my relative. Very considerate of her needs and problems and the food is of a good standard with varied menus. I do find it frustrating when we enter and leave that we need to use the bell to summon staff to enter the code for the door. They are busy with residents who require attention. Surely regular family visitors should be allowed access to the number?" (We discussed this at feedback)
"The care home desperately needs stability in their senior staff/manager. The inclusion/increase in hours of the activity coordinator has greatly helped in promoting relevant and appropriate activities. The introduction of a memories book for each resident provides an incentive for communication and reminiscence"
"We are not particularly happy with the services provided by this care home. Generally speaking the home is in a reasonable state of care and repair. We are also reasonably happy with the care provided by the staff. Having said that it is clearly evident that the staff are demoralised and there is a clear lack of leadership and management. During the years that our relative has been a resident, this home has lurched from one crisis to another and for most if that time there has been no permanent manager, but a host of "stand-ins" from other areas. The problems clearly lies with senior management at head office level who appear to be (quote) 'unsupportive' of their local staff and almost incapable of sourcing a long term management solution" (We discussed this at feedback)
Inspection report for Achvarasdal (Care Home) page 3 of 18 Inspection report
Self assessment
The Care Inspectorate received a fully completed self-assessment document from the provider. We were satisfied with the way the provider completed this and with the relevant information included for each heading that we grade services under.
The provider identified what it thought the service did well, some areas for development and any changes it had planned.
From this inspection we graded this service as:
Quality of care and support 3 - Adequate Quality of environment 3 - Adequate Quality of staffing 3 - Adequate Quality of management and leadership 2 - Weak
Quality of care and support
Findings from the inspection Staff interactions with people using the service were good. There was a high use of agency staff, however at the time of the inspection, all staff seemed to know the people using the service well and included them. Staff were generally supportive and communicated well with people using the service.
We found care plans had not been further developed and some people did not have care plans in place, in accordance with the format that was promoted by the provider. It is important for staff and families to have access to accurate information in personal plans about the care and support people need and are to receive. (See requirement 1)
Care plans for those people who lived with dementia, or a cognitive impairment, were not person centred and there was a lack of information about how staff could support residents with their stress and distress. The charts that were being used to monitor distress did not result in care plans being updated or staff being supported or guided with their interactions. (See recommendation 1)
Staff should develop and encourage a culture of promoting continence rather than managing continence. Staff should develop continence care plans with people, where needed, which support a promoting continence approach. (See recommendation 2)
Staff had some good information about people's life history, past, present and future wishes. Staff should continue to gather this information and use it in a way that works for the person in their day-to-day support. The service should use this information to develop activities that are meaningful to individual people using the services. The service should continue to explore and develop community links, to improve a sense of involvement with the local community for people using the service. (See recommendation 3)
In most of the care plans we looked, where applicable, appropriate Adults with Incapacity certificates (AWI's) and Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR's) forms were in place. The DNACPR's indicated that
Inspection report for Achvarasdal (Care Home) page 4 of 18 Inspection report they should be reviewed; however the GP had stated that these were 'indefinite'. The service should liaise with the GP practices to ensure that these were reviewed accordingly. It was not always clear who held Power of Attorney or Guardianship and the relevant information was not included in the person's care plan. The service was to ensure that staff had this information when assisting people to make decisions. (See recommendation 4)
There were no anticipatory care plans in place. Staff should discuss with people using the service, and involve relevant others where appropriate, to develop end of life plans that meet people's previous wishes as much as possible. (See recommendation 5)
There was some good information and examples of best practice with regard to the use of covert medications. All relevant parties had been involved and reviews had been held. There was evidence that staff were seeking assistance from the GP between reviews. Overall the management of medication was good and we found that staff were adhering to best practice.
There was good provision of activities. The coordinator was very enthusiastic and committed to providing a range of activities for residents to take part in. They had spent time with residents getting to know what they liked. They maintained records of who had taken part and if they had enjoyed their time. They spoke about how they would like to further develop a more meaningful activity programme.
Requirements Number of requirements: 1
1. The provider must ensure that the care plans for service users are in place, reviewed and amended so that they effectively set out how the service user's health, welfare and safety needs are to be met.
This is in order to comply with:
Regulation 5(1)(2)(a)(b)(i)(ii)(iii)(c) and (d) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 Scottish Statutory Instrument 2011/210)
Timescale for meeting this requirement: 31 January 2017
Recommendations Number of recommendations: 5
1. The provider should ensure that care plans are further developed for people who live with dementia, or have cognitive impairment. These should contain personal and unique information gathered by the service, which influences how they support people in their day to day life and makes a positive difference. There should also be guidance for staff in relation to appropriate strategies to use when supporting people in times of stress and distress. Care plans should be evaluated and updated as necessary to ensure that the information is a current reflection of people's needs.
National Care Standards Care Homes for Older People Standard 6: Support arrangements.
2. The provider should ensure that each person who uses the service should have an up to date, person-centred care plan in place that supports a promoting continence approach to continence care. That it is updated to
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reflect any changes in person's needs, circumstances, level of support or treatments, and is regularly reviewed with the person, and their representative, to ensure their needs are being met.
National Care Standards Care Homes for Older People Standard 6: Support arrangements.
3. The provider should ensure they take account of each person's ability, needs and preferences to ensure that there is activity provision suitable for all who use the service.
The service should explore and develop ways they can support people who use the service to maintain good links with their local community.
National Care Standards Care Homes for Older People, Standard 6: Support arrangements Standard 12: Lifestyle - Social Cultural and Religious Belief or Faith.
4. The provider should ensure that there were copies of documents, where legal arrangements were in place, about decision making and powers of others to act on behalf of people using the service. Relevant information was to be included in the person's care plan.
National Care Standards Care Homes for Older People Standard 6: Support arrangements Standard 8: Making choices.
5. The provider should ensure staff discuss with people using the service, where appropriate, to develop end of life plans that meet the person's previous wishes as much as possible and involve families, friends, those important to them and relevant health professionals.
National Care Standards Care Homes for Older People Standard 6: Support arrangements. Standard 19: Support and care in dying and death.
Grade: 3 - adequate
Quality of environment
Findings from the inspection The home was generally clean, hygienic and free from offensive odours. However, the service could ensure that there was guidance for staff about deep cleaning of bedrooms and carpets and add this to their cleaning schedules.
The systems and processes used for the overall management of maintenance of the building, water systems and the equipment used remained in place. These systems proved to be effective. Additional systems had been developed for the maintenance and cleaning of wheelchairs, walking aids, commodes and shower chairs and the use of bed rails and airwave mattresses.
An infection control audit had been carried out in August and an action plan, which detailed nine areas for
Inspection report for Achvarasdal (Care Home) page 6 of 18 Inspection report improvement had been developed. However, not all areas had been addressed. In addition there was no information about who was responsible to ensure these changes took place, or a date by which they were to be fully addressed. This included reference to all staff needing to take part in infection control training. We are making a recommendation about the effective use of audits within Quality Theme 4.
The way staff record falls, accidents and incidents and manage any follow up action needed to improve. (See requirement 1).
Staff promoted people's sense of wellbeing, belonging and identity by supporting them to personalise their rooms with pictures, photographs and personal belongings.
The service had made some improvements in areas of the home, to make it more suitable for people with dementia. The provider and management need to take a considered and informed approach to continue to enhance the environment. There were some sheltered seating areas in the garden, which was pleasant but not well maintained. The garden had some fencing but some of this was broken and not all areas were enclosed. People using the service could not easily access the garden with support and could not access outdoors independently. (See recommendation 1)
We spoke about the concerns of some relatives having to call staff to let them out of the home after visiting. They felt as regular visitors they should have access to the key code. Whilst the use of key codes is in relation to the protection of more vulnerable people, the service could take account of best practice in relation to the use of key codes and who should be able to access these. (See recommendation 2).
Requirements Number of requirements: 1
1. The provider must ensure they review the current arrangements for reporting and monitoring all accidents and incidents to ensure that: a) Staff report all accidents and incidents and maintain accurate records. b) Management and staff carry out regular risk assessments relating to accidents and incidents and take appropriate preventative action with regard to individual needs c) Management have a consistent approach to monitoring and analysing accidents and incidents and take appropriate action.
This is in order to comply with:
Regulations 4(1)(a), 10(1)(2)(a) of the Social Care and Social Work Improvement Scotland (Requirements of Care Services) Regulations 2011 Scottish Statutory Instrument 2011/210.
Timescale for meeting this requirement is: 31 January 2017
Recommendations Number of recommendations: 2
1. The provider and management should ensure they assess the care home environment, which was also to include the gardens and develop an improvement action plan, to continue to enhance the environment for people using the service with dementia, or cognitive or visual impairment.
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National Care Standards Care Homes for Older People Standard 4: Your environment.
Is Your Care Home dementia friendly? Enhancing Healing Environments (EHE) Environmental Assessment Tool http://hub.careinspectorate.com/media/302736/is-your-care-home-dementia-friendly-ehe-tool-kingsfund- mar13.pdf www.kingsfund.org.uk/dementia
2. The provider and management should ensure they review how they managed the security of the door leading into the home. This was so that residents' safety was maintained alongside the ease of those visiting. They were to take into consideration the best practice of the Mental Welfare Commission, specifically orf those who had a cognitive impairment and could not make informed choices about going out alone. In addition, they were to ensure that all residents' care plans and risk assessments indicated how they were working with residents to ensure their safety was being maintained.
National Care Standards Care Homes for Older People Standard 4: Your environment Standard 5: Management and staffing Standard 9: Feeling safe and secure.
Grade: 3 - adequate
Quality of staffing
Findings from the inspection The provider had developed a dementia training programme that linked to the Promoting Excellence Framework. Some of the staff had completed the three day dementia training for each level and then staff were to complete workbooks. However, this was not the case for all staff and we could not evidence, where workbooks had been completed, that they were being monitored.
The provider employed two dementia leads who had in the past visited the service to support staff with best practice. This had led to some improvements in the environment such as, signage.
There were also two dementia ambassadors in the service whose role it was to provide training and support for staff. However, they had been unable to attend any update meetings and had limited opportunities to provide training due to staffing issues.
Some training had been provided for staff since the last inspection of March 2016. This was in relation to the care and support of older people. Permanent members of staff (who administer medication) had received accredited training in relation to medication. However, we could not evidence that the night staff had received this training.
Since June 2016 there had been limited overall training opportunities for staff. Some staff told us that they had unmet training needs and that there were no plans in place to support them with this. This was mainly due to the staffing situation whereby staff were unable to be taken off the rota to attend. The person in charge at the time of the inspection was aware of the need for some staff to attend training such as, Safeguarding.
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There were limited numbers of staff who had been supported to achieve a Scottish Vocational Qualification (SVQ). Four members, which equates to a third of staff, had achieved at level 3 with one member of staff who was just about to complete. (See requirement 1).
There was a supervision plan in place but not all staff had received this. Not all staff had received an appraisal. The provider must address this to ensure that staff's performance and competencies were assessed and training needs identified and addressed through a training plan. (See recommendation 1).
The service had been using a high level of agency staff. This was due to difficulties with recruitment and staff leaving for other posts. Whilst the service tried to secure the same agency staff this was not always possible, which meant that there were times when residents were seeing unfamiliar faces. This can have an impact on their wellbeing and the ability for staff to provide a continuity of approach when delivering care. This also had an impact on permanent members of staff who told us that, at times, it could be stressful working with more than one agency staff. We could see from the rota that this was frequent for both day and night shift. However, it must be stated that the staffing numbers adhered to the schedule that was in place. The provider and management were to ensure that, when planning the rota, they took into account the skills, experience and employment status of the staff.
Requirements Number of requirements: 1
1. In meeting this requirement people using the service can be confident that the provider has an effective system for identifying and monitoring staff development and needs so that staff have the right skills and experience to care for them.
The provider must ensure that all staff employed to work within the home are trained to carry out their duties for which they are employed. They should ensure that accurate training records are maintained. In order to achieve this, the provider must:- a) Review the training needs of all staff and record your findings. b) Ensure that there is a mandatory training programme that addresses the review of training needs. This should include, but not be limited to, including training in the following areas: Dementia, Continence, Oral Health, Restraint and risk management, Care planning and review and Scottish Vocational Qualifications. c) Ensure that records are maintained detailing which training events have been attended and by whom. d) Develop a system to ensure that the learning from the training is implemented in practice. e) Following the training, seek feedback from people using the service and their carers about how well staff are caring for them.
This is in order to comply with:
Regulation 15(b)(i)(ii) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 Scottish Statutory Instrument 2011/210)
Timescale for meeting this requirement: 31 January 2017
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Recommendations Number of recommendations: 1
1. To ensure all of those people using the service that staff's practice was the most up to date and that they were effective in meeting needs the provider was to:-
a) ensure that they make proper provision for all staff to take part in a regular, effective and appropriate supervisions and an appraisal, and;
b) assess staff competence, identify any training needs which were then to be transferred to the training plan and addressed.
National Care Standards Care Homes for Older People Standard 5: Management and staffing.
Grade: 3 - adequate
Quality of management and leadership
Findings from the inspection The service used a variety of ways to include people and monitor the overall quality of the care and support that was being provided. We could see that some of these had led to improvements such as, the residents' meetings and improved activities, but that this was not the case for all of the systems that were used.
The service had introduced 'Resident of the day' as a way of promoting a more person centred approach to the planning and review of the care provided. However, we found that time constraints, due to the high use of agency, had meant that this was not always carried out. In addition not all sections of the form were complete. There was no evidence in the forms that we looked at that the resident's or their relative's views had been taken. The activity coordinator was not aware of their role with this work. We felt that this was a missed opportunity for them to gain information from residents as to their likes and dislikes.
While residents' and relatives' meetings had taken place and ideas and suggestions were asked for and given, there was no use of action plans to support how the service was going to address these. For example, relatives had asked that noticeboards be placed inside the main part of the building. They also spoke about their frustrations at having to request staff for the keypad code when leaving. We could not evidence that these areas had been taken forward.
Staff meetings had taken place and we could see from the minutes that these were more about housekeeping issues, rather than discussing and sharing ideas and ways to improve the outcome for the residents.
A general audit of the service was carried out by two of the provider's dementia specialists in August 2015 and it was comprehensive in its approach. However, the outcome with the work that needed to be done to improve the overall lived experience had only just been forwarded to the service at the time of the inspection. Therefore no actions had been taken.
Inspection report for Achvarasdal (Care Home) page 10 of 18 Inspection report
We were told that the provider's 'Towards Quality' tool had not been used and was, therefore, a missed opportunity to involve all stakeholders in planning for improvement.
The care plan audits that had been carried out showed that there had been no improvements. In addition, they did not specify who was to carry out this work, or when it was to be completed by. (See recommendation 1).
There had been a meeting held with staff and relatives at the beginning of August about the possible transfer of the service to another provider. Since that time staff felt that they had not been kept informed of the situation and this was causing some uncertainty and anxieties. As a group they had forwarded a list of questions to the provider and had not received any reply for several weeks. The provider was to work together with the staff, to allay their anxieties and to help them work toward providing positive outcomes for the people who live there.
Requirements Number of requirements: 0
Recommendations Number of recommendations: 1
1. The provider should ensure they continue to use and develop the quality assurance systems to effectively assess the quality of the service they provide. They should develop clear improvement plans to enhance the quality of the service and improve the outcomes for people using the service, their relatives and staff.
National Care Standards Care Homes for Older People Standard 5: Management and staffing arrangements.
Grade: 2 - weak
What the service has done to meet any requirements we made at or since the last inspection
Previous requirements
Requirement 1
The provider must ensure that all personal plans were to be reviewed and updated to reflect the individual care needs of each service user.
This is in order to comply with:
Regulation 4 (1)(a) and 5(2)(b) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 Scottish Statutory Instrument 2011/210).
Inspection report for Achvarasdal (Care Home) page 11 of 18 Inspection report
Timescale for meeting this requirement: 28 February 2016.
This requirement was made on 29 October 2015.
Action taken on previous requirement This requirement was found not to have been met at the follow up inspection of 30 March 2016.
We assessed how the service had met this requirement at this visit. Please refer to quality theme in relation to care and support for more detailed information.
Not met
Requirement 2
The provider must ensure that they were able to identify where service users are at risk of malnutrition/ dehydration and that they are carrying out assessments and taking appropriate actions to ensure service users' nutrition and hydration needs are met. Information was then to be used to develop and implement effective care plans which were to be reviewed on a regular basis.
This is in order to comply with:
Regulations 4(1)(a), 5(1)(2)(a)(b)(i)(ii)(iii) of the Social Care and Social Work Improvement Scotland (Requirements of Care Services) Regulations 2011 Scottish Statutory Instrument 2011/210.
Timescale for meeting this requirement: 28 February 2016.
This requirement was made on 29 October 2015.
Action taken on previous requirement This requirement was found not to have been met at the follow up inspection of 30 March 2016.
We assessed how the service had met this requirement at this visit. Please refer to quality theme in relation to care and support for more detailed information.
Not met
Requirement 3
The provider must ensure they review the overall management of accidents / incidents / falls to ensure that residents' safety was addressed. Once reviewed they were to ensure that appropriate records and care plans were generated and reviewed so that service users were not left at continued risk.
This is in order to comply with:
Regulations 4(1)(a), 10(1)(2)(a) of the Social Care and Social Work Improvement Scotland (Requirements of Care Services) Regulations 2011 Scottish Statutory Instrument 2011/210.
Timescale for meeting this requirement is: 28 February 2016.
This requirement was made on 29 October 2015.
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Action taken on previous requirement This requirement was found not to have been met at the follow up inspection of 30 March 2016.
We assessed how the service had met this requirement at this visit. Please refer to quality theme in relation to the environment for more detailed information.
Not met
Requirement 4
The provider must ensure they make proper provision for all staff to take part in a regular effective and appropriate appraisal. Staff performance and competence was to be assessed and any training needs were to be transferred to the training plan and addressed.
This is in order to comply with:
Regulation 15(b)(i)(ii) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 Scottish Statutory Instrument 2011/210).
Timescale for meeting this requirement: 28 February 2016.
This requirement was made on 29 October 2015.
Action taken on previous requirement This requirement was found not to have been met at the follow up inspection of 30 March 2016.
We assessed how the service had met this requirement at this visit. Please refer to quality theme in relation to staffing orf more detailed information.
Not met
Requirement 5
The provider must ensure that the number of care staff on duty, at any one time over any given 24 hour period is maintained at levels sufficient to meet both the number and needs of the people using the service and that you make appropriate contingency arrangements to cover periods of annual leave, sickness and vacancies within the service.
This is in order to comply with:
Regulations 4(1)(a) and 15(a) of the Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (Scottish Statutory Instrument 2011/210).
Timescale for meeting this requirement - A review of staffing levels and deployment was to be undertaken immediately following the inspection. Full compliance by 15 December 2015.
This requirement was made on 29 October 2015.
Action taken on previous requirement We received no information and could not evidence that the provider had reviewed staffing levels and deployment in line with the requirement that was made at the follow up inspection of 30 March 2016. The
Inspection report for Achvarasdal (Care Home) page 13 of 18 Inspection report
action plan did not specifically state what was being done to address this. Therefore, this requirement was found not to have been met at the follow up inspection of 30 March 2016.
We assessed how the service had met this requirement at this visit. Please refer to quality theme in relation to care and support for more detailed information.
Not met
What the service has done to meet any recommendations we made at or since the last inspection
Previous recommendations
Recommendation 1
The provider should ensure they continue to put in place and implement an effective programme of training for staff, to include (but not limited to): Nutrition, The Lived Experience (mealtimes), Medication, Risk Assessment, Palliative Care, Participation and Care Planning and Review. They were also to put in place and implement a system for the evaluation of all training to ensure that staff practice improves as a result of the training provided.
This recommendation was made on 29 October 2015.
Action taken on previous recommendation This recommendation was found not to have been met at the follow up inspection of 30 March 2016.
We assessed how the service had met this recommendation at this visit. Please refer to quality theme in relation to staffing for more detailed information.
Recommendation 2
The provider should ensure that staff took part in regular supervision sessions, as per their own policy and procedure. They were to ensure that training needs that were identified were transferred to the training plan and addressed.
This recommendation was made on 29 October 2015.
Action taken on previous recommendation This recommendation was found not to have been met at the follow up inspection of 30 March 2016.
We assessed how the service had met this recommendation at this visit. Please refer to quality theme in relation to staffing for more detailed information.
Recommendation 3
The provider should ensure that all staff took part in an induction, which met their needs. They were to ensure that at the end of the induction/probationary period, their suitability was assessed and that any further support and training needs were identified, planned and implemented.
Inspection report for Achvarasdal (Care Home) page 14 of 18 Inspection report
This recommendation was made on 29 October 2015.
Action taken on previous recommendation No new staff had commenced work since the last inspection of 30 March 2016. As a result we were unable to evidence whether or not this recommendation had been met and therefore remains in place.
Recommendation 4
The provider must ensure that there were robust and effective quality assurance systems and processes in place and that these were used. Residents, relatives and staff were to take part in how the service looked at and planned for improvements. Action plans were to be used and regularly reviewed in order to influence developments and changes to the provision of the service. This was in order to assess and improve the overall quality of service they provided.
This recommendation was made on 29 October 2015.
Action taken on previous recommendation This recommendation was found not to have been met at the follow up inspection of 30 March 2016.
We assessed how the service had met this recommendation at this visit. Please refer to quality theme in relation to management and leadership for more detailed information.
Complaints
Please see Care Inspectorate website (www.careinspectorate.com) for details of complaints about the service which have been upheld.
Enforcement
No enforcement action has been taken against this care service since the last inspection.
Inspection and grading history
Date Type Gradings 30 Mar 2016 Unannounced Care and support Not assessed Environment Not assessed Staffing Not assessed Management and leadership Not assessed
29 Oct 2015 Unannounced Care and support 3 - Adequate
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Date Type Gradings Environment 3 - Adequate Staffing 3 - Adequate Management and leadership 3 - Adequate
11 Feb 2015 Unannounced Care and support 3 - Adequate Environment 3 - Adequate Staffing 3 - Adequate Management and leadership 3 - Adequate
29 Jul 2014 Unannounced Care and support 3 - Adequate Environment 3 - Adequate Staffing 3 - Adequate Management and leadership 3 - Adequate
29 Jan 2014 Unannounced Care and support 3 - Adequate Environment 3 - Adequate Staffing 3 - Adequate Management and leadership 3 - Adequate
5 Sep 2013 Unannounced Care and support 3 - Adequate Environment 3 - Adequate Staffing 3 - Adequate Management and leadership 3 - Adequate
15 Nov 2012 Unannounced Care and support 4 - Good Environment 4 - Good Staffing 4 - Good Management and leadership 3 - Adequate
17 Apr 2012 Unannounced Care and support 1 - Unsatisfactory Environment Not assessed Staffing 2 - Weak Management and leadership Not assessed
22 Feb 2012 Unannounced Care and support 2 - Weak Environment Not assessed Staffing 3 - Adequate Management and leadership Not assessed
4 Nov 2011 Unannounced Care and support 3 - Adequate
Inspection report for Achvarasdal (Care Home) page 16 of 18 Inspection report
Date Type Gradings Environment Not assessed Staffing 3 - Adequate Management and leadership Not assessed
4 Oct 2010 Unannounced Care and support 5 - Very good Environment Not assessed Staffing Not assessed Management and leadership Not assessed
14 May 2010 Announced Care and support 5 - Very good Environment 5 - Very good Staffing Not assessed Management and leadership Not assessed
3 Feb 2010 Unannounced Care and support 5 - Very good Environment Not assessed Staffing 5 - Very good Management and leadership Not assessed
1 Sep 2009 Announced Care and support 5 - Very good Environment 5 - Very good Staffing 5 - Very good Management and leadership 5 - Very good
17 Feb 2009 Unannounced Care and support 5 - Very good Environment 5 - Very good Staffing 5 - Very good Management and leadership 5 - Very good
4 Jun 2008 Announced Care and support 5 - Very good Environment 5 - Very good Staffing 5 - Very good Management and leadership 5 - Very good
Inspection report for Achvarasdal (Care Home) page 17 of 18 Inspection report
To find out more
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Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas.
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