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Inspectors deliver ‘weak’ verdict on running of Inverness care home and order improvements

By Neil MacPhail

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Kingsmills Care Home, Inverness.
Kingsmills Care Home, Inverness.

An Inverness care home for the elderly has received an improvement notice and several requirements for change after inspectors delivered verdicts of “weak” for several important aspects in the running of the 60-bed facility.

Three inspectors from the Care Inspectorate visited Kingsmills Care Home unannounced earlier this year.

And they concluded that the inspection “highlighted crucial weaknesses in aspects of the service which significantly affected the care that people received.”

Support for resident’s wellbeing, leadership, and the staff team were all graded Weak, one above the lowest grading Unsatisfactory.

The home’s setting was judged Good but could be better, and care and support planning was Adequate.

Inadequate staffing levels appeared to be a major cause of the shortcomings found, and inspectors made it a requirement that the home improve this.

The report said: “The staffing levels were not sufficient to meet people's current level of need. Staff told us that there were often insufficient experienced care staff on shift to support people safely.

“This was because a significant proportion of the care team were new to the service and therefore lacked experience. The skills mix of staff meant that people were not getting the care they needed because skilled staff are vital in providing positive outcomes for people.

“Experienced staff told us they were exhausted due to working extra hours and supporting less experienced team members on shift. Although they demonstrated kindness towards people we saw a staff team who worked under pressure.

“As a consequence of the inspection feedback and the risks identified, the provider took action to address staffing concerns by increasing the number of staff on duty.”

The inspectors’ key messages were -

• We saw examples of sensitive care and support provided with warmth and affection.

• Staffing levels and skill mix were not sufficient and people's basic care needs were not always being met.

• There were concerns about areas of staff competence in moving and handling practice which put people at risk of harm.

• Food was of a good quality but people did not always receive the right support to help them eat and drink.

• Opportunities for meaningful activity and interaction with staff was limited.

• Key areas of practice such as supporting people with stress and distress and safeguarding needed to improve.

• Leaders did not always take appropriate action when concerns were raised about people's health and welfare.

• Senior staff did not always respond when care staff raised concerns about people.

• The environment was of a good standard although could be more dementia friendly.

• People's care plans were of a good standard but did not accurately reflect the care and support experienced by people who live in the service.

Regarding people's wellbeing and the evaluation of “weak for this key question”, the inspection identified some strengths, but these were compromised by significant weaknesses which significantly affected the care that people received.

As a result of the findings, an Improvement Notice under the Public Services Reform (Scotland) Act was issued on 24 April 2024.

The inspectorate ruled that by 14 July 2024 the care provider must ensure people who experience care have the opportunity to participate in activities to maintain their health and wellbeing by having sufficient staff available to support participation in activities and opportunities for meaningful indoor and outdoor activities.

Regarding weak leadership inspectors were concerned that staff were participating in, or felt unable to challenge, poor practice which impacted on people's health, emotional wellbeing and dignity.

“Leaders did not always take appropriate action when concerns were raised about people's health and welfare, for example unexplained bruising,” said the report.

“Some relatives told us they did not feel confident about raising concerns and had received limited feedback about actions taken or 'false promises' being made about improvements.

“Leaders had not always made appropriate notifications of certain events to the Care Inspectorate. These notifications allow the care inspectorate to check events have been managed safely. We identified a lack of analysis and limited effort to review what had gone wrong following adverse incidents and prevent it happening again, such as falls.

An inspection requirement made is that the provider must ensure staff have the necessary training, skills and competence to provide safe care and support.

A spokesperson for Kingsmill Care Home said: “A full review of the operations within the home are underway on the back of what is an incredibly disappointing report from the Care Inspectorate.

“Immediate changes were implemented within 24 hours of the visit and we’ve also made considerable progress since then. We’re confident that we will be able to meet the requirements set out within the given time period, ensuring that the next visit demonstrates our normal high standards.”

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