Inverness’s Castlehill Care Home making ‘notable improvements’ following earlier scathing report, Scotland’s Care Inspectorate says following new surprise inspection at Highland site
Improvements are still needed at a care home that was previously ordered to significantly improve the quality of its care or risk losing its licence.
Castlehill Care Home in Inverness, which can accommodate nearly 90 residents, recorded numerous “weak” ratings when inspected by the Care Inspectorate last year - which led to it being warned subsequently that its registration to operate was at risk without major improvements.
Despite its then operators objecting to “substantial” parts of that report, a subsequent shake-up in management at the site and follow-up inspections showed that progress was being made.
But following their last visit, inspectors said several requirements for improvement still needed to be made.
And the care home’s operators pledged swift action this summer in response to the earlier criticisms.
A new surprise inspection carried out on August 13 has now reported on progress.
And, although “notable improvements” have been made and a “significant reduction” in the use of agency staff has led to “greater consistency” in residents’ care, the home still received two “weak” ratings out of the five areas assessed.
Inspectors rated the care home as "adequate" in three of the five areas - how well it supported people's wellbeing, how good its staff team are, and the site's setting.
It scored "weak" in the other two areas, which covered its leadership and how well its care and support are planned.
Issuing their findings, the three inspectors who carried out the surprise inspection, said: “There were notable improvements in leadership, direction, and staff deployment, particularly on the first floor.
“Residents benefitted from greater consistency in their care and support due to a significant reduction in the use of agency staff.
“Recent key appointments were beginning to influence positive change and enhance practice across the service.”
But they added: “Further improvement was needed in staff training and practice relating to infection prevention and control, as well as medication management.
“Care planning and assessment also required development to better inform and guide staff in delivering person-centred care.”
In light of the progress being made, the inspectors have extended the deadline to October 31 for the care home to meet the requirements.
These requirements include one that the home “must ensure that people’s health, welfare and safety are promoted and protected through appropriate infection prevention and control procedures”.
Other previous areas cited for improvement that have not yet been fully met have been “restated” by the inspectors.
These included a requirement that the home “ensure that people’s health, welfare and safety are promoted and protected through appropriate infection prevention and control procedures”, which was met in part. The inspectors said: “We found that there had been a visible improvement in the cleanliness of the care home and there were sufficient housekeeping staff on duty each day which helped to maintain a high standard of cleanliness.
“However, quality assurance protocols in place were insufficient and ineffective to secure sustained improvement in practice and competency assessments were not used appropriately to identify gaps in skills, knowledge and practice.”
This led to a new requirement being issued for the outstanding areas.
Other improvements that have not yet been met included work to "ensure that residents, relatives and visitors are able to recognise and easily identify staff working in the service", and measures to ensure that "all legal authorisations were in place for people who were deemed to have limited capacity to make decisions".
Work is also still needed to keep indoor temperatures within recommended ranges , and to ensure that the "care planning process is tailored to a person's care and support needs".
But measures to ensure pain assessments are carried out when using prescribed pain medication were met.
A spokesperson for Castlehill Care Home said it was good to see that gradings were increasing, and that this reflected “the progress made” and the “improvements will continue”.
They said: “We are pleased that the improvement notice has been withdrawn by the Care Inspectorate. In collaboration with the Care Inspectorate, we agreed to extend the inspection period in order that the improvements made can be embedded and sustained. The grades have all increased, reflecting the progress made, and improvements will continue.
“NHS Highland is now carrying out 6-month care reviews in line with best practice, and at our request, since the NHS had not offered a care review for over two years for many residents.
“A refurbishment in excess of £1m of the ground-floor of the home is under way, and we would like to thank the residents and their families for their understanding during this time.”