Archived: Ayrshire House

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations.

On the day of our inspection staff interacted well with people. People and their relatives told us that they felt safe and well cared for. Staff knew how to keep people safe. The provider had systems and processes in place to keep people safe.

Medicines were administered and managed safely.

We found that people’s health care needs were assessed and care planned and delivered to meet those needs. People had access to healthcare professionals such as the district nurse and GP and also specialist professionals. People had their nutritional needs assessed and were supported with their meals to keep them healthy. Where people had specialist dietary needs appropriate arrangements were put in place to support them to manage these.

There were sufficient staff to meet people’s needs and staff responded in a timely and appropriate manner to people. Staff were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place and staff had received supervision.

People were encouraged to enjoy a range of leisure and social activities. People accessed local resources for leisure and took an active part in the local community. They were supported to maintain relationships that were important to them.

Staff felt able to raise concerns and issues with management. Relatives and people who lived at the service were aware of the process for raising concerns and were confident that they would be listened to. Regular audits were carried out and action plans put in place to address any issues which were identified.

Accidents and incidents were recorded and investigated. The provider had informed us of notifications. Notifications are events which have happened in the service that the provider is required to tell us about.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service support this practice.

Further information is in the detailed findings below

People who used the service confirmed the menu had been reviewed since we last visited in May 2013. We saw the menu provided a choice of well-balanced, nutritious meals that met people's needs. Comments received from people who used the service included, 'We have a new menu, we always get a choice of what to eat and can have an alternative if we don't like the choice.' And, 'If you are hungry and want a snack, you can ask the staff.'

People were protected against the risk of health care related infections. We saw the prevention and control of infections policy and procedure had been updated. We also saw the cleaning schedules had been amended.

The provider told us two part time staff had been appointed since we last visited in May 2013. We saw the dependency needs of people had been assessed and the rota showed required staffing levels.

We found the manager had introduced monthly audits to enable regular monitoring of the service. We also saw people who used the service and other people, such as professionals had been asked for their views about the quality of the service provided.

People who used the service talked positively about the care and support they received. One person told us, 'I like living at Ayrshire House very much.' And, 'I talk to my key worker if I'm sad, or (name), she's the top boss.'

Another person said, 'We have meetings with the staff and we talk about day trips.' And, 'It's lovely to live here, I like the activities, we do arts and crafts, play football and go out.'

We had some concerns about how people's weight was monitored and their nutritional needs met. Menus were not pre planned and people had limited choice of puddings and snacks.

We saw some infection control policies and procedures were not in place, which put people at the risk of infection

There were not always sufficient staffing levels available to meet people's assessed needs and that kept people safe.

The service lacked systems that assessed and monitored the quality of the service provided. People had not been asked about their views in relation to the standard of care provided.

We did not speak with people who used the service at this inspection. We spoke with the registered manager, two members of staff and looked at three people's care plan records.

We found the provider had developed and was using new care plan documentation. The support plans we looked at showed people's needs were assessed in a way that reflected their individual strengths, abilities and interests. This meant that staff had information and direction about how to meet people's individual needs.

One person told us, 'I've lived here a long time, I have lots of friends.'

Another person said, 'I like all the staff, they listen to me and help me.'

We asked if the staff showed dignity and respect, one person told us, 'We get a choice of when we go to bed and get up, the staff knock on our bedroom doors to see if we are awake.' Another person said, 'The food is lovely, you have a choice of something different if you don't like what there is.'

We spoke with two relatives of people who used the service, comments included, 'We are always welcomed, it's top class and we have no concerns.' And 'Communication is good, we are kept in the picture of what's happening. We get invited to attend review meetings.'

We saw some people had gone out either to their voluntary work placement or into the community independently. We saw other people assisting with domestic jobs around the house, for example supporting staff with the preparation of lunch. We saw a person sweeping up outside and other people doing different activities in the games room.