Archived: Houndswood House Care Home

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People and their relatives told us they felt safe. We looked at the recruitment of new staff. This showed that that there were robust recruitment procedures in place to safeguard people who used the service. We saw that new employees had only started work after after a full criminal records check had been completed and two satisfactory references had been received.

Is the service effective?

We looked at the care records of five people who lived at the home. We found these to be very detailed. Each care record included a booklet entitled 'Connecting with your Community'. This booklet contained information on people's background, their likes and dislikes, what makes them happy and what makes them sad. People told us that they were generally happy with the care that they or their relative received. One person told us, "Overall I am very happy here."

However, there was no evidence in any of the care records that either the person who lived in the home or their representative had given consent to the proposed care contained within the care plans.

We asked the provider to tell us what they are going to do to meet the requirements of the law in relation to gaining people's consent for the provision of their care.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. One relative said, "[Relative] is happy here. They appear to be very caring." We spoke with a health professional who was visiting the home on the day of our inspection. They told us, "The carer's are very lovely, really nice."

Is the service responsive?

One person told us, "They are very, very helpful in every way. Anytime I need them I press the buzzer and they come very quickly. They are very, very responsive." A relative said, "They are quick to respond if you bring anything to their attention." The manager told us that following the satisfaction survey completed in November 2013 the staffing ratio in the nursing unit had been increased and fresh fruit was provided every morning at snack time.

Is the service well-led?

The service has an effective quality assurance system with quality audits completed in a number of areas and concerns addressed. Records seen by us showed that staff are able to provide feedback to their managers, so their knowledge and experience is being properly taken into account.

We spoke with some of the people using the service as well as observing how staff interacted with them. One person told us "they help me when I need it" and "lunch was delicious". We spoke with staff and one told us "things have really improved since the last inspection".

We found that the home had made significant improvements since the previous inspection, although there was still some work to be done. For example we found that the home was free from odours except for two bedrooms. This was an improvement, and we saw evidence that the rooms were cleaned regularly and that the home manager monitored this closely.

We found that activities took place daily. We observed that staff were more person centred although on occasions they were task led, and did not focus on the person.

Improvements had been made in the care provided to people, for example, people's wounds had been appropriately dressed. Care plans had been updated, however, we found some sections of people's care plans still required more detail. Medication arrangements had improved, although there were some gaps and one person's cream had not been applied in accordance with their prescription. Audits had improved and action plans contained more detail. However, incidents were not always reviewed by management promptly, although some recent training was expected to aid and improve on this.

We found that people who used the service still had to wait to receive care and treatment and that there was still a lack of stimulation. The correct medication procedures were not always followed. We identified some examples of poor care and that people were not always treated with dignity and respect. Staffing levels had been increased but shifts were not always fully covered. Management did not have appropriate arrangements in place to monitor the quality of the service.

This meant that people were at risk of unsafe care and treatment and the provider had not taken suitable action to address issues of poor care.

We were told that there was an activity plan in place, we compared this to the activities which were provided and found that these were often different to the plan. The activities provided consisted of television in the lounge and newspapers and a mobile shop. People did have one to one sessions with the activities co-ordinator and a small number of people were taken out for walks in the garden.

We observed that there were not enough staff on duty and this was supported by the staff rota which indicated that the home did not consistently provide staff in accordance with staffing levels agreed by the provider. We found that medication was not always administered on a timely basis and that on occasions people did not receive their morning medication until lunchtime when their second dose may be due.