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Council / Generally positive inspection reports for care homes but staff shortages continue

The Overtonlea care home. Photo: Shetland Islands Council.

CARE homes across Shetland have been given generally positive inspection reports – but staff shortages are continuing to have an impact on some services.

The only care home not directly operated by Shetland Islands Council – the Walter and Joan Gray in Scalloway, which is run by CrossReach – received the highest inspection grades.

Reports from the Care Inspectorate were presented to a meeting of the Shetland integration joint board’s audit committee on Thursday.

The inspections in question, all undertaken in 2022, were the first since Covid restrictions were imposed and there is an acknowledgment that there continues to be areas of care yet to return to pre-pandemic levels due to staff shortages.

They covered the following care facilities: Edward Thomason and Taing House, Montfield Support Services, North Haven, Isleshavn, Nordalea, Fernlea, Overtonlea, Wastview, Walter and Joan Gray, Newcraigielea.

The Care Inspectorate ratings scale ranges from one (unsatisfactory) to six (excellent).

Edward Thomason and Taing House in Lerwick was given a three rating – “adequate” – for supporting people’s wellbeing, and a four – “good” – for leadership.

Inspectors praised staff’s caring and compassionate nature, as well as their hard work in ensuring people’s needs and outcomes were met.

People also enjoyed the food, and the mealtime experience was said to be sociable and pleasant.

There were a few areas requiring improvement, such as ensuring the consistent use of “best practice documentation” and effective medication management systems.

Montfield Support Services, also in Lerwick, was given two ‘three’ (adequate) ratings in the same categories.

Inspectors said they said staff providing kind and compassionate care, with the new leadership team having a positive impact on the service.

Leaders were clear about what aspects of the service needs to improve, while the environment was “clean and in a good state of repair”.

Areas for improvement included ensuring people have opportunities to engage in meaningful and stimulating activities, and that the provider should make sure folk’s hygiene and appearance are supported to a high standard.

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Requirements were imposed with timeframes given, with a plan formed to address these issues.

At North Haven in Brae there were two ‘three’ (adequate) ratings and three ‘four ratings’ (good) given in the areas assessed.

Key messages included that the home was largely clean and tidy, with family very happy with the care their relatives received.

However inspectors did note staff shortages within the service.

Areas of improvement included maintaining a high standard of infection prevention by providing the latest guidance to all staff, and ensuring all of the workforce are up to date with initial training and refresher courses.

Isleshavn in Yell was given two ‘three’ ratings (adequate), with inspectors saying people looked well, folk were generally happy with the care and support and staff were caring and compassionate.

They noted that difficulties in staff recruitment and retention meant some workers were doing very long hours.

Areas of improvement included implementing a falls prevention and management protocol and ensuring people have opportunities to engage in meaningful and stimulating activities.

A requirement with a timeframe of 1 June 2023 was imposed which included a need to assess the service’s performance through effective audit, and to review the effectiveness of actions put in place.

Nordalea in Unst was given two ‘four’ (good) ratings, with people happy with their care, while staff were noted to be compassionate and enthusiastic about their work.

There were a few areas of improvement, including ensuring effective medication management systems are in place.

Whalsay’s Fernlea was also given two ‘four’ (good) ratings, with inspectors noting a warm and welcome atmosphere and staff who were kind and attentive.

The care home was given a couple of areas of improvement, including ensuring effective medication management systems are in place.

It was a similar situation at Overtonlea in Levenwick, which was also given two ‘four’ (good) ratings.

People were said to be involved in how they were supported, and staff were happy to talk and share their ideas.

A few areas of improvement were identified which included ensuring a high standard of infection prevention and making sure all notifiable events are submitted to the Care Inspectorate in good time.

Wastview in Walls also had two ‘four’ (good) ratings, with the service deemed to be clean and homely and that people enjoyed warm relationships with staff.

One area of recommendation identified was that the service should continue to consider how it can make the most of all moments when staff are with people, building on their interests and providing short periods of activity throughout the day.

A report to members of the IJB audit committee said while there continues to be areas of care yet to return to pre-pandemic levels, feedback from individuals and their families are on the whole positive.

It added that each service is committed to addressing the improvement actions proposed.

The Walter and Joan Gray care home in Scalloway, the single facility not run directly by the council, was the only facility inspected which returned some ‘five’ – “very good” – ratings.

People were said to be happy with their care and support, and the environment was clean and well maintained. Inspectors also noted a culture that supported professional development.

It was also the only care facility where no areas of improvement were identified.

Shetland Islands Council recently went out to tender for a £3.8 million contract for the service as the current one is due to expire at the end of March.

Meanwhile Newcraigielea in Lerwick, which provides respite for adults with learning difficulties, returned two ‘four’ (good) ratings.

Inspectors said people were treated with dignity, compassion and respect and that the home was clean and welcoming.

Areas of improvement included ensuring staff are using “person-centred language” in their daily recordings, and that the provider should undertake regular assessment and supervision of workers.

IJB chief officer Brian Chittick told Thursday’s meeting that the chief social work officer and service managers have already met with the Care Inspectorate to discuss any further improvement plans.

Regarding staffing he said there has been the appointment of a team leader in a care facility recently, and that other recruitment opportunities are being explored.

Councillor Robbie McGregor, who has a history with the pharmacy sector, questioned the improvements required in some care facilities around medication.

Chittick said: “At the moment we are just in the final stages of a new medications administration policy.

“We have drafted that policy in collaboration with pharmacy colleagues as well.”

It will look at process, procedures and training. Chittick said it will be a “major backbone” in the future. 

Meanwhile Shetland West councillor Liz Peterson praised the work of staff in care homes, saying they are “doing a really good job”.

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