Council / ‘Decline’ in care home inspection grades but improvement work ongoing
WORK is ongoing with improvement plans at some of Shetland’s care homes amid what has been described as a “decline” in inspection gradings.
Members of Shetland’s integration joint board (IJB) were given assurance on Friday that work is also ongoing on a wider level across the care estate.
The meeting was told that the inspections in question were the first in Shetland under a new Care Inspectorate inspection process.
“It’s fair to say that they’ve been quite challenging visits, and our services have felt under a large amount of scrutiny,” acting community care resources manager Heidi Wharton-Baum said.
She said there have also been some difficulties in staff recruitment for senior roles, especially in the North Isles.
The Care Inspectorate reports related to the North Haven, Fernlea, Isleshaven, Overtonlea, Nordalea and Wastview care homes.
All of the care homes, which are run by Shetland Islands Council, received a number of a positive comments.
However there were some recommendations given.
North Haven in Brae was given an unannounced inspection in November 2024 and received two ‘good’ ratings and three ‘adequate’ ones. A follow-up inspection in March this year gave two ‘weak’ gradings.
Fernlea in Whalsay was given an unannounced inspection in February this year, and received one ‘very good’ rating, two ‘good’ grades and two ‘adequate’.
Meanwhile at Isleshaven in Yell an announced inspection took place in February this year, with the care home given four ‘adequate’ ratings and one ‘weak’.
In Levenwick the Overtonlea care home received three ‘good’ ratings following an unannounced inspection in April 2025.
The report to IJB members said that the Nordalea care home in Unst also had an unannounced inspection in April, getting two ‘good’ grades and two ‘adequate’.
Inspectors similarly carried out an unannounced visit to Wastview in Walls, with two ‘good’ grades and one ‘adequate’.
Wharton-Baum said improvement plans were put in place across all the inspected care homes.
She told a meeting of the IJB last week that inspectors were expected to return to Shetland “imminently”.
Some of the care facilities will be reinspected, and others will be inspected for first time this year.
IJB chair Natasha Cornick said it was important to highlight the section of the meeting papers which said the reports “provide assurance that the care being provided is safe and person centred”.
“But we’ve got to acknowledge that there’s a decline in the gradings of our care home estate and be assured that work is ongoing to improve quality of care across the board,” she said.
Cornick mentioned how there is already a “care home assurance” process in place with local teams visiting facilities regularly.
She asked if the issues highlighted by the Care Inspectorate are ones which were expected to have been picked up locally.
Adult social work manager Ruth MacMillan said the recent inspections have highlighted some “potential gaps” in the care home assurance process.
There has been discussion with people in the Care Inspectorate on this and some “learning” has been taken from other areas, including Greater Glasgow and Clyde.
MacMillan also said local teams are looking at the development of an “independent reviewing officer role” which would assist the process.
She added that the focus of local care assurance visits is on “support and improvement, not around people feeling that they’re having additional inspections”.
Meanwhile regarding medication in care homes NHS Shetland’s pharmacy director Anthony McDavitt also said work was ongoing in that area too.
He also said there is a “good culture” in care homes around staff reporting any issues or incidents.
Councillor Moraig Lyall also highlighted how some of the areas highlighted as weak were to do with leadership.
She asked if this reflected gaps in staffing or whether additional training was required.
Wharton-Baum said it was “partially both”.
“I think we have had some challenges in recruiting senior staff, especially in the North Isles,” she added.
“We are, because of that, looking at different structures now in terms of how we can provide a more robust cover of managers on site, most of the time.”
The meeting was told there were also a few new senior staff who are learning the role – which is something that cannot be rushed.
“I think the services have been under such immense pressures in terms of the client needs, that we now need to look at how we can resource in terms of team leaders effectively,” Wharton-Baum added.
IJB chief officer Jo Robinson added that there has also been staff movement between roles, some sickness, and vacancies too.
“I think we are in the process now of really consolidating…making sure that we always have that team leader role in place and we have sufficient people in place even to provide cover when there are other gaps,” she said.
Meanwhile board member Kathy Hubbard asked about the protocol of how a less than satisfactory report affects the admissions process.
MacMillan said stopping taking new admissions following ‘weak’ grades or below is only a recommendation from the Care Inspectorate, but it is something the council follows.
“We think we could be in a really difficult place if we didn’t [follow the recommendation], and also because we want to ensure people are getting the best level of care,” she said.
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