Care home manager hits back at criticism of its staffing levels

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Engleburn Care Home came under fire from the Care Quality Commission

CONCERN over staffing levels at a Barton care home have been highlighted by a national watchdog but the manager has hit back claiming the criticisms are “unfair”.

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Engleburn Care Home in Milford Road has dropped from its previous ‘good’ rating in 2017 to ‘requires improvement’, following a recent visit by Care Quality Commission inspectors.

They said it was falling down in three of the five areas graded – whether it was safe, caring and well-led. It was judged as good, however, with regard to being effective and responsive.

The most glaring criticism levelled against the home was a claim by one resident that she had been “humiliated” after shouting for help from staff to get out of bed, only to be told off for calling out.

One relative told inspectors it was often 11.30am before her mother was dressed by staff; she said she usually found her in the lounge in her dressing gown complaining of being “dumped” there.

In relation to staffing levels, a “majority” of residents asked by inspectors – although it was not stated how many – gave “negative” feedback on the subject, and relatives reported numbers being “a bit light”, the CQC said.

Even though staff were said to be “amazing”, one relative said her mother’s mobility had been affected by insufficient numbers of carers. The CQC added: “There was a consensus in the feedback from staff that staffing levels were sufficient. However, some felt they needed more staff.”

There was “mixed” evidence as to how risks were assessed, and more “robust” measures were needed, said the report, while relatives did not always feel involved in reviewing their care needs and plans. Furthermore, many care reviews had “very little information”, inspectors said.

The CQC report added risk management needed to be improved, including for falls, mobility, pressure care and infection control.

Some care documentation needed more detail and to clearly reflect people’s needs and risks, and it was said systems in place to monitor the quality and safety of the service were not always effective.

On a more positive note, the CQC report stated residents were treated with kindness and compassion, and records confirmed people received their medicines as prescribed.

Relevant pre-recruitment checks were conducted and staff received and had completed training in safeguarding adults, and knew how to identify, prevent and report abuse. The staff also received frequent support and one-to-one sessions or supervision to discuss areas of development.

Residents were supported with their nutritional needs when required, received varied meals and a choice of fresh food and drinks. Staff were aware of their likes and dislikes and a nutritional manager monitored their weight and dining experiences.

“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice,” said the CQC.

In response, Engleburn manger Tracey Holland said the home had already taken steps to address some of the issues flagged up.

But she questioned some points, saying: “The issues that were raised around the staffing were unfair and unjust.”

Staff have been given more supervision on responding to requests promptly and treating people with dignity, while improvements were being made to the care planning system.

Ms Holland told the A&T: “We currently have an amazing team comprising 69 permanent staff. Every week the rota goes out with every single hour covered.

“If there are any hours not able to be covered by Engleburn staff then we use an agency.

“These agency staff follow the same training as our permanent staff and are part of our team. In the home we have 76 clients, so we are very interested to find out what the CQC consider to be a ‘majority’. They only spoke to a few clients, and a few relatives.

“Many of the relatives spoken to gave the home a glowing report and could not praise it enough; however, none of these comments are reported.”

Ms Holland said they had challenged the parts of the report they believed were factually incorrect, while also pointing out that many positive comments had not been included.

She said: “The home will continue to provide excellent care for all of our clients and support for their families.

“We will also always continue to recruit further permanent staff that will add to our current wonderful team. At this current time we have five full-time staff on maternity leave.”

Ms Holland added that the home recently had a “thorough” two-day audit with the local authority’s dementia accreditation team.

“They felt that during their visit it was obvious how hard we worked to provide a safe, happy, warm, welcoming home to enrich the lives of our residents,” she added.

“Engleburn is a family-run home that has been established for nearly 30 years, with the same manager for 26 years. We strive to have a happy, safe home that provides the best we can on a daily basis for all of our residents.”

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1 COMMENT

  1. I read the article in the paper along with the CQC report and could not understand how different they are from my own experience. My father is a long-term resident at the home and the care he has received there since the beginning has been nothing but exemplary.

    Having read the CQC report I would fully support the Mangers view regarding staffing levels in that the CQC appear to value the comments of a few opinions rather than assess the facts relating to target and actual staffing levels. There is no comment on whether the home’s plan is adequate and no comment on whether the plan is met. The CQC report also states that their own observations were positive. A professional 3rd party trainer said, ‘the staff are caring’. Residents and their relatives also said that the staff ‘were caring’

    The CQC report quotes from the Home’s own February 2019 feedback and states that ‘We saw lots of positive comments including, ‘staff at Engleburn always prepared to listen to any concerns very kind and caring’. This presumably takes into account many more views than the very small sample interviewed during the inspection. Those that responded on the feedback will also have had more experience of the services provided than a couple of individuals. So I would be inclined to put much more weight on this than on a couple of negative comments. The February feedback reflects my own experience and I have no hesitation in continuing to support the staff and management at the home. The report in the paper along with the CQC report itself do nothing to change my view that Engleburn is an excellent care home and that my father is in the right place, receiving the care he needs and has done for the past 5 years.

    Having read through the CQC report I would make the following observations.

    Is the service safe

    The report observes ‘majority of feedback from people about staffing levels was negative’ and then goes on to make various quotes. First, given that they interviewed just 8 residents and 9 relatives/friends, out of 76 residents, the quote gives a misleading impression that ‘the majority’, relates to all residents and relations. The February 2019 feedback would be a better view of the majority which is very positive.
    The quotes of a few of those interviewed state that they want more staff. This is not an appropriate way to measure whether staffing is adequate. I am sure more staff would always be welcome, but that is not the point. The views of any single individual should not override the overall staff planning. Whether the planned staffing levels are met, and whether the plan is adequate, the report makes no comment about which questions the validity of the Requires Improvement rating.

    Is the service caring

    Once again the opening paragraph refers to relatives and residents claiming ‘there is not enough staff’ which appears to have caused the Requires Improvement rating. Again, the report makes no comment on the planned staffing levels as to whether this is adequate or not.
    The report also takes one person’s comment about whether they have been consulted on their care plan, leading to the impression that the review process is not adequate. Adequacy should be based on an assessment of the documents as to whether residents and relatives were actually consulted and at what periods. My evidence is that I am consulted every 6 months and have a full review with the opportunity to give feedback and comment. The report makes no comment about whether the review period is met, or whether the plan for reviews is adequate. In between reviews the staff and management are always available.
    At the time of the inspection, the report states that ‘we observed Staff demonstrated a detailed knowledge of people as individuals and knew their personal likes and dislikes. Staff showed respect for people by addressing them using their preferred name and maintaining eye contact. Staff communication with people was warm and friendly, showing a caring attitude’. The report also quotes an external training assessor who states that ‘the staff are caring’. Residents and their relatives state that the staff ‘were caring’. So it would appear that the comments of 2 people have overridden the direct evidence of the inspectors, professional people, and a more comprehensive feedback process.

    Is the service responsive

    This section starts with what appears to be reluctant praise stating that ‘care plans contained some good person-centred information’. There is then only one negative comment about religious beliefs. Even on this point the report points out that people’s religious needs were not documented, not that they weren’t met. The remainder of this section only includes praise including the achievement of a gold standard.

    Is the service well led

    The report identifies a number of improvements that should be made by management in terms of governance and as these are generally internal processes at the home, I cannot comment. But I would be confident that any improvements suggested would be taken on board and acted upon, as is evidenced by the changes mentioned on suggestions by relatives and residents and my own personal experience when providing feedback to both staff and management.

    In conclusion

    It is hard to reconcile the overall rating of the CQC report with my own experience of the excellent care provided by the home to my father, along with the evidence of the feedback survey from February 2019 which the report states that ‘We saw lots of positive comments including, ‘staff at Engleburn always prepared to listen to any concerns very kind and caring’.’

    The home will continue to receive my full support despite the negative comments in your article and from the CQC.

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