Elderly residents in an Aberdeen care home urinate in corridors and staff make little effort to stop them, inspection results have revealed.
After an inspection in September last year, the Care Inspectorate (CI) criticised staff at the Banks O'Dee care home in Tullos, Aberdeen for a lack of warmth and warned that most residents spend long periods with nothing to do.
Scotland's care watchdog says the care home must improve urgently.
Going outside for a cigarette was the most vigorous activity some residents engaged in, care inspectors found.
Staff were disinterested and poorly trained, while the home was in a poor state of repair, and the Inspectorate rated the home 'weak' on all fronts, covering standards of care, the living environment, staffing and management.
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Inspectors were still unhappy at a follow-up visit in December and the watchdog has now issued the home with a formal Improvement Notice, demanding it make urgent improvements by March11th to ensure residents are safe and well, or face further action.
The home, run by Four Seasons Health Care, must ensure there are enough staff and that they are competent and qualified, improve the activities on offer to elderly residents, and ensure their wishes are respected.
A complaint about the home in October – one of three the inspectorate upheld against the home in the last six months – related to "death and dying". The CI does not publish details of complaints, but it subsequently instructed the home to ensure staff are aware of residents wishes regarding DNACPRs (do not resuscitate orders).
The inspection in September highlighted a catalogue of cocerns.
Previous concerns about a "strong odour" within the home had not been allayed, inspectors said, adding: "One of the corridors downstairs had a strong smell of urine, because some of the men were doing the toilet there. There was no indication this was being addressed by helping people orientate themselves, or find the toilet."
Their report revealed residents who had expressed a preference for baths were being showered because it was more convenient for staff.
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Some staff did little more than meet residents basic needs, the September inspection found and inspectors added: "Some residents went for prolonged periods of time without staff interactions. Most of the interactions we saw were task-focused, lacked warmth and were impersonal".
"Some residents did go out to smoke but that was the limit of their daily exercise."
There were occasions where important medicine for residents had been misplaced or not ordered, the inspectors noted, meaning some did not get the treatment they needed.
There had been minimal improvements to the home since a previous inspection, the September inspection found, although a refurbishment plan is due to begin shortly. This must be completed to a high standard, the CI says: "this will ensure that the home becomes a nice place for residents to stay".
Inspectors say the CI "will not hesitate to act", if managers do not raise standards. The ultimate sanction would be to seek a court order to strip the home of its registration, effectively forcing it to close.
A spokesperson for the Care Inspectorate said: “The Improvement Notice we have issued clearly lays out the improvements we must see so that the care experienced by residents improves quickly.
“We will visit this care home again soon to check on progress and if we are not satisfied that the matters raised are being addressed urgently we will not hesitate to take further action.
“Everyone in Scotland has the right to safe, compassionate care which meets their needs and respects their rights."
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A spokesman for Four Seasons Health Care said the home had struggled to recruit staff but was acting to "improve the resident experience".
"We are sorry that Banks O’ Dee is not meeting the standards we expect our homes to provide. We have brought in a specialist Care Improvement Team, " he said.
"As an organisation we have robust systems, procedures and documentation to support a high standard of care and the improvement team will have oversight to ensure they are being properly followed in the home.
"The home’s operational challenges have been exacerbated by local difficulties in recruiting and retaining staff with the right skills in the strong local jobs market. This has necessitated high use of temporary agency staff who, although they are appropriately qualified, are not familiar with our policies and procedures and do not know the residents so well as our permanent staff.
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