Inspectors rate Tarland care home as ‘weak’ as concerns raised about staff levels and training

Inspectors have rated an Aberdeenshire care home as “weak” and flagged concerns about a lack of training and high turnover putting pressure on staff.

The Care Inspectorate paid an unannounced visit to Alastrean House, in Tarland, over two days in November.

The inspection came just one month after a complaint was upheld about the same home.

The Balhousie Care Group service received “weak” ratings in all four keys areas examined, including planning of care and leadership.

Training improvements a ‘priority’

The 16-page report highlights “significant concerns” surrounding staff competency and knowledge.

Inspectors identified improvements to staff training as a priority moving forward at the home.

The report states: “There were some areas of concern in terms of compliance with mandatory training, and evaluation of staff competence, which could present a risk to people living in the service

“During this inspection we had concerns about moving and handling and falls management which highlighted an urgent training need and regular staff competency assessments.

“Infection prevention and control training was included as part of mandatory training. However, we found through training records that compliance with mandatory training did not meet the minimum requirements of the organisation.”

The recording of falls by management was also found to be “inconsistent” and at times “incomplete”, with no falls analysis completed.

Further, the inspectors could not be “confident” that families were made aware of any falls.

They struggled to find “evidence” of several plans and audits being completed regularly, with the restraints register not being updated since 2020.

Operator Balhousie has said it is committed to making the required improvements to improve the welfare of residents.

Pressures on staff

While families praised regular staff, there were concerns raised about “unfamiliar agency staff” and the impact it could have on care and support.

The report states: “Regular staff were working hard to provide consistency and stability for people who lived in the care home. Family members told us, ‘The permanent nurses and carers are lovely’ and ‘I have nothing but high praise for the nursing staff ‘.

“Staff were clearly feeling the impact of the uncertainty of frequent changes of
managers and the high use of unfamiliar agency staff that had been required. Staff told us it had been quite a stressful time and that morale was low.”

Balhousie has said it “invests heavily” in recruitment but the rural location of Alastrean makes it “difficult to attract staff”.

Earlier this month, it was announced that two wards would be closing at the Alastrean home, with staffing levels noted as one of the reasons for the closure.

It was confirmed that the dementia unit at the Balhousie home in Huntly would also be shutting, with residents from both homes to be reallocated across Aberdeenshire.

The report also highlights management’s lack of communication with residents’ families.

It states: “We found it very difficult to see what communication took place with families.

“They told us that the nursing and care staff usually kept them up to date but they had less confidence in the management team who had failed to respond to emails or phone calls.”

By February 24, the home must show evidence of keeping an accurate record of plans, having quality assurance processes in place, reviewing people’s personal plans and identifying plans for training needs.

Focus on ‘immediate improvements’

Balhousie said is was “deeply disappointed” by the Care Inspectorate’s gradings.

A spokeswoman said: “Our residents and their utmost care are our clear focus along with the drive to successfully recover and exceed our expected standards.

“We are, however, thankful to the Care Inspectorate for acknowledging how very hard our staff are working, particularly at a time when the whole sector faces extreme staffing and recruitment pressures, as the Care Inspectorate highlight, and the wider public are acutely aware.

“In the passing months since the inspection, much progress has been made and we have every faith in the Alastrean team, which has a strong reputation for its care, that it will meet the CI’s requirements.

“They continue determinedly with the immediate improvement plan set in place, with around-the-clock, hands-on support from our dedicated Operations and Quality teams.

“We are fully committed to working closely with the Care Inspectorate to conclude the necessary improvements and, as always, to the health and wellbeing of our residents.”