Balhousie Pitlochry Care Home receives lowest possible mark

A Highland Perthshire nursing home has received the lowest mark possible following an unannounced inspection by Scotland’s care watchdog.

In the official report compiled by the Care Commission, the Balhousie Pitlochry Care Home was labelled “unsatisfactory” for its level of care and support.

Its quality of staffing and environment received a slightly higher mark, being classed as “weak,” while the only service seen as “adequate” was the management and leadership.

One of the areas highlighted for improvement following the inspection was medication recording, with prescriptions being administered over a 12-hour period, rather than throughout the waking day of the patient.

There were also instances of dementia patients being given tranquiliser medicine when they did not necessarily require it.

The report said, “Within the dementia unit we noted that a significant number of people were prescribed one particular anxiolytic or tranquiliser medicine used to relieve anxiety and reduce tension and irritability.

“These had been prescribed with the instruction to take when required. In most cases the instructions on the aide memoir were the same for each resident irrespective of the way their agitation manifested itself.

“This meant that some service users may have received medication used to relieve anxiety when it was not appropriate or necessary. One aide memoir included instructions for administering a medicine which was discontinued.”

Medication

During their visit, inspectors also highlighted queries about medication prescribed to certain residents.

These included people prescribed three different painkillers, two laxatives which work in the same way, an antipsychotic which in 2004 was recommended not to be used for people who have dementia, and medicines to treat “acute” conditions for short-term use being administered for lengthy periods.

Staff training was also an issue for concern because, although they were seen to be “kind and caring,” some employees had revealed a lack of training and induction, as well as difficulties communicating.

The report said, “One member of staff had commented that they had not received manual handling training but had been carrying out manual handling practice without being deemed as competent.

“Another commented that they had not received a formal induction.”

It added, “We received general comments regarding some language and communication difficulties among some staff.

“During the inspection we saw that one member of staff had offered a service user some biscuits which then had to be taken away because they were unable to have them due to having diabetes. The member of staff had not been aware of this.”

Positive view

Despite these issues, people who use the Balhousie Pitlochry Care Home and their carers have a generally positive view of the service, saying they felt able to approach staff and that relatives were well cared for.

The quality of management was also seen to be a strength, with regular staff meetings to discuss best practice issues, as well as improved communication between nurses and carers.

Despite the negative overall grading, elements of the level of care provided were praised, including meeting dietary requirements and providing activities for residents.

Balhousie Care Group chairman Tony Banks said that the firm acknowledged the findings of the report and were “fully committed” to addressing the issues raised.

He said, “We have already conducted our own internal audit and review of procedures and have drawn up a robust and detailed action plan which addresses each of the issues highlighted in the report and has been shared and agreed with the Care Commission.

“This action plan is already being implemented as a matter of urgency, including additional training and a new, enhanced senior management team.”

He added, “We are confident of resolving all the areas for improvement and expect this to be reflected in a more positive report in due course.”