Edinburgh council-run care home handed 'weak' report card over medication concerns

The council-run Royston Court is registered to look after up to 60 older people at its premises in the Granton area.

Inspectors have raised fears over medication and pain management at an Edinburgh care home.

The council-run Royston Court is registered to look after up to 60 older people at its premises in the Granton area. It was visited by the Care Inspectorate a week before councillors voted through £60million worth of social care cuts which will see two other homes close down and charities' funding slashed.

In a report by the watchdog, it was noted that residents of Royston Court 'did not always receive the right medication at the right time'. It reads: "The use of 'as required' medication for pain, and more generally the assessment and management of pain, was not well understood or well managed.

Royston Court care home

"Prescribed supplements to help maintain people's weight were not given when they should have been. The provider must take steps to improve this."

It was also highlighted that the 'skin integrity' of residents was placed at risk. That was because 'topical medication was not administered as prescribed and equipment used to relieve or reduce pressure injury was not set correctly'.

Inspectors pointed out 'inconsistencies' in the quality of care, with some staff forming good relationships but some residents feeling isolated. "Not all staff were able to build good relationships with people and this had a negative effect on the distress of some residents and their relatives", the report adds.

"When staff showed an enabling attitude towards people, this made residents feel safe and happy in their home. For example, staff supported someone through a bereavement and this had a substantial positive effect.

"This contrasted with how people showed signs of stress and distress or frustration because they were not always heard or acknowledged by some of the staff team."

It continues: "The rights of people to move freely around the home and have access to all the facilities as independently as possible were not well understood. Some areas of the home were locked with key pad locks.

"Restrictions to people's movement were not designed to benefit the individual, were not risk assessed or clearly documented. The provider must take action to make sure that people's rights are upheld."

Complaints recording was raised as another issue. "People's views were not being heard and complaints were not properly logged", the inspectors add.

"Recording complaints helps to make sure that the right procedures are followed. The provider must ensure that complaints are properly recorded and responded to and that information from complaints can be used to improve the service.

"While there were some methods in place to monitor aspects of the service, such as auditing, these were not implemented in a consistent way and the findings were not followed through. This meant that practice did not change and learning and development opportunities were not identified, which made the quality assurance processes largely ineffective.

"Staff mainly saw quality assurance processes as an additional task and did not understand how the process could benefit them and the people they supported.

"There was a lack of analysis of incidents, accidents and falls and no demonstrable effort to learn from these or use information to mitigate risks to people."

It was suggested that staff's performance should be monitored more closely and that the extensive use of agency staff left residents more anxious due to knowing many of their carers well enough.

A spokeswoman for the Edinburgh Health and Social Care Partnership said: "We welcomed the findings of the recent inspection at Royston Care Home. We are already implementing changes as a priority in the home, so we can continue to keep people in Edinburgh as happy, healthy and safe as possible."