A RESIDENT in Mount View, Duns, a residential home providing nursing and social care for adults with learning disabilities and complex health needs, was regularly restrained in a wheelchair because staff were too busy attending to others.
Evidence has also come to light of: other residents being left unattended and unoccupied for long periods of time; the use of residents’ money to buy equipment the service provider was supposed to purchase; one resident not receiving any of their money for almost 12 months after being admitted to the care home; the provider assuming responsibility for managing and spending the personal funds of some people who use the service without the necessary legislative controls being in place to ensure that residents’ monies are being spent appropriately and according to their wishes; and staffing issues.
A large scale investigation by NHS Borders and Scottish Borders Council identified a number of “serious concerns” about the running of Mount View by the Hawick based Streets Ahead (Borders) charity, and Social Care and Social Work Improvement Scotland (SCSWIS) inspectors made four unannounced visits to Mount View between May 22 and June 22 this year concluding: “Mount View is operating at an unsatisfactory level.”
They reported finding: “areas of concern which compromise the health, safety and wellbeing of residents and do not comply with best practice or legislation.
Inspectors reported: “A large scale investigation, initiated as a result of a report alleging the use of restraint with one resident, identified a number of serious concerns about this service.
“Immediate action is required by the provider in order to safeguard the health, welfare and safety of the people who use the service.
“We saw from our inspection visits that there is a distinct lack of evidence to suggest people who use the service are being appropriately supported or enabled to reach their full potential.
“We looked at care plans and saw that one resident had been regularly restrained in a wheelchair (with the use of a lap strap) because staff were attending to other residents. This practice has been looked into as part of a multi-agency large scale investigation, and has now stopped.
“We also found evidence in another resident’s financial records that restraint was being permitted at times when staff were busy assisting other people.”
The quality of the 24 hour care and support for the eight Mount View residents provided by Streets Ahead was graded as unsatisfactory, as was the environment. Staffing, management and leadership were graded as weak.
An inspection carried in January 2011 graded the care as very good, and the team who visited in June this year concluded that “there has been a significant decline in the quality of this service, resulting in poor outcomes for the people who use the service.”
A statement from Streets Ahead (Borders) reads: “We can confirm that there was a multi-agency investigation into some issues at Mountview, we have co-operated in every way and introduced new management resulting in significant change.
“Contractual arrangements with Scottish Borders Council and the lease of the property with Berwickshire Housing Association await the outcome of negotiations with Scottish Borders Council.
“The removal of NHS nursing staff has been planned for some time and has enabled us to introduce a social care model of support.”
The current staff team is made up of NHS Borders nurses and care staff employed by Streets Ahead, who have been running Mount View for since 2008, after being commissioned by NHS Borders.
Streets Ahead director Bridget Sinclair, who was responsible for development and training at Duns, has now retired .
In a joint response from Scottish Borders Council and NHS Borders they said: “Early in 2012, some concern about the standard of care at Mount View was expressed in relation to one resident.
“During the course of this enquiry, a number of further concerns about the quality of care were raised with the Joint Learning Disability Service and the Care Inspectorate.”
Responding to the inspectors’ findings the local agencies said: “These findings were taken very seriously and as a result, action is being taken to support Streets Ahead (Borders) to address the issues raised.
“These include improvements to: the fabric and furnishings of the building; the processes for support planning for each resident; support to staff in learning and development opportunities; support offered to staff through supervision and management.
“Crucially, since the original concerns were identified, additional support has been provided in the home by Borders and Scottish Borders Council staff and a review of each resident’s needs and support plan has been completed with the full involvement of families.”
As for the future of the service at Mount View: “Renewal of the contract is currently being progressed. We are working with Streets Ahead (Borders) to maintain consistency for the residents and their families.
“There is evidence of considerable improvements in the quality of service currently being provided and both NHS Borders and Scottish Borders Council are confident that Streets Ahead (Borders) is working closely with partners to maintain and improve the quality of life for all the residents at Mount View.
“The withdrawal of nursing care at Mount View was carried out as part of a thorough review of the health needs of the residents and as such was carefully assessed.
“Streets Ahead (Borders), as commissioned by NHS Borders, will provide the care required by residents while their health needs will continue to be met by the NHS Borders community health service.
The building in Teindhillgreen, Duns is leased from Berwickshire Housing Association and both the NHS Borders service contract and the lease expired in December 2011. NHS Borders and SBC say: “The service will continue to be commissioned and managed by Streets Ahead (Borders).”
The building in Teindhillgreen, Duns is leased from Berwickshire Housing Association and both the NHS Borders service contract and the lease expired in December 2011, with inspectors unable to find evidence of new contracts being agreed.
Berwickshire Housing Association confirmed that the lease has not yet been renewed but that Streets Ahead is paying rent on a month to month basis.