Staff team ‘motivated and embracing change’ to drive improvements at St Rognvalds 

An unannounced visit by the Care Inspectorate to St Rognvalds Care Home has found management oversight has improved and staff are motivated and embracing change needed to improve care, according to a report published today.

The follow up inspection was carried out to check progress on an outstanding requirement from previous inspections relating to staff deployment within the service.

Inspectors found the requirement has been met and as a result changed the evaluation for 'how good is our staff team?’ from "weak" to "adequate".

April's unannounced visit follows on from a monitoring visit in March.

They found two out of six previous requirements have been met:

• Staff have reduced their use of radio communications to have less impact and intrusion on the experience of those living in the home, and 
• Oversight and deployment of staff has improved, with a ‘small group living’ approach creating a homely and accessible environment for individuals, and improved accountability and clarity for staff on their specific responsibilities. The service is also introducing a ‘dependency tool’ to record levels of need in the home and support the service with ensuring that the right number of staff were available at the right time. 

Inspectors highlighted positives including:  

• A new interim manager and a dedicated improvement team had been appointed to support the service. 
• Management oversight had improved. 
• The staff team presented as motivated and were embracing change within the service. 

Although some progress has been made toward meeting the other four requirements, more work is required and a revised target date of 30 May 2025 has been agreed with the Council. 

These outstanding requirements include: 

Care related documentation used

Inspectors found this was now more streamlined and personalised, allowing staff to monitor key aspects of care including diet and fluid intake, positional changes and bowel activity. However, they found examples where food and fluid monitoring records required to be improved, as well as recording what actions had been taken when individuals had not met expected targets. The management team is including discussion about this during newly introduced twice-daily staff huddles. 

Quality assurance

Inspectors observed improvements in management oversight and the quality of the home environment, record keeping and overall engagement with residents. Feedback is actively being sought and shared, with an ‘open day’ event for residents and their families leading to the team creating an "improvement journey" wall at reception. The team is also planning a  ‘Resident of the Day’ to help keep people up to date and support person-centred care. Inspectors have suggested implementation of a robust audit schedule to help evaluate the impact of revised working practices on people's experiences.  

Health, safety and wellbeing of residents

Inspectors noted that accidents and incidents are being analysed to identify trends or patterns and implement any corrective action, and there is now a clearer structure in place for submitting notifications to the Care Inspectorate. More work is needed to ensure staff are reporting accidents and incidents in a timely manner. Inspectors suggested it become a standing prompt at twice-daily huddles - this has been adopted and now allows senior staff to discuss any adverse events with the staff team and offer guidance. 

Personal plans

Inspectors noted progress in this area, with improved quality of information within personal plans and risk assessments, including continence, nutrition and hydration needs and falls reduction strategies. More work is needed to ensure advice from external professionals is promptly added to personal plans, and that ways to meet the needs and preferences of individual residents are clearly set out. 

Stephen Brown is Chief Officer of the Orkney Health and Social Care Partnership: “This report reflects ongoing hard work by the team at St Rognvalds to improve the experience for their residents, their eagerness to adopt new ways of working to achieve this, and their determination to listen to families as they see the work through.

“We’re appreciative of the collegiate approach throughout by the Care Inspectorate, who’ve offered advice and examples of innovative practice throughout their visits, which staff have enthusiastically explored and adapted to the needs of the residents and families.” 

The full inspection report is available on the Care Inspectorate website.