Care service inspection report

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1 Care service inspection report Full inspection Shared Lives Service - Perth & Kinross Adult Placement Service Suite 2 South Inch Business Centre Shore Road Perth Inspection completed on 16 May 2016

2 Service provided by: The Richmond Fellowship Scotland Limited Service provider number: SP Care service number: CS Inspection Visit Type: Unannounced Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and set out improvements that must be made. We also investigate complaints about care services and take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. Contact Us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY Inspection report page 2 of 28

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of care and support 4 Quality of staffing 5 Quality of management and leadership Good Very Good N/A What the service does well The service has a robust recruitment and assessment process for recruiting shared lives carers. Staff were skilled in working with carers, and service users to ensure they were well matched and carers provided support to individuals which was person centred. The manager and coordinator were committed to encouraging the active participation of service users and carers to contribute to the development of the service. What the service could do better The service should undertake regular audits of support plans, ensuring they archive historic information and retain current or important information in the file. This will help ensure information in support plans is kept up to date. The service should develop a consistent format for risk assessment and risk management plans which brings together the information required. This will help make it clearer for the carer their role in supporting and safeguarding the individual and others. page 3 of 28

4 The service should ensure that where a person has an appointed power of attorney or guardian that contact details are recorded. The powers conferred should also be detailed as well as how these should be put into practice in relation to planning and providing care and support. What the service has done since the last inspection The service has responded positively to areas for improvement suggested at the last inspection. The manager and service coordinator have continued to develop ways to further promote the work of the service and to encourage interest in, and recruitment to the role of shared lives carer. The service have worked in partnership with a range of multi-disciplinary professionals to support positive outcomes for the people who use the service. Conclusion The service have a strong commitment to supporting carers to offer opportunities for adults using the service to have enjoyable life experiences and to develop their skills and confidence in all areas of their lives. page 4 of 28

5 1 About the service we inspected Inspection report The Perth and Kinross Shared Lives Service is provided by The Richmond Fellowship Scotland. Shared Lives is an alternative and highly person-centred approach to care and support for adults. Shared Lives carers open up their home, family and social connections to service users and through flexible arrangements offer a wide range of responses to best meet people's needs. At the time of the inspection four adults were using the shared lives service supported by shared lives carers. The service aims are: - To provide support to individuals across Perthshire which is very personalised, person-centred and affordable. To offer shared lives in a safe, nurturing environment which enables individuals to live in and be part of their community. - Promote independence. - Help build long-lasting community connections. - Provide support in a flexible way that meets individual needs. - Provide short to medium term rehabilitative support. - Provide long-term support within the carers own home. - Provide continuity of support to relative carers to enable them to continue in their role. The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at The service was registered with the Care Inspectorate in October Recommendations page 5 of 28

6 A recommendation is a statement that sets out actions that a care service provider should take to improve or develop the quality of the service, but where failure to do so would not directly result in enforcement. Recommendations are based on the National Care Standards, SSSC codes of practice and recognised good practice. These must also be outcomes-based and if the provider meets the recommendation this would improve outcomes for people receiving the service. Requirements A requirement is a statement which sets out what a care service must do to improve outcomes for people who use services and must be linked to a breach in the Public Services Reform (Scotland) Act 2010 (the "Act"), its regulations, or orders made under the Act, or a condition of registration. Requirements are enforceable in law. We make requirements where (a) there is evidence of poor outcomes for people using the service or (b) there is the potential for poor outcomes which would affect people's health, safety or welfare. Based on the findings of this inspection this service has been awarded the following grades: Quality of care and support - Grade 4 - Good Quality of staffing - Grade 5 - Very Good Quality of management and leadership - N/A Inspection report This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. page 6 of 28

7 2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care. What we did during the inspection We wrote this report following an unannounced inspection. The inspection took place between 27 April 2016 and 16 May Feedback was given to the registered manager and the service coordinator on the 16 May As part of the inspection, we took account of the completed self assessment that we asked the provider to submit to us. We asked the manager to distribute 10 Care Standards Questionnaires (CSQs) to service users and we received one completed CSQ. Throughout the inspection, evidence was gathered from a number of sources which included; a review and examination of a range of policies, procedures, records and other documentation, including the following: - certificate of registration - service user files - carer files - records relating to service development work. - samples of person-centred support plans - samples of risk assessment and risk management plans - adult support and protection policy and procedures - information pack for service users - information for shared lives carers - complaints records - accident/incident reporting - minutes of service user review meetings - minutes of carer reviews - staff and carer training information page 7 of 28

8 - staff supervision and appraisal records - minutes of carer meetings. - carers assessment and recruitment processes - service newsletters. We also spoke with two people who used the service and spoke with one relative who told us about their experience of the service. We spoke with three shared lives carers and the registered manager and service coordinator. All of the above information was taken into account and included within the body of the report. Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at page 8 of 28

9 The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The Care Inspectorate received an updated self assessment document from the service provider. In the self assessment the provider identified what they thought they did well and some areas for development. Taking the views of people using the care service into account Throughout the inspection we met and spoke to people who used the service as well as shared Lives carers. They provided very positive feedback about the support they received. one service user completed a care service questionnaire and strongly agreed they were happy with the quality of support provided. Comments from service users included: - "Staff always ask if I am ok, they offer to help me if necessary". - "I am very happy with the service provided". - "staff understand how to help me". - " I get very good support". - "Much happier now, nothing I would want to change". - "Quite happy with service". page 9 of 28

10 Taking carers' views into account We spoke with one relative of a person using the service who indicated they were very happy with the service provided and comments included: - "Very good service, nothing negative to say". Inspection report page 10 of 28

11 3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 4 - Good Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths We found some good evidence that this service is supporting service users to ensure their health and wellbeing needs are being met. We decided this after speaking with service users, their relatives, shared lives carers, the service coordinator and professionals who support people using the service. We also looked at support plans for individuals as well as reviews and risk assessment documents. We found that support plans contained information about each individual's health and wellbeing needs and how they should be supported to keep well. Plans contained contact details for health professionals, as well as detail of important people in an individual's life. Service users told us how carers would support them with attending health appointments and the information gained would be used to make any adjustments necessary to the support they required. We saw evidence of changes in supports being made in response to health advice. We could see where carers were supporting service users to gain advice from health professionals around health screening and health promotion. We saw examples where carers had undertaken further training around certain health page 11 of 28

12 issues. Carers we spoke to told us how this had helped to inform and develop their understanding, and had enhanced the support they provided to individuals. We saw evidence of the service working in partnership with other providers and professionals to support positive health outcomes for individuals. This helped to support broader outcomes which the individual wanted to achieve regarding things like keeping well and making healthy lifestyle choices. We found carers were knowledgeable about what an individual wanted to achieve and their role in supporting them. Regular review meetings were taking place with service users and those involved in their support. This enabled progress toward meeting outcomes to be monitored and any changes needed to support were made. This coordinated approach meant that support provided was consistent and responsive to the individuals developing needs. We observed good open communication between service users and carers. We saw records of regular contact between service users, carers and the service coordinator. This meant that service users felt confident about raising any concerns or issues they had and we could see that where any concern was raised this was responded to promptly and appropriately. People who use the service and one relative we spoke to told us: - "I would say to staff if I was unhappy with anything". - "Staff always ask me if I am ok, they offer to help me if necessary". Inspection report - "I meet with coordinator as often as I am available, will speak to coordinator or text in between visits". - "Regular updates with coordinator, can contact her at anytime, can also go through carer". We saw evidence of a rigorous assessment, approval and review process for page 12 of 28

13 people interested in becoming a shared lives carer. This involved the service coordinator meeting with interested carers on several occasions over a period of months. The application process was completed following thorough recruitment checks and final appraisal of the application detail from an approval panel. Comprehensive information was provided on the role and what is expected of a shared lives carer. This made it clear to carers their responsibilities regarding supporting the health and safety of individuals. As well as their role in promoting the health, wellbeing and independence of service users. The service had an adult support and protection policy and procedure in place. Staff and carers we spoke to were aware of their responsibilities in reporting any concerns regarding risks to service users safety and wellbeing. Records demonstrated that carers had undertaken adult support and protection training and refreshed their knowledge of this regularly. A range of risk assessments were completed with service users and carers which included home safety checks (see Areas for Improvement below). We could see where advice had been sought and implemented to ensure all measures were in place to reduce any risks identified. This demonstrated that the service were committed to promoting the health, safety and wellbeing of service users. We could see that the support carers provided focused on promoting independence and the interests and activities an individual enjoyed. Service users were encouraged to develop their interests, and friendships and to take part in activities in their local communities. There was a focus on keeping well with people taking part in activities such as swimming, walking, singing and drama groups. Service users told us how the support from their carer had helped them feel more confident and able to look after themselves in various aspects of their lives. We saw and heard from service users how they had been supported to gain independence with using public transport, cooking, budgeting, managing their mail and keeping safe when out and about. Comments from service users and one relative included: page 13 of 28

14 - "I can do some thing's for myself but my support worker gives me guidance". - "Now I can travel independently, plan my journey... and keep up with my friends". - "Carer supports with cooking and promoting independence with this". - "Focussing on support with menu planning, X will go to purchase ingredients". Shared lives carers had access to a range of training available through the providers training calendar. In addition we saw evidence of carers accessing training from a variety of sources. The service coordinator kept carers informed of any changes in policies or training courses which could support them in their role. We saw evidence of the coordinator and carers having undertaken training in a range of areas related to supporting wellbeing and safeguarding individuals from harm. Overall we found there was a strong focus on supporting individuals to keep well and to maintain their health and wellbeing. Areas for improvement We saw a number of risk assessments and risk management plans in place for service users. We found that some had been compiled by the referring social worker. Others such as health and safety risk assessments had been completed by the service. We discussed with the service coordinator how it should be made clearer for the carer and service users, the risks identified and actions to be taken to support positive risk taking and management. We suggested this could be achieved through developing a consistent format which brings together the information required, rather than having several different documents containing the information. This will help make it clearer for the carer their role in supporting and safeguarding the individual and others. We found support plans provided a good framework for recording information, page 14 of 28

15 however often there were areas of support which were incomplete and some details of key people were not fully recorded. We also found some files contained support plans which were out of date. We discussed with the registered manager and service coordinator that this could lead to confusion around what is the most up to date information about the support an individual requires. We discussed the benefits of auditing support plans, archiving historic information and retaining current or important information in the file. We also discussed the use of a tracking sheet in the front of the file which would show at a glance when individual documents had been reviewed and whether any work was needed to bring the plan up to date. The service is keen to establish a file audit format and are currently reviewing all service user files to ensure all information is complete and up to date. We found that some people who used the service had welfare guardians and this was not always clearly identified in their support plan. We discussed this with the registered manager and service coordinator. We advised them that we would expect to see contact details of any appointed Guardians or Power of Attorney. We would also expect the service to have detail of the delegated powers and how these powers should be put into practice in relation to planning and providing care and support. We discussed the Mental Welfare Commissions publication 'Working with the adults with incapacity (Scotland) Act which provides further information and guidance. Available via the care inspectorate hub The service was keen to source this and to follow guidance to help clarify roles and responsibilities in relation to legal arrangements. Grade 4 - Good Number of requirements - 0 Number of recommendations - 0 Statement 5 Inspection report page 15 of 28

16 We respond to service users' care and support needs using person centered values. Service strengths We found the service were very good at promoting person-centred values in response to service user's care and support needs. We looked in detail at samples of service user support plans,review meeting minutes, risk assessments and risk management plans. These demonstrated that service users were involved in planning their support which was centred around their needs and preferences. As discussed elsewhere in this report we saw evidence of a rigorous assessment and selection process for people interested in becoming shared lives carers. Assessment visits to carers centred around gaining an understanding of prospective carers' interests, talents, family background, personality and support networks. This helped build a picture of the individual's skills, experience and interests as well as their understanding of the role. An information pack was provided to the potential service user which provided a range of information on the aims of the service and what to expect from shared lives. This also included the opportunity to complete a list of preferences relating to carers skills and interests. These were then considered to support the service users and carers.matching process. We spoke with one service user who told us about their experience of transition to the service. We found this involved the service coordinator identifying a carer who may be a good match for the person and arranging a series of meetings with the individual, carer and those involved in support. We could see that there had been a planned transition which took place over a number of months at a pace which suited the service user. The process was led by the individual service user. The coordinator was in regular contact with both the service user and carer at each stage of the process to support with any adjustments to be made to the plan. The service user commented on their experience of transition to the service: page 16 of 28

17 - "Made plan for meeting up over three-month period,wasn't rushed, I picked date for moving in, I wanted exams to be finished first". - "Met initially and went bowling, had tea and gradually built up visits to overnights". One relative commented on the matching process: - "Has been good match they get on well, X can talk to carer". Inspection report We heard from service users and carers and saw documentation which demonstrated that there was very good communication between the people who use the service, carers and the service coordinator. This helped to monitor supports in place. Service users and carers told us they could easily speak to the coordinator if they had any concerns or issues and these would be addressed promptly. Support plans we looked at contained comprehensive information about each individual and their likes,dislikes and important people in their lives. A one page profile captured a sense of the individual, their character and what was important to them. There was clear information about the outcomes a person wanted to achieve and the support required to help them achieve their outcomes in a range of areas in their lives. Service users we spoke to talked about the goals they hoped to achieve and the support they were receiving to help them. People's personal outcomes ranged from developing skills around independent living, developing new hobbies and interests, goals around educational attainment, developing confidence and building relationships. Carers we spoke to demonstrated a detailed knowledge of the needs of the individual they were supporting, and what they hoped to achieve. Carers were very clear about their role in supporting them. We found carers were attuned to the strengths and attributes of the individual as well as areas where they might need further support to develop their page 17 of 28

18 confidence and independence. We could see where service users were encouraged to build on their strengths and this helped them increase their confidence in their abilities. Carers told us that if they felt they needed training or further guidance to enhance the support they provided this would be arranged. We could see where carers had attended training which helped them gain a greater understanding of certain situations, conditions affecting service users. We saw evidence of how this had helped carers provide appropriate responses and promote positive outcomes for individuals. Support plans contained detail of the support a person needed with decisionmaking and how choices could be communicated to maximise their understanding. We saw and heard how people were encouraged to make their own decisions and choices in their day-to-day life. Support plans also detailed how best to communicate information and this included detail of how a person might react and what this might mean. This all helped in ensuring people had the support they needed to make informed decisions about their lives. We could see how this promoted their confidence, responsibility and their control over their lives. We looked at samples of review meetings which had taken place which provided the opportunity for the service user, carer and those involved in their support to come together to look at progress made toward outcomes. This helped to consider what had worked well and what the person wanted to change. There was close contact with other providers and professionals supporting an individual. Working in this coordinated way ensured support was consistent and carers were able to support the person to work toward their personal goals. We could see that the service coordinator kept records of contact with service users, carers and people involved in support. This helped ensure progress was being monitored and any changes to needs were addressed promptly. We heard very positive feedback from service users, relatives and professionals page 18 of 28

19 about how the service was flexible and able to adapt to an individual's changing needs. Comments included: - "Carer works well in identifying and planning out tasks together with X". - "If there is anything I want to talk about I can contact carer or coordinator". - "Good contact meetings with social worker twice per year". - "If we bring anything up or want to change these are addressed quite promptly". Service users and relatives told us they received service quality questionnaires every six months. We looked at completed questionnaires which demonstrated that respondents had very high levels of satisfaction with the service, staff and management of the service. We could see that action plans were completed to address any issues raised from questionnaires and result of questionnaires were circulated to all service users and their relatives. This meant that service users and their relatives could see how their views influenced service development. The people we spoke to during this inspection confirmed that they were happy with how their support was planned and that it reflected their needs and preferences. This along with the other examples provided, demonstrated how person centred values were central to the way the service was planned and provided. Areas for improvement The service should continue to work with individuals to develop person centred plans. They should ensure that information in plans is kept up to date and the outcomes a person wants to achieve and support they require is clearly set out. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Inspection report page 19 of 28

20 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths We found that this service was performing very well in the areas covered by this statement. We concluded this after we spoke with service users, carers and with the service coordinator and registered manager. We also reviewed samples of support plans and other records, and reviewed staff and carer supervision and appraisal records. Staff records which we reviewed confirmed the coordinator was qualified and experienced in carrying out the role. Records also showed the coordinator had attended a comprehensive range of training relevant to the role and the further development of the service. We could see that the registered manager and service coordinator were in regular contact with the shared lives plus network, attending meetings and seminars organised by the network. This provided the opportunity for staff, carers and service users to learn about developments and to share good practice examples from the 'shared lives community'. The coordinator told us she received regular supervision from the manager and was well supported within her role by her manager and the wider organisation. We could see from the coordinators supervision and appraisal records that discussions took place around, people using the service, the development of the service, adult support and protection concerns. There was also a strong focus on supporting the learning and development needs of the coordinator. page 20 of 28

21 The registered manager and coordinator were in daily contact and the coordinator kept the manager appraised of any changes and developments with service users and carers. We saw evidence of the registered manager seeking the views of service users and carers to contribute to the coordinators annual appraisal. We could see how this feedback then helped to inform areas for development for the coordinator and to support service improvement. We could see that the coordinator and manager met regularly to discuss and review actions planned for improving and developing the service. Action plans included feedback from service users and carers and incorporated areas for improvement from the previous Care Inspectorate inspection. This demonstrated that the views of people using the service and carers were central to the ongoing improvement of the service. The coordinator had developed very good professional relationships with relevant external agencies and with placing social workers. The coordinator told us how she would arrange to present information about the service at team meetings and various community events to promote the work of the service. The service were working on further ways to promote interest in the work of shared lives and in becoming a shared lives carer. On reviewing the information provided to potential shared lives carers we found carers were given a comprehensive information pack. This contained a range of information about the service as well as details of what is expected of a carer in relation to various areas of responsibility and practice. This included identifying learning opportunities together with the coordinator which would help equip the carer with the skills and confidence to provide support to service users. This made it clear from the outset the commitment to continuous learning expected of carers. We could see that the coordinator had regular supervision, contact and review meetings with carers. Carer reviews offered the opportunity to monitor the progress of each carer in relation to the support they were providing. We could see that the views of service users, family members and stakeholders were sought. These views helped to contribute to reviewing the skills and knowledge of a carer in various areas of support, such as enabling choice and decisionmaking, and supporting effective communication. page 21 of 28

22 Review action plans then highlighted areas for further development and set time scales for actions to be completed. This helped to promote continuous learning and to ensure carers were providing support which was person centred. The service had Introduced e learning modules for carers, accessible in a range of topics related to practice. We spoke to one carer who had completed e learning modules and found this had been supportive in enhancing their practice. Some carers had highlighted that it was difficult coming into the office to access computers. The coordinator was working with the provider to ensure carers could access training more easily from their chosen devices and locations. Carers told us they were confident that they could easily contact the coordinator to discuss any aspect of their learning and development. They told us the coordinator would help source any training needed to support their learning and enhance their work with service users. Carers told us about meeting with other shared lives carers and we saw minutes of two meetings which had taken place. Minutes of carers meetings showed discussions had taken place around various areas of practice including, protection of vulnerable adults, various policies, and recommendations from the keys to life learning disability strategy. Carers told us they valued meeting with other carers and found it a good opportunity to discuss practice experiences, and to learn and gain support from each other. The manager and service coordinator demonstrated a commitment to listening to the views of service users, carers and stakeholders as to how the service could improve..we found they were keen to look for opportunities to take forward any improvements suggested. Overall we found staff and carers were motivated and committed to developing and improving the service. This was reflected in the positive feedback we received from service users about the service and staff team. page 22 of 28

23 Areas for improvement The service kept records of training carers completed, and the support provided to them in their role. We found this information was not always easily accessible in the carers file. We suggested the service could more clearly evidence this by bringing together information held into one format and one point of access. This would help ensure there was a clearer record of the training and support each carer had received to support them in carrying out their role. We discussed with the manager and service coordinator how further developing the carers meetings would be beneficial in building peer support networks. Meetings would also provide further opportunities to share information, knowledge and good practice experiences amongst carers. The manager and service coordinator told us how they have plans to further develop the carer meetings. We talked about various ways this could be achieved such as organising speakers on topics relevant to the role and involving experienced carers in supporting those new to the role. We look forward to seeing how this progresses at our next inspection. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Statement 4 We ensure that everyone working in the service has an ethos of respect towards service users and each other. Service strengths We considered how the service was performing in relation to this statement by talking to people who used the service, to family members and to staff. We also looked at how care and support was planned and agreed with people and how carers were supported in their roles in providing support in a personcentred manner. Some of the strengths we saw were: Inspection report page 23 of 28

24 We found all staff and carers we spoke to were aware of their responsibilities if they had any concerns about potential or actual risks or harm to service users or others. We talked to carers who told us they could easily speak to the service coordinator, manager or out of hours staff if they were concerned or had any issues regarding a service user. Carers told us that any issues or concerns they raised were always responded to promptly and resolved appropriately. We witnessed respectful interactions between carers and service users. Service users told us they felt confident speaking to their carer or the coordinator if they were unhappy with any aspect of their support. We saw examples where service users had talked to their carer or coordinator about things which were making them anxious or worried. We could see that changes had been made to support, which respected their wishes. All carers we spoke to talked of there being good open communication between carer's coordinators, service users and their families. Discussions with service users and relatives confirmed this view. Service users, professionals and relatives we spoke to, spoke highly of carers, the manager and service coordinator and their friendly and professional approach. They also told us if they raised concerns these would be addressed timeously. Service users, relatives and carers told us they would have regular one to one meetings and telephone contact with the service coordinator. They valued this contact and opportunity to feedback their views and feelings about the service. The service had responded promptly to suggestions for improvement made at the last Care Inspectorate inspection. The service coordinator was keeping clear records of monitoring and support visits made to carers and service users. These visits were an important way of confirming that carers were working with people in a way which respected the individual's needs and preferences. page 24 of 28

25 We could see that carers were encouraging service users to articulate their choices and preferences in all aspects of their day-to-day life. Carers were seen to promote the independence of service users in a variety of ways. This helped to support individuals to learn new skills and to develop confidence in their abilities. We noted that the service had responded to suggestions made at the last Care Inspectorate inspection and service specific questionnaires were distributed to service users, relatives and stakeholders. We could see where these had been completed and feedback gained was very positive. We saw evidence of questionnaire responses summarised and actions planned as a result of responses. This helped confirm with service users and their relatives that their views were valued and respected. Areas for improvement The service should continue to develop participation methods to ensure service users views are sought and contribute to service improvements. We discussed the various ways to increase opportunities for service users to be involved. These included plans to invite service users and carers to be involved in carers assessment panels, service users contributing to the service newsletter and developing a service user consultation group. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 page 25 of 28

26 Quality Theme 4: Quality of Management and Leadership Quality theme not assessed 4 What the service has done to meet any requirements we made at our last inspection Previous requirements There are no outstanding requirements. 5 What the service has done to meet any recommendations we made at our last inspection Previous recommendations 1. The manager should ensure that carers know and abide by the service policies and procedures. This includes notifying the service of any incidents which may impact on the safety, quality of experience or outcomes for the service user. This recommendation was made on 18 May 2015 We saw evidence of details of service policies and procedures being shared with carers. Carers we spoke with were aware of their role and responsibilities in notifying the service of any incident which may impact on the safety, quality of experience or outcomes for service users. page 26 of 28

27 6 Complaints No complaints have been upheld, or partially upheld, since the last inspection. 7 Enforcements We have taken no enforcement action against this care service since the last inspection. 8 Additional Information There is no additional information. 9 Inspection and grading history Date Type Gradings 18 May 2015 Unannounced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership 4 - Good 18 Jul 2014 Unannounced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership 3 - Adequate page 27 of 28

28 To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. You can also read more about our work online. Contact Us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY Other languages and formats This report is available in other languages and formats on request. Inspection report Tha am foillseachadh seo ri fhaighinn ann an cruthannan is c?nain eile ma nithear iarrtas. page 28 of 28

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