Care service inspection report

Transcription

1 Care service inspection report Full inspection Shakti Women's Aid - Housing Support Service Housing Support Service Edinburgh Inspection completed on 18 July 2016

2 Inspection report Service provided by: Shakti Women's Aid 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 enquiries@careinspectorate.com page 2 of 22

3 Inspection report 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 5 Quality of staffing 5 Quality of management and leadership Very Good Very Good N/A What the service does well The service effectively supported women and children who had experienced domestic abuse. Shakti staff were knowledgeable about the specific support needs of the women and children to whom they offered support. Staff engaged in effective partnership working to promote awareness of the impact of domestic abuse and to promote awareness of the needs of their service users. Shakti Women's Aid provided an environment where women felt safe. The support provided by Shakti helped women to work towards establishing safer and more independent lifestyles. What the service could do better The service should ensure that detailed risk management plans are written up for all service users to address all identified risks. The service had plans to role out mindfulness training across its staff group. The service was continuing to explore funding options for the future in order to continue to develop the service it delivered. What the service has done since the last inspection Shakti Women's Aid had attained the LGBT charter mark. page 3 of 22

4 Inspection report The service had recently undergone a restructure of staffing arrangements. This had resulted in an increase in both the housing support team leader role and children's services team leader role from 7 hours to 21 hours, and to the creation of an outreach team leader post of 14 hours. Shakti Women's Aid has continued to implement their electronic case management system, Oasis. This has contributed to improved record keeping on support delivered to individual service users. The service has met the requirement imposed at the last inspection in relation to reviewing support plans. An award of 3,000 has recently been won by Shakti to fund outings for the children of women using the service. Conclusion Shakti provided high quality care and support to women and children using their services. With the help of this support, women and children were able to make positive lifestyle changes and to progress towards safer, more independent lifestyles. page 4 of 22

5 1 About the service we inspected Inspection report Shakti Women's Aid is registered to provide a housing support service. It is a registered charity, managed by a volunteer Board of Directors. Shakti was established in 1986 to provide a service to black minority ethnic (BME) women and their children, who are fleeing or experiencing domestic abuse. The service is provided to women and children living in refuges or in the wider community. It works towards empowering BME women to make informed choices about their lives and move from dependence to independence. Shakti's aims include: 'a philosophy of empowerment as we recognise that a major aspect of abuse results from loss of control. That is why we will give you support for what your wishes are to allow you to regain autonomy of your life'. Recommendations 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: page 5 of 22

6 Inspection report Quality of care and support - Grade 5 - Very Good Quality of staffing - Grade 5 - Very Good Quality of management and leadership - N/A 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 22

7 Inspection report 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 carried out an unannounced inspection visit to the service on 11 May We carried out a second visit on 2 June During this inspection we: Observed the service's registration certificate on display. We read: service user electronic service user files, we read staff files, minutes of staff meetings. We participated an a woman's group meeting attended by twelve women. We also spoke 1:1 with three service users. During the inspection visit we spoke directly with the service manager, the team leader for the outreach service, the children and young people's team leader, the follow on worker for the children's team and three caseworkers. We attempted to contact identified professionals who had regular contact with the service but we were unsuccessful. 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 page 7 of 22

8 Inspection Focus Areas (IFAs) Inspection report 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 22

9 Inspection report 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 a fully completed self assessment document from the provider. We were satisfied with the way the provider had completed this and with the relevant information included in relation to the quality themes we were assessing. Taking the views of people using the care service into account We participated an a woman's group meeting attended by twelve women. We also spoke 1:1 with three service users. Service users made the following comments: - 'I opened my heart to the staff at Shakti. I learned to love myself. I talked about my experience to staff. I am now very happy when I wake up in the morning. I have gained my life and now I can stop taking my tablets. I got the help I needed from Shakti. I got emotional support and they took me to the council to organise accommodation. I feel safe now. I have had the help I needed. I didn't know about this organisation till I contacted the police. I feel very thankful to Shakti. These staff are like mothers. The staff helped me understand and they let me go at my pace'. - 'I got help with everything - food, somewhere to live, help to get a divorce, help to remain in the UK, psychological help. Staff are very helpful. They listen to what I say. The staff understand what I've been through. Staff have spoken to me about how to keep myself safe. I feel safe here. The refuge is comfortable. It page 9 of 22

10 Inspection report feels like a sanctuary. The women support each other. Staff told me where to go to get counselling and where to go for English classes. I now have the confidence to do things myself. Staff from here come to meetings with me. I can call a staff member at any time of the night if I need to talk. My keyworker is like my mum. My keyworker helped me with everything. It helps she speaks my language. My keyworker helped me work towards my goals in my support plan'. - 'They organised a place to live. I had lost my self respect, my self esteem. They are so friendly. They provide a friendly environment. Staff treat me with respect, they behave like they are family. My experience has been quite good - I am happy with it. Previously my thoughts about my life were very negative. Now I feel I can do something with my life. I am learning to be strong and to take decisions. I am enjoying the contact with other women. We talk together, eat together, we learn together. It feels safe. Staff are friendly, helpful. They helped me with benefits, she sorted things for me. She did everything to help me'. Taking carers' views into account Carers were not interviewed as part of this inspection. page 10 of 22

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: 5 - Very Good Inspection report Statement 2 We enable service users to make individual choices and ensure that every service user can be supported to achieve their potential. Service Strengths Staff were pro-active in supporting service users to achieve their identified goals. Given the nature of the service, in terms of responding to black and ethnic minority women, the service produced the key documents in their welcome pack in the five most common languages within their service user group. Copies in other languages were available on request. We found that, when required, service users were supported to attend meetings with police or solicitors to investigate or initiate either criminal or legal issues. This was an area where service users particularly welcomed the support and advice which staff were able to give on account of previous experience in dealing with very similar issues. If appropriate, staff would advocate on behalf of service users, either at meetings or by making phone calls, in order to ensure service users achieved identified outcomes. This included negotiations over housing applications. Staff provided women with information which helped them to make informed choices. Service users were encouraged to identify subjects they wanted to cover within their women's group programme (discussed further in the following statement). Women were given the help they needed to recover from their experience of trauma. Some service users were attempting to recover from lives where they had not been in control and not been given the opportunity to fully develop the skills they needed to live independently. The staff supported page 11 of 22

12 service users to develop these skills. Service users were supported to become more integrated in the community. Women we spoke with told us that staff supported them to move on from the refuge to set up independently in their own accommodation. This reflected Shakti's main aim of empowering black minority ethnic women. Service users we spoke with were aware that if they were not happy with the service they received they had the opportunity to influence this in a number of ways including through the complaints procedure. Areas for improvement The service should continue to find ways to demonstrate how they are developing service provision in response to service user feedback. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Inspection report Statement 3 We ensure that service users' health and wellbeing needs are met. Service Strengths A significant proportion of Shakti service users did not speak English as a first language but were often able to engage with one or more staff members who spoke the same first language as themselves. Service users told us that they appreciated being able to communicate with a staff member in their own language. The staff group spoke in total 20 different languages. The service was rolling out its use of the electronic case management system Oasis. We found from reading electronic service user files that there were detailed records compiled in relation to each individual service user. Staff compiled in depth notes following their regular keyworker meetings with service users which meant there were up to date records of individuals' page 12 of 22

13 Inspection report circumstances. This ensured that the service would be able to provide the appropriate support even when specific keyworkers were absent. The service was using the support planning tool Outcomes Star which was an interactive tool which facilitated service users' involvement in compiling their own support needs. Women were actively involved in identifying their own support needs. We saw, from reading service user files, that staff discussed and agreed personal safety plans with individual service users, which was aimed at minimising the potential for harm. The service also compiled a more detailed risk assessment. The risk assessment process was used to identify if service users were at a particularly high risk of harm in relation to the perpetrator. Individuals who were assessed as being at particularly high risk in this regard were referred to the local Multi Agency Risk Assessment Conference (MARAC). Shakti staff contributed to this multi agency discussion group which was aimed at protecting women and children and minimising the risk of harm from perpetrators. On admission to the service women were given practical assistance if necessary. This might involve providing emergency supplies of food to individual service users. Shakti ran a women's group for women who used their service. We read the programme for this group as well as participating, as part of this inspection, in a scheduled art session which was part of this group programme. We found that a range of activities were organised for women and their children as part of the group programme. Activities delivered to service users had included trips to sites of interest as well as useful sessions where speakers were invited in to meet and talk with service users. For example, the group programme had included a session on cultural music and dancing, a writing workshop, mask making, a celebration of international women's day, self defence and an information session on emotional health. The group programme provided women with an opportunity to reduce their social isolation. On a 1:1 basis staff sometimes accompanied service users to engage in recreational activities such as accompanying service users to the gym. Staff sourced discount passes for service users to make use of Local Authority recreational facilities. page 13 of 22

14 Areas for improvement The service should ensure that risk management plans clearly address all identified risks. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Inspection report page 14 of 22

15 Inspection report 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 Staff we spoke with were passionate about their work and staff morale was strong. We were able to observe that staff were hard working and we noted that there was a high level of demand for this service. Individual staff members we spoke with told us that they enjoyed their work. A member of staff we spoke with made the following comments in relation to her role: - 'Working with the women is wonderful. When they come in they don't always know where they are going. I help them to laugh and relax'. The staff team consisted of mainly long standing staff members. Staff had generally therefore built up a detailed knowledge base in relation to the needs of their service group. Staff had in depth insight into the nature and impact of domestic abuse. The staff team had recently received specific training on how to help service users recover from trauma. Staff told us that, providing funding could be obtained, they were encouraged and supported to attend training courses in relevant areas of professional interest. The service was affiliated to Scottish Women's Aid (SWA) and staff were therefore able to access SWA's training calendar. Shakti staff were also able to access training via the local authority. The staff team brought a diverse range of knowledge and experience to their work. Staff we spoke with told us that individual staff members were good at sharing their particular knowledge with other team members as appropriate. The staff ensured that they engaged in verbal handovers, prior to taking leave, to provide detailed casework information to other team members. The staff supported each other in their work by engaging in group problem solving in page 15 of 22

16 relation to any specific difficulties in supporting a family or individual. The team also supported each other by engaging in debriefing sessions to support each other in relation to coping with emotive situations. Where staff required additional support they were able to access a professional counselling service which was in place for all Shakti staff members. Staff we spoke with, and we found from reading staff files, received regular 1:1 formal supervision. Staff told us that they were able to access informal support and supervision as and when required. We noted that the service held regular staff team meetings. Staff told us that they felt supported in their role. Shakti staff worked with other organisations to share their knowledge and to raise awareness of the needs associated with their service group. For example, we read a report which had been prepared for and submitted to the Scottish Government in relation to the nature of abuse experienced by their client group. Staff practice was guided by the service's policy framework as well as by National Care Standards and the Scottish Social Services Council's Codes of Practice. Areas for improvement The service should ensure that ongoing detailed records of all training being taken by staff is recorded in individual training logs. The service should ensure that a scheduled staff refresher session for Adult Support and Protection in September goes ahead in order to ensure that staff maintain up to date knowledge in this area. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Inspection report Statement 4 We ensure that everyone working in the service has an ethos of respect towards service users and each other. page 16 of 22

17 Inspection report Service Strengths We found that support was delivered in close consultation with service users. Service users feelings' and opinions were valued and respected. We noted, from observing staff interacting with service users, that relationships between staff and service users were mutually respectful. The service was committed to respecting the diversity of cultural and religious needs presented by their service user group. This included responding to specific dietary requirements and providing women with their own cooking utensils. We found, from speaking to staff and service users that staff respected service users' choice by agreeing to service users' requests to meet at alternative locations if preferred. Service user's need for privacy and confidentiality was respected. Staff took care to explain to service users how they complied with data protection requirements. During the inspection we participated in an art class which was being delivered as part of the women's group programme. It was evident that the group programme was another means of respecting and empowering women who used the service. The session was being delivered by a service user who had agreed to take the session. We were able to observe, during our inspection, that the service respected service users by operating an 'open door policy' which encouraged service users to approach staff when they were in need of support. We were told by service users that the refuge accommodation was maintained to a high standard reflecting respect for service users. We found, from speaking with both staff and service users, that both groups felt supported and encouraged to express their views on how the service could be developed. Service users were able to feedback their opinions through regular consultation and by using the service's suggestion box. The service held an annual staff 'away day' which provided staff with an opportunity to contribute their views on reviewing the service's business plan. Staff and service users told us that they felt their opinions were heard and respected. page 17 of 22

18 Areas for improvement The service should continue to perform to the very good standard it has established in relation to this statement. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Inspection report page 18 of 22

19 Quality Theme 4: Quality of Management and Leadership Quality theme not assessed Inspection report 4 What the service has done to meet any requirements we made at our last inspection Previous requirements 1. The provider must ensure that all personal plans are formally updated at least once every six months or more often if required. This is in order to comply with Scottish Statutory Instruments 2011, no 210, Regulation no 5 (i) (iii) and National Care Standards, Housing Support Services, Support Arrangements, Standard 4. Timescale: To commence on receipt of the report and to be completed within six months. This requirement was made on 27 May 2014 The service has more fully implemented their electronic case management system, Oasis, which has contributed to improvements in record keeping and scheduling of support plan reviews. Met - Within Timescales page 19 of 22

20 5 What the service has done to meet any recommendations we made at our last inspection Previous recommendations There are no outstanding recommendations. Inspection report 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 27 May 2014 Unannounced Care and support 4 - Good Environment Not Assessed Staffing 5 - Very Good Management and Leadership 5 - Very Good 20 Sep 2013 Unannounced Care and support 5 - Very Good page 20 of 22

21 Inspection report Environment Staffing Management and Leadership Not Assessed 5 - Very Good 5 - Very Good 1 Nov 2011 Announced (Short Notice) Care and support Environment Staffing Management and Leadership 5 - Very Good Not Assessed Not Assessed 5 - Very Good 19 Mar 2009 Announced Care and support 5 - Very Good Environment Not Assessed Staffing 5 - Very Good Management and Leadership 4 - Good page 21 of 22

22 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 cànain eile ma nithear iarrtas. page 22 of 22