Millport Housing Support Service Housing Support Service

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1 Millport Housing Support Service Housing Support Service 19 George Street Millport Isle of Cumbrae KA28 0BQ Telephone: Type of inspection: Unannounced Inspection completed on: 24 October 2016 Service provided by: Embrace (Combined) Limited Service provider number: SP Care service number: CS

2 About the service Millport Care at Home and Housing Support Services provides packages of care and support for service users, who have a range of care needs in their own homes. The people who use this service live independently with mixed packages of care on the island of Millport. In addition the service supports one person who lives in Largs. The aims and objectives of the service are stated as; "to deliver a service of personal/social care to meet the needs of individuals within their own home and community". What people told us Sixteen people were using the service at the time of the inspection. Prior to the inspection we sent out eight care standard questionnaires from which we received five replies. We were able to visit six people either in their own homes or in the community during the inspection. All the feedback we received was positive about the service. For example, people told us: "I feel like I've matured so much since I first came here." "My new care plan has loads in it." "We can speak to the management if there are any problems." "The Autism course talked about relationships, it was really good." "I've been learning how to cook." "We have meetings where the management come to see us, we also have housing support meetings." "I like the staff I've got, I've good support to enjoy my activities." "I wouldn't change anything about it." Self assessment The Care Inspectorate received a completed self-assessment from the provider. The provider identified what it thought the service did well and gave some examples of improvements in x and y areas as well as identifying some areas that the provider believed can be improved. While the self-assessment had taken a more outcome focused approach from previous years there is scope to improve this further; we suggested that the management look at the booklets; "Meaningful and Measurable - Recording Outcomes in Support Planning and Review," and "Personal Outcomes - learning from the meaningful and measurable project." both by Emma Miller and Karen Barrie of the Scottish Government's Joint Improvement Team, to help with this. From this inspection we graded this service as: Quality of care and support Quality of staffing Quality of management and leadership 5 - Very Good 5 - Very Good 5 - Very Good Quality of care and support page 2 of 10

3 Findings from the inspection The service works closely with the community learning disability team who visit the service to look at supporting services users and staff. People are also supported to keep well by attending regular health appointments and screenings with staff maintaining close links with community health professionals on service user's behalf as well as monitoring the administration of medication. Service users told us that they live life how they want. They told us that they feel safe to go out into the local community with and without support, going to; colleges, clubs and to work. Some told us that they had been supported to feel confident about using local transport to get about themselves not just on the Island but across in Inverclyde as well. Out of 16 people who use the service; three people are in full time education, four people are in part-time education, one person is in employment and one person is in voluntary work. The service has on the whole been able to offer people a consistent staff team. Staff are guided to adopt a consistent approach towards supporting people within Care Plans and through staff training; this is important to reassure people they will be supported through difficult situations and to try and avoid triggering negative behaviour. The outcome is that people who use the service trust staff and feel safe. People who use the service told us that they feel listened to. The service has set up various initiatives to support this outcome. Service users have regular meetings with their keyworkers, there are monthly tenants meetings, co-production events and some joint training events where service users have the chance to complete the same training as staff. The provider reviewed the service's involvement and inclusion procedures and identified some areas where they could make improvements. Management should ensure that when they audit care plans old information is archived and all information is dated. There could be confusion from reading the care plans we sampled as old and new information was stored undated within the same folder. We discussed with management that there was room to improve the outcome focus within care plans and suggested that they consider the guidance by the Scottish Government's Joint Improvement Team's "Meaningful and measurable project," to help them do this. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 5 - very good Quality of staffing Findings from the inspection Some of the people that we spoke with told us that they had been involved in interviewing new staff. Some had been involved in recruitment faires as well. page 3 of 10

4 Service users told us they feel positive about the relationships that they have with staff and that staff care about them. People told us that they were encouraged to say what they wanted to do and that staff help them to do this. Service users told us staff treated them with respect. We observed staff interaction with the people they support during the inspection and saw warmth in the relationships. The provider has put in place good support structures for staff in terms of regular supervision, appraisals, and team meetings they have also brought in outside health colleagues to support staff review situations. Staff told us that management are open to suggestions and will encourage them to think through problems to look for solutions. Staff receive regular training and refresher training. This allows staff to feel confident in their role which has a knock on effect on how service users view staff. We viewed the computerised training records within the service and found over 90% of staff were up-to-date with all their training. An outcome from this is that service users are confident that staff know them, understand their needs and treat them as individuals. Staff we spoke with displayed a very good awareness of the people they supported. As mentioned under the previous theme there has been opportunities for the people who use the service to join staff on training courses. For example one person we spoke with told us that they had taken part in Autism training. They told us they recognised many of the traits discussed at the training within themselves while staff we spoke to, gave good examples of how the training had helped them better understand individual's support needs. The manager for the service works 50% of her time with this service and 50% of her time within the provider's care home on the Millport. We discussed how the provider should consider some additional support for the manager to oversee the service. Currently there are no team leaders within this service to support the manager. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 5 - very good Quality of management and leadership Findings from the inspection The service has put in place several ways for people to share their views about the service. Senior management from the Embrace Group have visited Millport more regularly in the last year; including attending the coproduction events and meeting service users as part of their quality assurance audits. Service users told us that they were confident that their views would be listened to and that their views helped to shape the development of the service. page 4 of 10

5 Service users receive regular reviews, carried out by the registered manager. They and their relatives are sent out surveys by the service asking pertinent questions about the quality of the service provided; the service acts on the feedback that it receives. For example one survey asked if people wanted the service to start up a newsletter, over 90% wanted this so the service has developed one and started to send them out. We saw good feedback from relatives about the newsletters. The outcome is that people feel their views inform the development of the service. People that use the service told us that they had confidence in the way the service was managed. This has been helped by an open approach adopted by management. The service newsletter contained information about the Care Inspectorate; our inspections and our reports. It was explained how people could get involved in the inspection process. Newsletters also explained how people could make a complaint about the service if there was anything they were not happy about. It is healthy to encourage participation in the development and improvement of a service. Care plans within the service have improved over the last couple of years but while there is a greater focus on outcomes for individuals the management need to review how these outcomes are evaluated. More thought needs to be put into evidencing what has been tried to help someone reach their outcomes and what could be changed if something is not working. Since the last inspection the provider has carried out two external quality audits to identify what the service is doing well and where it needs to improve. The provider creates Quality Improvement Points (QIP's) after each audit; these are re-checked at the following audit. We note that the number of areas for improvement at the second audit had been significantly less that at the first inspection. This is a sign that management will act upon feedback. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 5 - very good What the service has done to meet any requirements we made at or since the last inspection Previous requirements There are no outstanding requirements. page 5 of 10

6 What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 The service should ensure that monitoring sheets within care plans state clearly; why something is being monitored, for how long, and when staff would be required to take action. page 6 of 10

7 NCS 4 Housing Support Services - Housing Support Planning This recommendation was made on 16 October Action taken on previous recommendation The provider has changed the templates on their new fluid and dietary recording sheets to incorporate these details. Recommendation 2 The provider should ensure that supervision is offered to staff in line with it's supervision policy. NCS 3 Housing Support Services - Management and Arrangements This recommendation was made on 16 October Action taken on previous recommendation The frequency of supervision has been increased in line with the provider's policy. We discussed that the manager that they may benefit from the support of a senior support worker to assist with staff supervisions. This is something for the provider to consider. Recommendation 3 The management team should ensure that staff and service users are aware of disability hate crime and what to do if they experience it. NCS 3 Housing Support Services - Management and Arrangements This recommendation was made on 16 October Action taken on previous recommendation The provider has sent two staff on a training course on disability hate crime and they fed back to their colleagues at their next team meeting. We suggested that the management watch "I am me," and use this as a discussion point with staff and service users. This is a drama which was produced as part of the Scottish Government's awareness raising campaign about disability hate crime. Recommendation 4 The provider should review what procedures that they have in place to evidence that service users can influence the direction of the organisation. NCS 8 Housing Support Services - Expressing Your Views This recommendation was made on 16 October Action taken on previous recommendation The provider has organised co-production workshops which have brought together people who use the services and their families along with staff and senior management to consider how the service could be developed. page 7 of 10

8 Recommendation 5 The provider should create a procedure for dealing with concerns, which are not formal complaints, raised by anyone connected with their registered services which has sets time frames for actions to be completed and is signed off by senior management once completed. This is a recommendation against the National Care Standards; Housing Support Services - Standard 3 Management and Arrangements. This recommendation was made on 16 October Action taken on previous recommendation The management team had not created a separate record of concerns since the last inspection, however we discussed the issue again and they have agreed that they will start to keep a record of concerns in the back of their complaints record book. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at Enforcement No enforcement action has been taken against this care service since the last inspection. Inspection and grading history Date Type Gradings 16 Oct 2015 Unannounced Care and support 4 - Good 4 - Good Management and leadership 2 - Weak 6 Feb 2015 Unannounced Care and support 4 - Good 4 - Good Management and leadership 4 - Good page 8 of 10

9 Date Type Gradings 31 Mar 2014 Announced (short notice) Care and support 3 - Adequate 4 - Good Management and leadership 3 - Adequate 12 Feb 2013 Unannounced Care and support 5 - Very good 5 - Very good Management and leadership 5 - Very good 19 Oct 2010 Announced Care and support 5 - Very good Management and leadership 21 Jan 2010 Announced Care and support 5 - Very good 5 - Very good Management and leadership 5 - Very good 12 Mar 2009 Announced Care and support 5 - Very good 5 - Very good Management and leadership 4 - Good page 9 of 10

10 To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can 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. You can also read more about our work online at Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com Find us on Facebook Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 10 of 10