Deaf Action - Outreach Visiting Support Service Housing Support Service 7/2 Slateford Green Edinburgh EH14 1NE Telephone:

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1 Deaf Action - Outreach Visiting Support Service Housing Support Service 7/2 Slateford Green Edinburgh EH14 1NE Telephone: Inspected by: Mary Moncur Type of inspection: Announced (Short Notice) Inspection completed on: 27 February 2014

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 12 4 Other information 23 5 Summary of grades 24 6 Inspection and grading history 24 Service provided by: Deaf Action Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Mary Moncur Telephone enquiries@careinspectorate.com Deaf Action - Outreach Visiting Support Service, page 2 of 25

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 5 Very Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well The service supports the communication needs of deaf people very well. They provide personalised support to each person using the service. They retain an experienced and knowledgeable staff team who know the people they are supporting well and understand the issues deaf people experience. The management team are open and supportive to staff and people using the service and strongly committed to providing the best quality service possible. What the service could do better The service is continuing to improve how it hears feedback from people using the service and they should make sure they can show how the service improves as a result. They are building on improvements made in care and support planning and should make sure everyone using the service is fully involved in this process. They are continuing to develop outcomes based care and support planning. The service has developed a more in depth quality audit process and they should make sure they complete this process over the next year. Deaf Action has agreed a strategic plan for the and the manager intends to use this with the staff team to plan development of the service. What the service has done since the last inspection The service has made progress with all of the recommendations for improvement we made at our last inspection. They have plans in place for more successful ways of gathering feedback from people using the service, have improved care and support planning and have developed a more in depth quality assurance process as a result. Deaf Action - Outreach Visiting Support Service, page 3 of 25

4 They have continued to develop learning opportunities for staff, based on the changing needs of people using the service. Deaf Action has refocused on strategic planning, giving the service a framework for future development. Conclusion We continue to hear a high level of satisfaction from people using the service and their families and see some excellent practice in supporting communication. Support staff are highly committed to making sure the people they support enjoy the best quality of life possible. With the strategic plan in place, the manager intends to focus on building on service strengths and making sure quality is continuously improved. Who did this inspection Mary Moncur Deaf Action - Outreach Visiting Support Service, page 4 of 25

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Prior to 1 April 2011, this function was carried out by the Care Commission. Information in relation to all care services is available on our website at Deaf Action Outreach Visiting Support Service and Support Service - Care at Home provide housing support and care at home to individuals living in a cluster of flats in Slateford Green in Edinburgh and to individuals living in their own homes in Edinburgh, Mid, East and West Lothian and Fife. The type and level of support provided is based on individual's assessed needs and ranges from 1 hour per week to 49 hours per week. Support with communication is integral to everyone's support. Around 50 people were using the service at the time of our inspection. These services were previously registered with the Care Commission and transferred their registration to the Care Inspectorate on 1 April Deaf Action's mission statement is to "raise awareness of the needs and rights of deaf people, challenge discrimination and provide services to promote independence and quality of life." Requirements and recommendations If we are concerned about some aspect of a service, or think it needs to do more to improve, we may make a recommendation or requirement. - A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service based on best practice or the National Care Standards. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reform (Scotland) Act 2010 ("the Act") and secondary legislation made under the Act, or a condition of registration. Where there are breaches of Regulations, Orders or conditions, a requirement may be made. Requirements are legally enforceable at the discretion of the Inspectorate. We have continued three recommendations for improvement in this report. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 5 - Very Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Deaf Action - Outreach Visiting Support Service, page 5 of 25

6 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. Deaf Action - Outreach Visiting Support Service, page 6 of 25

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 after a short notice announced inspection of the service. We gave the service a few days notice to make sure staff were available when we visited. The inspection was carried out by Mary Moncur, Care Inspectorate inspector. The inspection took place between 29 January and 21 February We gave feedback to the manager on 27 February As part of the inspection, we took account of the completed annual return and self assessment forms that we asked the provider to submit to us. We sent 27 care standard questionnaires to the manager to distribute to people using the service and their relatives or carers. Eighteen people using the service returned completed questionnaires. Two relatives returned completed questionnaires. We also asked the manager to give out 15 questionnaires to staff and we received eight completed questionnaires. During this inspection we gathered evidence from various sources, including the following: We spoke with * people using the service, 1:1 and at the lunch club * one relative * the manager * the seniors and some support staff * a mental health nurse and occupational therapist. We looked at * a sample of records for people using the service * information for people about the service, including how to make a complaint to the service and to us * the survey questionnaire to gather people's views * complaint/concerns information * newsletters Deaf Action - Outreach Visiting Support Service, page 7 of 25

8 * accident and incident reports * a sample of staff records * the staff handbook * staff qualifications information * a sample of team meeting records * the planner for staff 1:1 supervision and appraisal * findings from staff questionnaires to inform strategic plan * records of local quality audits * spreadsheet to monitor individual's reviews and support plan updates * Deaf Action Strategic Plan for 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 Deaf Action - Outreach Visiting Support Service, page 8 of 25

9 What the service has done to meet any recommendations we made at our last inspection 1. Outcomes and actions necessary to progress any issues or improvements as a result of consultation should be clearly recorded to include what action is to be taken, by whom and in what timescale. These records should be signed and dated to confirm completion. As the service was in the process of completing the survey by questionnaires and planned for interpreter students to facilitate feedback we were not able to evidence this recommendation has been met. We are continuing this at this inspection. 2. The manager should continue to develop care and support planning to ensure that each service user is aware of this and how they can contribute to their plan and reviews. While we saw that most people had been actively involved in developing and reviewing their support plan and the service had developed the review forms to better record people's involvement, we found some examples where people receiving outreach support did not have a personal plan in place and reviews of the Deaf Action service had not taken place. We are continuing the recommendation at this inspection to make sure it is fully met. 3. Where an action is identified as a result of quality audits there should be a clear record of the outcome to monitor improvement or if further action is needed. The service had developed a more in depth quality audit system and now planned to implement this. We are continuing this recommendation, with the addition of completion of the quality audit, to make sure the process is completed over the next year. 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 Deaf Action - Outreach Visiting Support Service, page 9 of 25

10 Comments on Self Assessment Inspection report continued 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. We received a fully completed self assessment document from the provider. We were satisfied with the way they had completed this with relevant information included for each heading we grade services under. They identified what they thought the service did well, some areas for improvement and any changes they had planned. The provider told us how the people using the service were involved in improving the quality of the service. Taking the views of people using the care service into account Around 50 people were using the service at the time of our inspection. Eighteen people using the service returned completed care standard questionnaires. They all agreed, 10 of the 18 strongly agreeing, they were happy with the quality of care and support they received from the service. Comments included, "I am happy Deaf Action always same support worker. This I prefer same person." We met a group of people at the lunch club. They clearly enjoyed the social event, with a lot of interaction and humour. Staff and people using the service were happy in each others company. The general impression was that people were very happy with the service. We met three people in their own homes, two of them with staff to help us communicate. They were all very happy with the service overall. One had made a number of comments on the questionnaire returned to us. However, they were not directly related to this service's provision. They told us their support worker was helping with these things and some had already been addressed. They also told us about the range of things they were getting support with to assist them with their goal of finding employment. We were impressed by the relationship between the person and their support worker, which was warm, respectful and relaxed. Another person we met told us about the range of things they get support with to manage their home and get involved in their community. They talked highly of staff, particularly those who they'd known for some time. They had some questions and comments, which the senior member of staff was able to answer. They said they felt they needed more support and the member of staff said they could help them contact the social worker for assessment. The third person spoke very warmly about their support worker and the difference they made in their life. Taking carers' views into account Two relatives returned completed questionnaires. Both agreed they were happy, one strongly agreeing, with the quality of care and support their family member received. Deaf Action - Outreach Visiting Support Service, page 10 of 25

11 We met one of the relatives who said they were happy with the service overall. They said they had raised concerns in the past and they were addressed by the service. Their concerns now were more about services for deaf people in general. We have included some of the suggestions they made for improvement of this service in the body of the report. We also met two relatives when visiting people using the service. They were very happy with the support their family member was receiving from Deaf Action and spoke highly of the support staff. Deaf Action - Outreach Visiting Support Service, page 11 of 25

12 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 Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths At this inspection we found the service was performing to a very good standard in relation to this statement. We spoke to some of the people using the service and their relatives at a lunch club and in their own homes. We looked at individual's records, the survey of views, newsletters and complaints information. We spoke to the manager, seniors and some of the support staff. We found the service had maintained the strengths we saw at the last inspection, including; * active involvement of individuals and, where relevant their families, in planning and reviewing their own support * a participation strategy, including seeking views through day to day contact and an annual survey using questionnaires * complaints and concerns information and procedures * staff skilled in communicating with people using the service and who know the individuals well, including their likes and dislikes. We saw that people using the service were comfortable in expressing their views and raising any issues or concerns. We heard that where any concerns had been raised the service addressed these. Most people who returned questionnaires to us said the service asked their opinion on how it could improve. At our last inspection the manager told us the service continued to try different methods to involve people in improving the service. They told us they were now arranging interpreter student placements in the service. They planned to use this as an opportunity to be able to gather more independent feedback. The student Deaf Action - Outreach Visiting Support Service, page 12 of 25

13 placement plan included facilitating feedback from people using the service, for example by carrying out structured interviews. The paper based questionnaires had not proved particularly successful, with a poor response rate. It was felt that this approach would be more successful. Areas for improvement The service intends to carry out the plan for interpreter students to facilitate feedback from people using the service. They will plan improvements based on the feedback received. At our last inspection we made a recommendation that the service should clearly record improvement actions following consultation. As the service was in the process of completing the survey by questionnaires and planned for interpreter students to facilitate feedback we were not able to evidence this recommendation has been met. We are continuing this at this inspection (see recommendation1). We discussed that the planned development of the newsletter could provide an opportunity to let people know about the feedback received and the changes made as a result. We noted that the information for people using the service or who may want to use the service was dated and not as relevant for people using the outreach service. The manager agreed the service could look at updating this. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. Outcomes and actions necessary to progress any issues or improvements as a result of consultation should be clearly recorded to include what action is to be taken, by whom and in what timescale. These records should be signed and dated to confirm completion. National Care Standards Housing Support Services Standard 8 Expressing your view National Care Standards Care at Home Standard 11 Expressing your views. Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued The service was very good in the way people's health and well being needs were met. To assess this statement we spoke to people using the service and their relatives and looked at a sample of individuals' records. We spoke to the manager, seniors, some of the support staff and two health professionals the service works with regularly. Deaf Action - Outreach Visiting Support Service, page 13 of 25

14 We found the service had maintained the strengths we saw at the last inspection, including; * detailed care and support plans, including risk assessments and regular reviews for people living at Slateford Green and most people using the outreach service * staff knowledgeable about individual's care and support needs and know people well so notice changes quickly * staff making sure people attended health appointments, accompanying them to assist with communication as necessary * close working with health professionals to make sure people stay as well as they can * support for individuals to have a healthy lifestyle and enjoy the best quality of life possible. Since our last inspection the service had developed a new recording format for review discussion to better focus on outcomes individuals wanted to achieve. Two health professionals who worked regularly with the service gave very positive feedback about the care and support the service provided. One commented that the care and support was "excellent". They said staff were always keen to let them know if there were any concerns and to act on their advice. The other described examples where staff had gone "above and beyond" in supporting individuals to remain living in their own home. People who returned questionnaires to us agreed, 11 of the 20 strongly agreeing, they were happy with the quality of care and support. People we met were happy with the support they received. Areas for improvement Inspection report continued At the last inspection we made a recommendation that the service should continue to develop care and support planning to ensure each service user is aware of this and how they can contribute to the review. While we saw that most people had been actively involved in developing and reviewing their support plan and the service had developed the review forms to better record people's involvement, we found some examples where people receiving outreach support did not have a personal plan in place and reviews of the Deaf Action service had not taken place. We are continuing the recommendation at this inspection to make sure it is fully met (see recommendation 1). The service intends to continue to develop a personal outcomes approach to support planning and review. We shared that some other services had found the "Talking Points" personal outcomes approach useful as a framework. We shared a suggestion we had heard that the service could look at developing information on resources and leisure activities in different localities where outreach support is provided. This could help staff be prepared with ideas for things to do Deaf Action - Outreach Visiting Support Service, page 14 of 25

15 when supporting people with leisure activities. We also shared the difficulties young people using the service had in finding suitable leisure time activities where they could meet their peers. We discussed whether Deaf Action might be able to support opportunities for this. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. The manager should continue to develop care and support planning to ensure that each service user is aware of this and how they can contribute to their plan and reviews. National Care Standards Housing Support Services Standard 4 Housing support planning National Care Standards Care at Home Standard 3 Your personal plan. Deaf Action - Outreach Visiting Support Service, page 15 of 25

16 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 the service performed very well in making sure people experienced support from staff who had the skills, knowledge and experience required. To assess this we took into account the views of people using the service and their families. We looked at a sample of staff records, staff training information and some staff meeting records. We spoke to the manager, seniors, some of the support staff and two health professionals the service works with regularly. We found the service had maintained the strengths we saw at our last inspection, including; * induction training for new staff and refresher training in core topics for established staff * regular 1:1 supervision meetings with staff to support their practice * staff skilled in using British Sign Language and aware of individual's communication support needs * most staff with relevant qualifications and opportunities for others to work towards these. Staff had opportunities to meet regularly and share practice and learn from each other. They told us they felt well supported, by peers, seniors and the manager. We heard they worked well together as a team and we saw staff work well together. In questionnaires staff told us they received the training they needed to meet their learning needs. We heard there were appraisal systems in place to support staff's development. The service continued to develop learning opportunities to meet individual's changing needs, such as dementia awareness and autism awareness. The two health professionals who work regularly with the service spoke highly of staff's competence. One said, "I have always found staff helpful, supportive and sympathetic towards our clients' needs." They commented on staff's flexibility in the way they worked with people. The other said, "Staff are always approachable and willing to help out in any way they can" and they are "very skilled in working with Deaf Action - Outreach Visiting Support Service, page 16 of 25

17 clients with additional difficulties". Most of the people who returned questionnaires to us agreed, 11 of the 20 strongly agreeing, staff had the skills to support them. People we spoke to were very happy with the staff providing their support. Areas for improvement The manager noted that changes in the senior team had meant changes in supervision arrangements. The availability of interpreters could also make supervision with deaf staff difficult to organise. They had put in place a planner for 2014 to make sure all staff had regular 1:1 supervision meetings and completed an appraisal of their performance and development plan. Arrangements were being put in place to facilitate these meetings with deaf staff. The service planned to improve the regularity of whole staff team meetings, with interpreter support to facilitate all staff's involvement in discussion. Grade awarded for this statement: 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 The service was excellent at making sure staff worked with an ethos of respect towards people using the service and each other. We heard from people using the service, saw staff work with people using the service and each other and spoke to staff about the people they support, their relatives and their colleagues. The things we looked at to assess Quality Theme 1 Statement 1 and Quality Theme 3 Statement 3 were also relevant to this statement. The strengths relating to service user participation noted under Quality Theme 1 Statement 1 are relevant to this statement. The service's commitment to involving people demonstrated respect for people using the service. The feedback gathered provided information on how well the service does in treating people with respect and suggestions for improvement. The strengths in relation to having a well trained, professional and motivated workforce noted under Quality Theme 3 Statement 3 are relevant to making sure everyone has an ethos of respect towards people using the service and their colleagues. Achieving Scottish Vocational Qualifications encourages reflective practice. 1:1 support and supervision and team discussions provide opportunities for ongoing reflection and improvement. We found staff to be aware of the Scottish Social Deaf Action - Outreach Visiting Support Service, page 17 of 25

18 Services Council Code of Practice and the National Care Standards. The service's staff handbook included expected standards of behaviour from staff. Staff talked about people they work with and their families in a warm and respectful way. We saw staff show respect when working with people. People using the service were very comfortable with staff and humour was used appropriately. Staff always used sign language when a deaf person was present, either someone who uses the service or a colleague. We saw staff work together in a respectful way and heard how the team worked well together. Managers spoke about and to staff in a respectful way. Everyone who returned questionnaires to us agreed, 12 of the 20 strongly agreeing, staff treat them with respect. People we spoke to felt respected by staff. Areas for improvement In self assessment the service said they plan to complete a series of development workshops with staff on values, person centred working and service user involvement. This will support everyone in maintaining and building on excellent practice. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Inspection report continued Deaf Action - Outreach Visiting Support Service, page 18 of 25

19 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very Good Statement 2 We involve our workforce in determining the direction and future objectives of the service. Service strengths The information we looked at for Quality Theme 3 is also relevant to this statement. We also spoke to managers and staff about opportunities staff had to put forward ideas to improve the service and how these were used. We looked at information from the consultation with staff to inform the strategic plan and the strategic plan. We found the service provided very good opportunities for staff to get involved in developing the service. The strengths we noted under Quality Theme 3 Statement 3 about supervision and team meetings are also relevant to this statement. These provided opportunities for staff to put forward ideas and suggestions. The strengths noted under Quality Theme 3 Statement 4 are relevant to this statement. Staff who feel respected, listened to and valued are more likely to put forward ideas and suggestions for service development. Staff were experienced in supporting people who are deaf, including a number of staff who are deaf. This meant they had a good understanding of the issues deaf people face and were able to contribute ideas and suggestions about how the service could support people to overcome these. We found a culture of openness in the service. The manager and seniors were available and welcomed staff's ideas for improvement and development of the service. Deaf Action had gone through a period of change and re-organisation, with a new Chief Executive in post. We heard the organisation had re-focused on strategic planning. Staff had had opportunities to complete questionnaires giving their views about the service and how service could be developed. Responses had been collated and used to inform a Strategic Plan for , which included Deaf Action's vision, mission, values and four strategic aims. Objectives, actions and outcomes had been identified for each aim. Deaf Action - Outreach Visiting Support Service, page 19 of 25

20 These strengths meant that people using the service could feel the service is open to hearing the views of staff who know them well. Areas for improvement We heard that issues with the availability of interpreters and electronic notetakers had hindered deaf staff's involvement in staff meetings and discussion. The service now had a plan in place to address these issues and make sure all staff could be actively involved in discussions. The next step in the strategic planning process was for the team to plan how the service would contribute to achieving the strategic aims and objectives and, through professional development planning, how each member of staff could contribute. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide Service strengths Inspection report continued At this inspection we found the service's performance was very good for this statement. The information we looked at to assess the quality of care and support and the quality of staffing was relevant to this statement. We looked at the service's quality audit systems and spoke to the manager and seniors. The strengths relating to service user participation noted under Quality Theme 1 Statement 1 are relevant to this statement. These provided opportunities for people using the service and their relatives to influence the quality of service they receive. The strengths noted under Quality Theme 3 in relation to the quality of staffing contribute to assuring the quality of the service people receive, providing reassurance that staff who are delivering their support are safe and competent to do so. The service's strengths in involving the workforce in determining the direction and future objectives of the service, noted under Quality Theme 4 Statement 2, are relevant to managing the quality of the service and mean that people using the service can feel the service is open to hearing the views of care staff who know them well. We found there was a strong commitment from staff and managers to provide the best quality of service possible. Some local quality audits, such as medication records and ensuring support plans and risk assessments were updated following review or Deaf Action - Outreach Visiting Support Service, page 20 of 25

21 when changes occurred, were in place. The manager had introduced a spreadsheet for planning and recording reviews of individuals support and a forward planner for staff's 1:1 supervision and appraisal meetings. The service had developed a more in depth quality audit system. Deaf Action held the Investors in People Award and was accredited by the Scottish Qualifications Authority for Scottish Vocational Qualifications. We heard about regular contact with local authorities to ensure contract compliance, including maintaining expected quality. The service works well with us in our role as regulator. They submit all the information we require timeously and notify us of any significant events. They were open with us at inspection, making sure we had access to all the information we required and encouraging people using the service and staff at all levels to get involved. These quality assurance systems and processes meant people using the service and their relatives could feel the service was working hard to make sure their service continues to improve. Areas for improvement Inspection report continued The areas for improvement relating to service user participation noted under Quality Theme 1 Statement 1 are relevant to this statement. These will continue to improve opportunities for people using the service and their relatives to influence the quality of service they receive. The areas for improvement noted under Quality Theme 3 in relation to the quality of staffing will contribute to continuing to improve the quality of the service people receive, providing reassurance that the service is continuing to improve how staff's professional development is supported. The areas for improvement in involving the workforce in determining the direction and future objectives of the service, noted under Quality Theme 4 Statement 2, are relevant to improving how the service manages quality. They mean that people using the service can feel the service is working hard to hear the views of staff who know them well. The service now planned to implement the more in depth quality audit system, with action planning for improvement following completion of the audit. We made a recommendation relating to this at our last inspection which we are continuing, with the addition of completion of the quality audit, at this inspection (see recommendation 1). Deaf Action - Outreach Visiting Support Service, page 21 of 25

22 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. The service should complete the more in depth quality audit. Where an action is identified as a result of the outcomes of the quality audit there should be a clear record of the outcome to monitor improvement or if further action is needed. National Care Standards Housing Support Services Standard 3 Management and staffing arrangements National Care Standards Care at Home Standard 4 Management and staffing. Deaf Action - Outreach Visiting Support Service, page 22 of 25

23 4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information The manager was registered on the managers of care home services part of the Scottish Social Services Council register. At the time of our inspection he was in the process of registering on the housing support services and care at home parts of the register. Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in the Care Inspectorate re-grading a Quality Statement within the Quality of Management and Leadership Theme (or for childminders, Quality of Staffing Theme) as unsatisfactory (1). This will result in the Quality Theme being re-graded as unsatisfactory (1). Deaf Action - Outreach Visiting Support Service, page 23 of 25

24 5 Summary of grades Quality of Care and Support Very Good Statement 1 Statement Very Good 5 - Very Good Quality of Staffing Very Good Statement 3 Statement Very Good 6 - Excellent Quality of Management and Leadership Very Good Statement 2 Statement Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 19 Feb 2013 Announced (Short Notice) Care and support Staffing Management and Leadership 5 - Very Good 5 - Very Good 5 - Very Good 24 Aug 2010 Announced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership Not Assessed 12 Mar 2010 Announced Care and support 4 - Good Staffing 4 - Good Management and Leadership Not Assessed 24 Mar 2009 Announced Care and support 4 - Good Staffing 4 - Good Management and Leadership 4 - Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Deaf Action - Outreach Visiting Support Service, page 24 of 25

25 To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on This inspection report is published by the Care Inspectorate. You can get more copies of this report and others by downloading it from our website: or by telephoning Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: enquiries@careinspectorate.com Web: Deaf Action - Outreach Visiting Support Service, page 25 of 25