Family Support Service Support Service Care at Home Family Support Team Randall House, Macmerry Business Park Macmerry Tranent EH33 1RW Telephone:

Transcription

1 Family Support Service Support Service Care at Home Family Support Team Randall House, Macmerry Business Park Macmerry Tranent EH33 1RW Telephone: Type of inspection: Unannounced Inspection completed on: 15 October 2014

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 10 4 Other information 19 5 Summary of grades 20 6 Inspection and grading history 20 Service provided by: East Lothian Council Service provider number: SP Care service number: CS If you wish to contact the Care Inspectorate about this inspection report, please call us on or us at enquiries@careinspectorate.com Family Support Service, page 2 of 21

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 We found that the service provided very good respite care and support to children and their families. The service was able to be flexible in responding to changing need. Staff were skilled at forming very positive relationships with children and their families. The service was held in high regard by those using it. What the service could do better Due to managerial absences and leave, supervision sessions had been missed and no team meeting had been held since 21 July The team should be supported through the forthcoming period of change. Family Support Service, page 3 of 21

4 What the service has done since the last inspection The service had broadened its service user group to include families in crisis. The service had produced a user friendly "Support Plan" pro forma. The service had negotiated a period of change and was due to have a new manager in place in a matter of weeks. Staff did not always feel that they were appropriately consulted regarding change. Conclusion The Family Support Service provides a valuable service to people in East Lothian. We found that the service provided very good respite care and support to children and their families. The service was able to be flexible in responding to changing need. Staff were skilled at forming very positive relationships with children and their families. The service was held in high regard by those using it. Family Support Service, page 4 of 21

5 1 About the service we inspected Before 1 April 2011 this service was registered with the Care Commission. On this date the new scrutiny body, Social Care and Social Work Improvement Scotland (the Care Inspectorate) took over the work of the Care Commission, including registration of care services. This means that from 1 April 2011 this service continued its registration under the new body, the Care Inspectorate. Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve its service, 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 but where failure to do so will not directly result in enforcement. Recommendations are based on the National Care Standards, relevant codes of practice and recognised good practice. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reforms (Scotland) Act 2010 and Regulations or Orders made under the Act, or a condition of registration. Where there are breaches of the Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. The Family Support Service is a Care at Home service provided by East Lothian Council Children's Wellbeing Department. The service is registered to provide planned intervention, at home, to children and their families. family support workers work from Randall House in Macmerry. The service works with up to 12 families at any given time. In their information leaflet they say: "The Care at Home service is provided by Family Support Assistants who offer care and practical support to vulnerable children and their families. Some of these children may have disabilities and some families may need day-to-day help with child care." 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. 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. Family Support Service, page 5 of 21

6 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 This unannounced inspection was carried out by an inspector from the care inspectorate on 15 and 23 October Prior to inspection we looked at the annual return and the self assessment that the service submitted to us. We received one service user and one staff questionnaire. We spoke on the telephone to five parents/carers who used the service. We spoke to all three members of the staff team. We spoke with the manager of the service. We looked at a range of records including support plans and case notes. 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. Family Support Service, page 6 of 21

7 Fire safety issues Inspection report continued 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 Family Support Service, page 7 of 21

8 What the service has done to meet any recommendations we made at our last inspection Two recommendations were made following the inspection of 10 March 2014: 1. The service should consider how they could consult with all service users to reflect their views and use this information to make improvements. National Care standards - Care at home - Standard 11: Expressing your views. Outcome: This recommendation has been met. 2. The service should consider how they can identify and record outcomes for service users which would show progress made or changes needed to the care plans. National Care Standards - Care at home - Standard 3: Your personal plan. Outcome: This recommendation has been met. 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 completed self assessment document from the service provider as requested. The service identified what they were doing well and also their vision for the future. They identified ways that they could further improve their service. Family Support Service, page 8 of 21

9 Taking the views of people using the care service into account We received one completed satisfaction questionnaire and spoke with five parents/ carers on the telephone. Views of the service were very positive as were the views on relationships with staff. Comments included: "an excellent service" "staff are all great" "fantastic service" "the staff are nice" "I'm very happy with the service I receive" "they help maintain a good routine for (child)" "communication is good". Taking carers' views into account See above. Family Support Service, page 9 of 21

10 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 We found that the service was very good at gathering and responding to the views of service users. The service followed the council's participation and engagement strategy, which detailed how staff would look for feedback from the people who use the service. The provider had a dedicated officer who promoted service user participation and published findings on a regular basis. An information leaflet told service users about the service, the role of the support workers and relevant policies and procedures. This gave families the opportunity to make comment and provided details of where they could get further information. It also told them who they could talk to if they wanted to make a complaint about the service. This included the contact details of the Care Inspectorate. From initial assessment onwards, children and parents/carers were involved fully in planning respite and support. Regular review meetings ensured this dialogue continued throughout the service's involvement with the family. A range of other professionals attended these meetings as required, for example, educational psychologist and speech therapist. We saw that the service could be very flexible in meeting the needs of service users; for example, by providing overnight support and by changing the times of visits. Family Support Service, page 10 of 21

11 Service users described to us the very positive relationships they had with workers and told us that they were confident in raising any issues they the might have. Service users told us that communication with the service was "very good". Areas for improvement As planned, the support plan should include a timescale for tasks to be completed. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Family Support Service, page 11 of 21

12 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued We found that the service promoted the health and wellbeing of service users very well. The service told us that "Service users' physical and mental health and wellbeing needs are assessed by the social worker responsible for the case, and shared with the manager of this service who briefs the individual family support worker fully, both at the point of allocation and on an ongoing basis. In the event of the assessment showing a need for any more specialised medical assessments, these would be organised by the allocated social worker in conjunction with the health visitor or GP." The strengths noted in previous inspection reports remained in place including: * supporting people to achieve potential and a positive quality of life. * assessment at the start of placement to ensure that all of the people involved with the family were aware of what they needed to do * good communication with other agencies in order to direct parents towards the services they needed * supporting parents to care for their children's medical needs * protecting children through knowledge of child protection procedures * staff who were knowledgeable about child development and, in particular, relevant issues for children with additional needs * the service tried very hard to accommodate requests for support and were very flexible in what they could offer * staff had worked with other professionals to minimise barriers caused by language or disability in order to ensure that everyone who needed to could use the service * enabling good communication, for example using 'signalong' and British Sign Language * supporting children's emotional well being * planning effective programmes for working with families Including help with dressing and bathing, organising and cleaning the family home, cooking, shopping, making healthy choices, choosing and buying the right clothing, good parenting skills. * providing necessary respite for parents by offering play activities. We saw that all of the service users had a support plan which was compiled by all of the professionals working with them. The plan identified the tasks relevant to the Family Support Service. In addition, each support worker recorded details from their contact with service users. These recordings were concise and appropriate. Family Support Service, page 12 of 21

13 Areas for improvement The service should continue to promote the health and wellbeing of service users. We were told that risk assessment was carried out at the initial visit to the service users. Risks would then be recorded within case notes. The manager agreed with us that a pro-forma to record risk assessments would enhance this process. The proforma should be updated as required and at review. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. A risk assessment pro-forma should be in place. This should be updated as required and at review. NCS 3 Care at Home - Your Personal Plan. Family Support Service, page 13 of 21

14 Quality Theme 3: Quality of Staffing 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 staffing in the service. Service strengths Evidence found in Quality of Care and Support, Statement 1, also applies to this statement. Areas for improvement Evidence found in Quality of Care and Support, Statement 1, also applies to this statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Family Support Service, page 14 of 21

15 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 staff team to be dedicated and well motivated in carrying out their work. It was clear that they knew the families very well and were committed to positive outcomes for them. Families/carers told us that they valued the support they received and that relationships with staff were very good. East Lothian Council published guidance which provided staff with appropriate support and instruction to enable them to carry out their work. Included in this were policies and procedures such as a grievance procedure and a whistle blowing policy. All of the Family Support workers were qualified to at least SVQ Level 3 in Childcare and Education. All staff took part in the council's Professional Development Review System (PDRS) where staff identified their skills, areas for development and personal objectives for the coming year. Staff found this process helpful and supportive. We were told that the council promoted training through a 'protected learning calendar' where staff could attend relevant in-house training sessions. Recently, staff had taken part in training such as Epilepsy Awareness, Adult Protection, Autism, Child Protection and Moving and Handling. Staff had all completed Child Protection level 1 training. Staff had also attended "Teamteach" training, a recognised Positive Handling approach involving risk reduction strategies. A lone working policy was in place that required staff to sign out and sign back in following home visits. We were satisfied that staff were aware of the National Care Standards and the Scottish Social Services Council Code of Practice. They said they felt that they worked well together as a team. Staff told us that they felt supported by the manager. Inspection report continued Family Support Service, page 15 of 21

16 Areas for improvement Up until August 2014, regular staff meetings took place where staff discussed practice and explored ideas that helped them to keep up to date with current practice issues and identify ways to work with the people who used their service. Due to absence and leave, these meetings had not taken place. They should be reinstated as soon as possible, especially during this period of change. Likewise, supervision had not been as frequent as previously recorded in inspection reports. This should be addressed immediately. We did note that temporary support arrangements had been put in place during the manager's absence. The team should be supported through the forthcoming period of change. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The manager should ensure that: a) Staff receive regular supervision. b) The team meeting be held regularly. NCS 4 Care at Home - Management and Staffing. Family Support Service, page 16 of 21

17 Quality Theme 4: Quality of Management and Leadership 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 management and leadership of the service. Service strengths Evidence found in Quality of Care and Support, Statement 1, also applies to this statement. Areas for improvement Evidence found in Quality of Care and Support, Statement 1, also applies to this statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Family Support Service, page 17 of 21

18 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 In Quality Theme 1 Statement 1, we identified a range of ways that the service involved parents/carers, children and young people in assessing the quality of the service. We also commented upon the involvement of other stakeholders; for example, social workers, occupational therapists and health visitors. Their views on the service informed practice. The manager had used staff meetings, supervision and PDRS to reflect with staff on the needs of the families in order to provide the most effective support. We also saw evidence that managers carried out case file audits to monitor practice. Staff could access all the necessary policies and procedures through the council 'intranet' system and used these to inform practice. The service told us that "We ensured last year that the manager observed all our staff interacting with service users. We aim to repeat this with the new manager." They also told us that "We respond to any ongoing feedback as it occurs. We meet regularly as team leaders and managers to look at issues of quality assurance. We use the outcomes of local and National Significant Case Reviews to compare and improve systems. We operate a Feedback Comments, Suggestions and Complaints system to enable service users and others to comment on their experiences of the service." Exit questionnaires were used at the end of service involvement with each family. The service made appropriate notifications to the Care Inspectorate. Areas for improvement The service should continue to quality assure performance and practice. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Family Support Service, page 18 of 21

19 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 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). Family Support Service, page 19 of 21

20 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 1 Statement Very Good 5 - Very Good Quality of Management and Leadership Very Good Statement 1 Statement Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 10 Mar 2014 Announced (Short Notice) Care and support Staffing Management and Leadership 5 - Very Good 5 - Very Good 5 - Very Good 18 Mar 2013 Unannounced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership 4 - Good 17 Nov 2011 Unannounced 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. Family Support Service, page 20 of 21

21 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: Family Support Service, page 21 of 21