Angus Women's Aid Housing Support Service Arbroath

Transcription

1 Angus Women's Aid Housing Support Service Arbroath Type of inspection: Unannounced Inspection completed on: 18 November 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 20 5 Summary of grades 21 6 Inspection and grading history 21 Service provided by: Angus Women's Aid Ltd 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 Angus Women's Aid, page 2 of 22

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 Angus Women's Aid provides a comprehensive support service to meet the needs of women and children who use their support service. Service users we spoke with told us they receive an immediate response to their crises situations. The service provides a secure and supportive environment where women feel safe. The staff work closely with professionals from other agencies to ensure that service provision across agencies is streamlined. Staff we spoke with were insightful about the impact of domestic abuse and are highly motivated in their roles. The service supports a culture of continuous learning for their staff. What the service could do better The service is exploring ways of improving service user involvement at Board level. The service has a sub group which is reviewing their Human Resources policies and procedures. The service should continue to find ways to maximise service user involvement. What the service has done since the last inspection The service has changed premises since the last inspection. The service has worked with Evaluation Support Scotland. Following this input, the service ran a focus group to help to identify key areas of service provision to be monitored. The service has just secured funding for a volunteer co-ordinator post. The service has established a more regular pattern of team meetings. The service has developed an Annual Review programme for all policies and procedures. Angus Women's Aid, page 3 of 22

4 Conclusion Inspection report continued Angus Women's Aid provides effective person centred support to women who are, or have previously been, experiencing domestic abuse. We found that this support assisted women to establish independent lives and work towards achieving their goals. Angus Women's Aid, page 4 of 22

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at The service was previously registered with the Care Commission in 2004 and transferred its registration to the Care Inspectorate on 1 April Requirements and recommendations If we are concerned about some aspect of a service, or think it could 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 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 Reform (Scotland) Act 2010 and the 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. Angus Women's Aid is run by a voluntary Board of Directors. The service is registered to provide a housing support service to women and their children who have been affected by domestic abuse. Outreach support and refuge accommodation is provided to families or single women in the Angus area, or the wider community, as detailed on the certificate of registration. 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. Angus Women's Aid, page 5 of 22

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 - We read the service's registration certificate - We read seven service users' files - We read the service's Introduction Pack for service users - We spoke with three service users in a focus group - We contacted six other service users by telephone - We spoke with the MARAC independent advocate - We spoke with a women's support worker - We spoke with the chief executive officer (CEO) - We spoke with the service manager - We met and spoke with the Board of Directors - We spoke with the office manager - We read minutes of staff supervision sessions - We read minutes of team meeting - We read the service's policy documents - We read the completed Care Inspectorate questionnaires (seven from service users, four from staff) - We read the service's Performance Management information. 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 Angus Women's Aid, page 6 of 22

7 Inspection Focus Areas (IFAs) Inspection report continued 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 Angus Women's Aid, page 7 of 22

8 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 This inspection was unanounced. On the day of our visit, not many service users were available to speak to us. We contacted more service users by telephone after the inspection visit. Service users we spoke with gave us the following feedback: "The staff were very helpful. They were there to talk to when I was struggling with different things. It was daunting to make the move. It was a big step to move out to a refuge." "I do wonder about the visitors' policy. I do appreciate the need for security but I couldn't have anyone to visit and I felt isolated." "The staff were great. I went to all the groups." "Someone came from the Citizens Advice Bureau and gave us advice about housing issues and we got help with filling in forms. The groups were very interesting." "They helped me to move on. I know other service users felt they missed the level of contact with staff at Women's Aid." Angus Women's Aid, page 8 of 22

9 "I think the groups are really good. The staff are brilliant. It's a wonderful, fantastic organisation which helps people when they are at the end of the road. You have got nowhere else to go at the point you contact Women's Aid. This is a matter of life and death for some people." "It's a brilliant service, it's a roof over my head, they supply food if you have no money when you arrive. It's brilliant and I can't find any bad points.' There's always someone to talk to." "I get on brilliantly with my keyworker. The staff are so open and honest. I have gone to the groups although they are more oriented round young mums." "There is nothing they could do more. I am extremely satisfied with the support I have received." "The flat had everything I needed." "I was pleasantly suprised. I didn't know what to expect." Taking carers' views into account Carers were not interviewed during this inspection. Angus Women's Aid, page 9 of 22

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 evidence during this inspection that the service was performing at a very good standard in relation to this statement. On entering the service, women were given an information pack which ensured they could be clear about what to expect. This pack contained a copy of the service's confidentiality policy, information on data protection and data sharing, information on health and safety and statements on adult protection and child protection. Women were able to participate in an initial evaluation where they were encouraged to comment on the refuge environment and to make suggestions on improvements. The service used the support planning tool, 'Outcomes Star', which allowed for service user input. Service users were also encouraged to contribute to the review of their support plan. This level of service user involvement ensured that support plans were personalised and that they were adapted, when required, to any change in support needs. The staff also worked with service users to complete their risk assessment. This involved considering ways to effectively manage any identified risks. The service used a keyworker system which provided an opportunity for service users to regularly express their views on the support they required. Service users were also able to give their feedback at weekly house meetings. Service users we spoke with also described very regular, informal contact with staff either at the refuge or in the office, when they would be able to share their views. The women we spoke with said that they were aware of how to make complaints. We saw that the service displayed their complaints procedure. Angus Women's Aid, page 10 of 22

11 We found the service used focus groups to encourage women, children and young people to express their views. A recent focus group had explored how service outcomes were written up and whether they made sense to both service users and staff. Focus groups were used generally to inform future developments within the service. Service users were able to use the organisation's computer to access a survey monkey. This meant feedback was anonymous. Exit interviews were held with every woman leaving the service. Areas for improvement The service should continue to develop their participation strategy as a way to maximise service user involvement. A working group had been set up to explore ways of improving service user involvement, specifically at the Board of Directors level. These areas of development will be followed up at the next inspection. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Angus Women's Aid, page 11 of 22

12 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued We found that the service had achieved a very good standard of practice in relation to this Quality Statement. The staff we spoke with were committed to delivering person centred support. The support planning tool, 'Outcomes Star' helped to identify a wide range of support needs related to health and well being. Staff were familiar with relevant local agencies and appropriately signposted service users to services which could meet particular needs, such as addiction support. Service users were supported to register with local GPs and dentists. Where possible, the service attempted to set up links/referrals in advance of a woman arriving at the refuge, so that support systems were in place as early as possible. In response to service user feedback, the service had set up a group programme. Sessions were delivered three times a week. The group addressed issues such as self esteem, confidence, assertiveness and healthy lifestyles. The service also held pampering and relaxation sessions which focused on well being. We saw that the service had its own snall library which both service users and staff were able to access. Activity programmes were drawn up in consultation with service users; for example, the service held an art group and a walking group (which met at different times throughout the year). There were also weekly drop-ins where women could meet up for coffee. Where service users were identified as being at particularly high risk in relation to domestic violence, they were referred to the MARAC (Multi Agency Risk Assessment Conference) which is discussed further under Quality Statement 3.3. The purpose of this process was to ensure that agencies were working together to keep women as safe as possible. Staff worked closely with professionals from other agencies to ensure that service provided across agencies were streamlined to maximise the suitability and quality of support provided to service users. After leaving a refuge women, children and young people were offered 'follow on' support to help them set up home in their new accommodation. Women could receive longer term support from the outreach service. The service's robust risk assessment process was used to identify any health issues. The service used an adapted version of the risk assessment tool CAADA which had additional sections included to address further risk factors. CCTV had been installed at the family block. Women at the refuge were supplied with personal safety alarms. A staff member visited the refuge every day and the service manager carried out a health and safety check at the refuge once a fortnight. Angus Women's Aid, page 12 of 22

13 Areas for improvement The service should continue to build on the range of activities available to women as a means of overcoming their isolation. Otherwise, the service should continue to maintain the very good practice it has established in relation to this statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Angus Women's Aid, page 13 of 22

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 See comments under Quality Statement 1.1 in relation to this statement. Areas for improvement See comments under Quality Statement 1.1 in relation to this statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Angus Women's Aid, page 14 of 22

15 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Inspection report continued We found that the service was performing at a very good standard in relation to this Quality Statement. We found that the service had a well established staff group. Staff morale was strong and the staff we spoke with during the inspection were passionate about their work. The high level of staff commitment was reflected in the quality of care and support delivered to service users, as discussed under Quality Theme 1, and as reflected in the views of people using the service. Staff received formal 1:1 monthly supervison at which they reviewed their casework and addressed any issues relating to their role. In addition to formal supervision, staff told us that supervision was available on an ad hoc basis if required. The staff we spoke with told us that they found supervision helpful and that they generally felt supported in their role, both by their line manager and by the other team members. We were told that arrangements were in place for staff to access external counselling if required. We saw that staff received annual appraisals which provided an opportunity for both the staff member and their line manager to take stock of progress overall and identify any significant issues, including training requirements. The service also held regular staff meetings. The two sub teams (housing support workers and children's workers) each met weekly and then all staff came together for monthly whole team meetings. The staff group included a MARAC independent advocate. We spoke with this staff member who was in the final stages of completing the specialist training for her role. This staff member represented individual women at the monthly MARAC meetings. Women who were discussed at the MARAC were referred to other agencies for follow up support as required. There was a 13 week probation programme in place for all new staff. We found that staff had access to a wide range of training. The service was affilliated to Scottish Women's Aid which delivered relevant training as required. Staff also had access to training opportunities through the local Council including, for example, child protection and adult protection training. The staff group accessed - learning where appropriate. Training needs were reviewed on an ongoing basis. We found staff held a wide range of qualifications relevant to their roles. The service gave high priority to ongoing staff training and development and we found that the staff group were completing a number of relevant qualifications at the time of the inspection. The staff group had attained a number of their professional qualifications whilst employed with Angus Women's Aid. Angus Women's Aid, page 15 of 22

16 Staff were encouraged to share their learning with other team members. Following suggestions from staff, external speakers were invited to the service to deliver training sessions. The service manager was registered with the Scottish Social Services Council as the service's manager. The manager had a Degree in Education and was qualified to SVQ level 4. Staff went out to schools to work with both teachers and pupils to promote understanding of healthy relationships and awareness of issues related to domestic violence. Staff also delivered similar awareness raising sessions with professionals from other relevant agencies such as Social Work and Health. All staff had access to copies of the National Care Standards and the Scottish Social Services Council's Codes of Practice. Areas for improvement The MARAC independent advocate was a relatively new role which was still being defined. We will follow progress with this at the next inspection. Otherwise, the service should continue to maintain the very good practice it has established in relation to this statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Angus Women's Aid, page 16 of 22

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 See comments under Quality Statement 1.1 in relation to this statement. Areas for improvement See comments under Quality Statement 1.1 in relation to this statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Angus Women's Aid, page 17 of 22

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 Inspection report continued The service was performing to a very good standard in relation to this Quality Statement. As detailed in Quality Statement 1.1, service users had a range of opportunities to assess the quality of the service provided. We found that the service had compiled a summary analysis of the feedback provided by service users and that this feedback had been very positive. We saw that the service had a 'You said... We Did' board on display, which demonstrated how the service had recently responded to suggestions made by service users. Staff said they were committed to supporting the continued participation of women, children and young people in contributing to the development of the organisation. The monthly formal staff supervision system, discussed under Quality Statement 3.3 helped to ensure that all casework was reviewed and that staff were supported. The supervision process therefore provided another opportunity to quality assure service provision. Staff practice was guided by the service's policies. Staff were aware of the Care Inspectorate's notification system which they would be able to use if required. We found that individual service user files contained a checklist with entries on the checklist being signed off and dated when dealt with. This helped to quality assure the service provided to each service user. The service produced an Annual Report which reported on highlights over the year, a breakdown of expenditure, and summary statistics related to service provision. The service had a Strategic Plan in place which detailed the future direction of the service. In addition to scheduled Board meetings, the CEO met regularly with the Chair of the Board to discuss any areas for development. The CEO used a participative leadership model which supported a democratic way of working with staff. Staff told us that they felt very comfortable approaching their manager to raise any issues or concerns regarding service delivery. The service managers prepared monthly performance reports which were submitted to the service's Board of Management. The Board was proactive in its performance mangement role. The Board members represented a range of professional backgrounds (including social work, human resources and addictions) from which the staff group, and the service generally, were able to benefit. Angus Women's Aid, page 18 of 22

19 The service used the Scottish Women's Aid monitoring and evaluation framework. The service had been assessed as meeting all the Scottish Women's Aid National Service Standards. This was another method of measuring the quality of service provision. Areas for improvement The service was currently planning a Human Resources sub group to explore ways to improve Human Resources policies and procedures. Work on the service's Strategic Plan was ongoing. Progress with these areas of development will be followed up at the next inspection. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Angus Women's Aid, page 19 of 22

20 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). Angus Women's Aid, page 20 of 22

21 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 29 May 2013 Announced (Short Notice) Care and support Staffing Management and Leadership 5 - Very Good 5 - Very Good 5 - Very Good 6 Jun 2012 Announced (Short Notice) Care and support Staffing Management and Leadership 4 - Good Not Assessed 5 - Very Good 7 Jan 2010 Announced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership 4 - Good 24 Mar 2009 Announced Care and support 4 - Good Staffing 4 - Good Management and Leadership 3 - Adequate All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Angus Women's Aid, page 21 of 22

22 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: Angus Women's Aid, page 22 of 22