Care service inspection report

Transcription

1 Care service inspection report Full inspection Willowbank Bungalows 1,2&3 Care Home Service Willowbank Glendaveny Peterhead Inspection completed on 09 May 2016

2 Service provided by: Aberdeenshire Council Service provider number: SP Care service number: CS Inspection Visit Type: Unannounced Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and set out improvements that must be made. We also investigate complaints about care services and take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. Contact Us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com page 2 of 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 6 Excellent Quality of environment 6 Excellent Quality of staffing Quality of management and leadership N/A N/A What the service does well The service provided a very homely environment for the people living there. There continued to be a consistent staff team at the service which has ensured that the staff members have a very good knowledge of each resident. This also helped the residents to be understood. What the service could do better Although not stated as a recommendation, the service should consider installing Wifi access at the service. This would enable residents to get better use of their tablet computers and smartphones. What the service has done since the last inspection The service has continued to develop over the years. Residents have become more independent and confident when using public transport. Two residents are looking to move to the nearby town to more independent living. page 3 of 21

4 Conclusion Inspection report This service provides excellent support in a manner that suits each resident. The maintenance of the same staff team has helped this. page 4 of 21

5 1 About the service we inspected Inspection report The Willowbank Bungalows 1, 2 & 3 provide a service from three bungalows in the Glendaveney area near to Peterhead. The manager works in all three bungalows and is based in bungalow 2 when carrying out administrative duties. The bungalows provide accommodation and support for up to 14 adults with learning disabilities. At the time of the inspection there were 10 residents staying at the service. Bungalow 1 has recently moved to the former respite house, with the respite service moving the other way. This was to enable a more person centred service to a resident. The service's aims include; respecting privacy, maintaining dignity, promoting choice, safeguarding rights, promoting a needs-led service, providing a working environment that enables staff to support these aims and regularly evaluating the service provided. The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April Recommendations A recommendation is a statement that sets out actions that a care service provider should take to improve or develop the quality of the service, but where failure to do so would not directly result in enforcement. Recommendations are based on the National Care Standards, SSSC codes of practice and recognised good practice. These must also be outcomes-based and if the provider meets the recommendation this would improve outcomes for people receiving the service. Requirements A requirement is a statement which sets out what a care service must do to improve outcomes for people who use services and must be linked to a breach in the Public Services Reform (Scotland) Act 2010 (the "Act"), its regulations, or page 5 of 21

6 orders made under the Act, or a condition of registration. Requirements are enforceable in law. We make requirements where (a) there is evidence of poor outcomes for people using the service or (b) there is the potential for poor outcomes which would affect people's health, safety or welfare. Based on the findings of this inspection this service has been awarded the following grades: Quality of care and support - Grade 6 - Excellent Quality of environment - Grade 6 - Excellent Quality of staffing - N/A Quality of management and leadership - N/A Inspection report This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. page 6 of 21

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 an unannounced inspection which began on Thursday 5 May 2016 between 9.00am and 4.30pm. The inspection was completed and feedback given to the manager on Monday 9 May During the visit we gathered evidence from various sources, including written records: - current self assessment document - six Care Standard Questionnaires (CSQs) returned by residents - three residents' care plans including daily notes - various policies - staff training records - household risk assessments. Discussions with various people, including: - four residents - the manager - 3 social care officers. 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. page 7 of 21

8 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 page 8 of 21

9 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 completed this, and with the relevant information included for each heading that we grade services under. The provider identified what it thought the service did well, some areas for development and any changes planned. Taking the views of people using the care service into account Fourteen CSQs were issued to the residents. Only six were returned. However these provided information that they were happy with the service that they were receiving. During the inspection we spoke with four service users over lunch. They all appeared very happy and interacted with the staff members. Taking carers' views into account No family carers were present during the inspection. 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: 6 - Excellent Statement 3 We ensure that service users' health and wellbeing needs are met. Service Strengths At this inspection we found that the service was performing at an excellent standard for this statement. We found that the residents maintained good health and wellbeing. This related to their general health and specific health issues were well-managed. Residents attended the GP, supported by staff members as necessary. Regular contact was maintained with the multidisciplinary teams including the diabetic nurse. One resident had diabetes but this was well-managed with support from the staff members. Regular visits from the diabetic nurse to check progress and provide training and information to the staff team took place. Medication reviews took place with the GP over the telephone if there was no recent involvement with the person for a health related condition. The residents involved their family members in their care if they wanted them to be. Residents and families attended regular reviews about the residents care. Support plans were in place which was person centred and provided clear information about the resident's needs and their daily routines. The residents had active social lives. This included attending their daily activities and attending social events out with the service. page 10 of 21

11 There had been recent changes to the accommodation. One service user was being supported on a one-to-one basis to ensure that they were supported in a safe and secure environment which met the needs of the resident. A small staff team supported this resident to maintain continuity. Staff members had received appropriate training to help identify specific triggers to behaviours and also the most appropriate ways to manage this behaviour. A number of residents had become more independent in their travel. This was mainly now being able to travel by bus into the nearby town. Support plans detailed this and also had risk assessments which ensure that the residents had their mobile phones with them to call if they missed the bus. With the improved confidence and independence of some of the residents, it had been identified that two residents are planning to move into a shared house in Peterhead. This has been the wish of the residents and this was being discussed with their families. Areas for improvement The service should continue to support residents to achieve their full potential and to continue to support the residents with their plans to move to independent living. Grade 6 - Excellent Number of requirements - 0 Number of recommendations - 0 Inspection report Statement 4 We use a range of communication methods to ensure we meet the needs of service users. Service Strengths At this inspection we found that the service was performing at an excellent standard for this statement. Residents were listened to and were able to communicate with the staff members and each other. Most residents were able to communicate verbally. page 11 of 21

12 The service had a very low turnover of staff members. The staff members were able to understand residents from speech and expressions and mannerisms. The support plans provided very good information about the methods of communication used by the residents. Visual support plans were used for residents who required this to help them with specific tasks. One example showed photographs of each part of the process of filling and switching on the washing machine. Photo boards were also used to show residents the staff member on duty, daily chores and which resident was responsible for the task. The resident in bungalow 1 had a more detailed daily picture board of their day. Staff pictures were changed as necessary and a photo was included for visitors to the service. However visitors was avoided and any maintenance was carried out when they were not at home. Pictorial activity timetables were also used to help the resident be aware of what group they were to attend the following day. The level of use of pictorial tools varied as needed by the resident. Residents made various decisions about daily choices and other issues such as holidays. Staff members had been trained to use talking mats and this technique was used for some residents. As identified in quality theme 1 - statement 3, residents had improved their confidence and independence and were now travelling independently. The use of their mobile phones was a vital communication aid. Also the residents carried an emergency assistance card which provided contact details of the service. One resident had a vibrating watch which was set to let them know that it was time to return to the bus station to catch the bus home. Areas for improvement The service should continue to identify the communication needs of the residents. Further use of pictorial support plans should be developed as appropriate. Grade 6 - Excellent Number of requirements - 0 Number of recommendations - 0 Inspection report page 12 of 21

13 Quality Theme 2: Quality of Grade awarded for this theme: 6 - Excellent Statement 2 We make sure that the environment is safe and service users are protected. Service Strengths At this inspection we found that the service was performing at an excellent standard for this statement. Residents felt safe and secure at the service. Staff members rang the door bell and waited for the door to be answered before entering the houses. The houses were clean, tidy and provided an appropriate environment for the purpose. Recent changes to the accommodation had been planned to address the needs of the residents. The Care Inspectorate had been notified and approval provided. Systems were in place at the service to maintain the safety of residents and staff members. Appropriate health and safety monitoring took place by the staff team and an annual inspection by a local authority inspector. Various household and individual risk assessments had been developed. These ensured that the residents maintained safety but also to enable them to develop household domestic skills. Regular systems were in place to ensure that various alarm systems worked properly. These systems were adapted to alert residents who had sensory disabilities. Easy read fire instructions were on the wall so that the residents could easily understand the process. Revised fire risk assessments had been prepared and viewed by the fire and rescue service following the change of use of one of the bungalows. page 13 of 21

14 Areas for improvement The staff at the service should continue to ensure the safety of the residents, but also providing them with skills to improve their independence and assist the move to more independent living for some of the residents. Grade 6 - Excellent Number of requirements - 0 Number of recommendations - 0 Inspection report Statement 4 The accommodation we provide ensures that the privacy of service users is respected. Service Strengths At this inspection we found that the service was performing at an excellent standard for this statement. Residents were treated with respect at this service. Their dignity and privacy was promoted and maintained at all times. Staff members rang the door bell and waited to be invited into the house. They also knock on resident's doors to request permission to enter. Some residents had a key to their room. This was available to all residents but only asked for by a few residents. Residents also had cash boxes within their room. These were kept in a locked drawer in the room. Keys to this drawer were kept by residents if they wished. Otherwise staff members supported the residents to access their cash tin. Safe financial systems were being carried out with daily balance checks and monitoring taking place. A few residents also were self medicating and they were responsible for locking this away securely. Residents can speak with staff members at any time. This can be in the office or the resident's room to ensure that the discussion can be in private. Residents can entertain their visitors/families in their rooms or a space will be found to give privacy. page 14 of 21

15 Areas for improvement The service should continue to respect the privacy and dignity of the residents and to promote this to the residents by showing good examples. Grade 6 - Excellent Number of requirements - 0 Number of recommendations - 0 Inspection report page 15 of 21

16 Quality Theme 3: Quality of Quality theme not assessed page 16 of 21

17 Quality Theme 4: Quality of Management and Leadership Quality theme not assessed 4 What the service has done to meet any requirements we made at our last inspection Previous requirements There are no outstanding requirements. 5 What the service has done to meet any recommendations we made at our last inspection Previous recommendations There are no outstanding recommendations. 6 Complaints No complaints have been upheld, or partially upheld, since the last inspection. page 17 of 21

18 7 Enforcements We have taken no enforcement action against this care service since the last inspection. Inspection report 8 Additional Information There is no additional information. 9 Inspection and grading history Date Type Gradings 27 May 2015 Unannounced Care and support Management and Leadership 11 Jun 2014 Unannounced Care and support Management and Leadership 6 Jun 2013 Unannounced Care and support Management and Leadership 13 Nov 2012 Unannounced Care and support 4 - Good Management and Leadership 4 - Good 29 Feb 2012 Re-grade Care and support page 18 of 21

19 Management and Leadership 4 - Good 24 Feb 2012 Re-grade Care and support Management and Leadership 1 - Unsatisfactory 22 Nov 2011 Unannounced Care and support Management and Leadership 4 - Good 26 Oct 2010 Unannounced Care and support Management and Leadership 13 May 2010 Announced Care and support Management and Leadership 2 Nov 2009 Unannounced Care and support Management and Leadership 14 May 2009 Announced Care and support Management and Leadership 6 Jan 2009 Unannounced Care and support 4 - Good Management and Leadership 17 Nov 2008 Announced Care and support page 19 of 21

20 Management and Leadership 4 - Good 4 - Good page 20 of 21

21 To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. You can also read more about our work online. Contact Us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY Other languages and formats This report is available in other languages and formats on request. Inspection report Tha am foillseachadh seo ri fhaighinn ann an cruthannan is c?nain eile ma nithear iarrtas. page 21 of 21