Care service inspection report

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1 Care service inspection report Full inspection Care & Support at Home Housing Support Service Hillend Centre 2 East Crawford Street Greenock Inspection completed on 12 May 2016

2 Service provided by: Inverclyde 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 page 2 of 32

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 N/A What the service does well The majority of people who used the service that we spoke with or received questionnaires from were very positive about the quality of care and support provided. Meaningful participation of service users and their relatives/carers continued to be embedded in the culture and ethos of the service. Social care and healthcare needs were well supported through collaborative working with healthcare colleagues and other agencies. Staff were well-trained, professional and provided care and support in a person-centred way. The quality of service was complimented by very good use of reablement, telehealthcare, telecare and assistive technology. The provider was very good at quality assurance and continually strived for improvement. What the service could do better The provider had good insight into the areas for development that needed addressed to further improve the service. We discussed some areas for improvement identified at this inspection, including improving care planning,supervision and appraisal and dementia training signposting the provider to appropriate guidance. page 3 of 32

4 What the service has done since the last inspection Inspection report The service has maintained very good quality standards across the quality themes we inspected. Conclusion Care & Support at Home is a very well liked and well received service by the people who use it. The staff in the service work hard to improve standards of care whilst promoting independence and person-centred care. There is a very good culture of learning and continuous improvement. Some elements of the service are innovative. The service is prepared to try new ideas with the involvement of people who use the service at every stage. Any areas for improvement that have been identified at this inspection are clearly understood by the provider and we are confident that they will work hard to address these. page 4 of 32

5 1 About the service we inspected Inspection report Inverclyde Council's Care & Support at Home service has been registered with the Care Inspectorate since April 2011 to provide an integrated Housing Support and Care at Home service to people living in their own homes. The service includes reablement, home care, meals on wheels, respite, community alarms, telecare, benefits maximisation and a rapid response service. The service is mainly provided by staff employed by Inverclyde Council although services may also be contracted out to the private or voluntary sector. The principal aim of the service is to enable people to live as normal and independent a life as possible in their own home. Specific objectives are: - To provide home care services to assist people in their own homes and enable them to remain there. - To provide home care in a way which will ensure that the independence of service users is enhanced and their lifestyles are safeguarded. - To provide home care in a way that demonstrates respect for the service users' home and possessions. - To manage home care services in a way that ensures Service Objectives and the Charter of Rights for Home Care Services are fulfilled and quality standards are met. 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 page 5 of 32

6 in the Public Services Reform (Scotland) Act 2010 (the "Act"), its regulations, or 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 5 - Very Good Quality of staffing - Grade 5 - Very Good 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 32

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 following an unannounced inspection. The inspection was carried out by one inspectors. The inspection took place on Thursday 12 May 2016 between 10.20am and 15.35pm. We gave feedback to the manager and team leader on Thursday 12 May As part of the inspection, we took account of the self assessment form that we asked the provider to complete and submit to us. We issued two hundred and fifty care standards questionnaires (CSQs) to the manager to give to service users to complete and we got ninety four completed questionnaires back. We asked the manager to give out one hundred questionnaires to staff and we got twenty eight completed questionnaires back. During this inspection we gathered evidence from various sources, including the following: We spoke with: - The manager - One team leader We looked at: - A sample of personal plans and single shared assessment care plans. - Service newsletters. - A client feedback report (collated responses). - The online scheduling and monitoring system (CM2000). - A sample of client observation reports. page 7 of 32

8 - A sample of staff training records and a staff training plan. - Home Support Workers Procedures and Handbook. - The provider's complaints policy and procedures. - A sample of accident/incident/complaint records. - The registration certificate. - Public liability insurance. - Employers liability insurance. - A sample of minutes of meetings with service users, carers and staff. Inspection report An Inspector Volunteer is a member of the public who volunteers to work alongside Inspectors during the Inspection process. Inspector Volunteer have a unique experience of either being a service user themselves or being a carer for someone who has used services. The Inspector Volunteer role is to speak with people using the service being inspected and gathering their views. In addition, where the Inspector Volunteer makes their own observations from their perspective as a recipient or a carer, these may also be recorded. During the inspection the Inspector Volunteer spoke to four service users and three carers individually by telephone. The Inspector Volunteer views on the service can be seen under the statement 'Views of People using the Service' of this report. 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 8 of 32

9 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 9 of 32

10 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 by 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 it had planned. The provider told us how the people who used the care service had taken part in the self assessment process. Taking the views of people using the care service into account We issued two hundred and fifty care standards questionnaires (CSQs) to the manager to give to service users to complete and we got ninety four completed questionnaires back. Sixty eight were from service users. All the completed CSQs either agreed or strongly agreed that overall they were happy with the quality of care and support. One disagreed. Nineteen people indicated that they did not know about the service's complaint procedure and twenty-four people indicated that they didn't know they could also make a complaint to the Care Inspectorate. page 10 of 32

11 Six people indicated that staff did not have enough time to carry out the agreed care and support. Six people indicated that the service did not ask their opinion on how it can improve One person indicated that they did not know the names of the staff providing the care. We received the following comments in the completed and returned CSQs:- "Excellent care and attention from supportive and caring staff at all levels." "If times are changing the office should notify me of this, which they have not done. The home support worker should not show up early or late due to the change. I expect them to arrive at the time I have agreed. At times I feel rushed, I would like more time. The home support workers are nice and very helpful unfortunately they don't have enough time. I feel continuity of home support worker is important. They get to know me and will know if something is wrong." "I am 100% satisfied with my service and support. The carers know all my needs and treat me with respect and dignity. I couldn't live in my own home without all the support I get." "As far as I am concerned the service is exceptional." "The continuity of the service is very important to me." "The carers have been very supportive. The service is excellent in every way. I have appreciated their encouraging me to do as much as possible." "Excellent service, carers lovely, very respectful, kind and great empathy." "More flexibility needed sometimes I feel im keeping the girls late for their next client if I need to use the commode." "I couldn't do without the carers. I really think this is a great service." page 11 of 32

12 "The carers that visit me quite often do jobs which are not part of my care plan but makes life easier for me. I find all staff attentive without being intrusive or patronising. I feel sometimes they are rushed between jobs." "The care and support given is first class. Needs are met respectfully. Time keeping amazing. Carers are chatty and positive." "I have great faith in carers. I look forward to the carer coming in the morning, very attentive and takes time with me." "If I didn't have the care I wouldn't be able to stay at home." "Very happy with the care I get and have no complaints about the service." "I would like to thank everyone involved, I think it is an excellent service that is provided." "Continuity not good but getting better." "Staff that come to me treat me very well and with respect and dignity. Very thankful for their help and support." " All staff are nice and helpful ". " I don't think some of the times we are given is enough for some clients who need quite a lot to be done in a small space of time ". " I am very pleased with the service. I have a nice staff group". " I find my carers very supportive and cheery, especially at week ends". " I have very good staff and they treat me well ". " I am happy with my workers ". Inspection report An Inspector Volunteer is a member of the public who volunteers to work alongside Inspectors during the Inspection process. Inspector Volunteer have a page 12 of 32

13 unique experience of either being a service user themselves or being a carer for someone who has used services. The Inspector Volunteer role is to speak with people using the service being inspected and gathering their views. In addition, where the Inspector Volunteer makes their own observations from their perspective as a recipient or a carer, these may also be recorded. During the inspection the Inspector Volunteer spoke to four service users individually by telephone. Service users made the following comments to the Inspector Volunteer:- Inspection report " Staff don't have a great deal of time but they manage to do what I need. It was a different girl this morning but I knew her from before. Staff speak to me and treat me with respect ". " No complaints at all. Sometimes its strangers but not very often. They do what I ask and they are quite good I've no complaints. I kid on with the staff and they know me. No problems". " Nothing but praise for them. No issue with time. I get a supervisor in to do a review and ask questions. The odd time I get a different carer but hey introduce themselves at the door. No complaints about the staff ". Taking carers' views into account We issued two hundred and fifty care standards questionnaires (CSQs) to the manager to give to service users to complete and we got ninety four completed questionnaires back. Twenty six were from relatives. All the completed CSQs either agreed or strongly agreed that overall they were happy with the quality of care and support. page 13 of 32

14 One relative indicated that they did not know about the service's complaint procedure they didn't know they could also make a complaint to the Care Inspectorate. One relative indicated that the service did not ask their opinion on how it can improve We received the following comments in the completed and returned CSQs:- "My relative has wonderful carers and is so pleased with all them of them they treat my relative well and my relative enjoys their chats. All the girl's are amazing." "Generally speaking most reliable and regular but whenever a delay is inevitable a call from the office informing of delay is most appreciated because the forewarning affords an opportunity to reschedule. This good communication is a key element in the quality of service which is given. Carers knowledge and recommendation of equipment available is also highly valued. Keep up the good work." "During service checks it would be advantage to make appointments in advance and let relative/carer know also. This would give a chance for them to be available at time to check ensure information that is passed on is correct and to add any thought to the process. Staff who provide care done with the utmost professionalism and care that is expected. Overall, the carers who provide the home support services have been marvellous and a credit to themselves." "Satisfied with the service. I have a very good continuity in my care visitors. Admin, managerial and support staff are also very good". " I feel I can approach Senior with anything at any time and she listens to me with regards to my relative ". " Ensure staff have all relevant training required to support my relative. Big variation from one support worker to another. More continuity of all staff having the same knowledge. Ask all support staff to have high standards of respect shown to clients and their families". page 14 of 32

15 " Carers are frequently changed for no apparent reason. All the ladies are very nice and helpful but I feel fewer changes would be beneficial." During the inspection the Inspector Volunteer spoke to three carers individually by telephone. Carers made the following comments to the Inspector Volunteer:- " Staff are very good with my relative ". " Usually the same carer. Staff know what to do its brilliant. Every so of come back and see everything is alright. Staff laugh a lot and it cheers my relative up. Staff treat my relative with dignity and respect ". " They are not rushed but tight timescales to do work. Very respectful, totally respectful.could not fault the staff. Staff are very good, communication is very good ". page 15 of 32

16 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 3 We ensure that service users' health and wellbeing needs are met. Service Strengths From the evidence we were presented with, we concluded that the service was performing at a very good level in areas covered by this statement. The service generally met the health and welfare needs of service users. We found the service was delivering good quality care resulting in good outcomes for people using the service. People using the service had good support plans that identified a range of care needs: - We found that care plans reflected individual needs. - We saw detailed and informative risk assessments which informed staff on the tasks to be carried out. - We found that some of the information in the care plan was written in a person-centred way. We found that the service had good links with healthcare professionals, regularly liaised with GP and district nurse, and often referred people to health page 16 of 32

17 professionals such as the Community Psychiatric Nurse or Occupational Therapist. Where it was identified as part of the support plan, staff supported people to attend hospital, GP and chiropodist appointments. Appropriate risk assessments were in place and there was an appropriate system in place for reporting accidents and incidents. We found that care plans were being reviewed at least once in every six months to comply with legal requirements. We were pleased to see that the service was in the process of developing a new person centred outcome focussed care plan and was using SHANARRI. SHANARRI is a set of eight indicators to assess a child or young person's overall wellbeing and identify any concerns. The provider had adapted these indicators for use with adults. SHANARRI stands for: - Safe - Healthy - Achieving - Nurtured - Active - Respected - Responsible - Included We look forward to seeing how this develops going forward and how it improves outcomes for service users. Inspection report We signposted the service to the Joint Improvement Team publication 'Talking Points Personal Outcomes Approach Practical Guide' for information and guidance. The majority of people who completed our questionnaires were aware of their personal plans, the information contained in them. Overall, people strongly agreed or agreed that their needs and preferences were detailed in their plans and that the service checked with them regularly that they were meeting their page 17 of 32

18 needs. The majority of people agreed or strongly agreed that they were happy with the quality of care and support from the service. Service user communication needs were assessed by staff at initial referral to the service and where necessary at care review meetings. The provider used a range of communication methods and systems to communicate with service users. Information for service users could be provided in alternative formats to aid communication. For example the newsletter could be provided in an audio format. For people where English was not their first language an interpreter service could be accessed. Staff communication was also an area of importance as many staff worked in the community alone or in dispersed teams. Good communication with staff was aided by the use of smart technology. An example of this was the electronic monitoring and scheduling system. This system allowed information about service users' needs, changes or special instructions to be sent to staff quickly via the mobile phone system. The phone system also monitored the timing of visits and the staff who attended. Communication between staff and service users included the use of support plans and communication diaries kept in service users homes. This meant that staff visiting the service user could access the most up date information about any support needs the individual required. Family members and other carers could also use the communication diary as a means of passing information to staff when they were not present in the service user's home. The service used an electronic document management system which had improved access to written client information and other correspondence. This meant that important information was held centrally and could be accessed by staff, (with appropriate permissions), more speedily than the previous system used. Overall the feedback from the majority of people who use the service and their relatives was very positive with the majority indicating that they were satisfied with the service they received. page 18 of 32

19 Areas for improvement The provider should continue to monitor the very good quality of care. The provider should ensure it is rigorous in identifying any areas for improvement and implementing action plans to address these. We discussed notifications which had been submitted to the Care Inspectorate and we requested that the manager submit two updated notifications to the Care Inspectorate for issues reported on 04 September 2015 and 09 September 2015 respectively. Two recommendations had been made as a result of a complaint made on 15 December 2015 and finalised on 4 March We received an action plan from the provider on 18 March 2016 detailing the action they were going to take to address the two recommendations. We are satisfied that the provider is making progress to address these recommendations. However, we will continue to monitor progress at the next inspection. (See Recommendations 1 and 2). We signposted the service to the 'The Improvement Hub' website ( ) the new improvement resource for health and social care with a suite of programmes and a dedicated team all in place to support health and social care services to improve for information and guidance. Grade 5 - Very Good Number of requirements - 0 Recommendations Number of recommendations - 2 Inspection report 1. People who use the service should be given choice and adequate advanced notice about meetings to discuss aspects of care and support. National Care Standards: Care at Home, Standard 3: Your Personal Plan. And Standard 4: Management and Staffing. And Standard 11: Expressing your Views. And taking account of National Care Standards: Housing Support Services, page 19 of 32

20 Standard 6: Choice and Communication. 2. The manager needs to ensure that essential personal care is provided in a way which maintains the dignity of people who use the service. National Care Standards: Care at Home, Standards 3: Your Personal Plan. And Standard 4: Management and Staffing. And Standard 9.6: Private Life. And taking account of National Care Standards: Housing Support Services, Standard 6: Choice and Communication. Statement 6 People who use, or would like to use the service, and those who are ceasing the service, are fully informed as to what the service provides. Service Strengths The service used a range of ways to ensure that service users were fully informed. We found that the service issued service users with a 'Welcome Pack' and a 'Service User Agreement' which covered the majority of information as set out in the National Care Standards. This welcome pack included information on the services complaints procedure. We thought the information in the welcome pack was detailed and comprehensive and gave service users all the information they needed to make an informed decision. We also found that the service had comprehensive detailed and informative 'Service User Agreement' (SUA) which was issued to service users and this was signed and dated. The information we saw detailed service users rights and responsibilities. We found that each service user had a named key worker in place who was responsible for the needs of individual service users. page 20 of 32

21 We found that service user had access to independent advocacy. Inspection report Service users had a written agreement when they started using the service. They and their representatives were actively involved in putting this together along with their personal plan of care. Having a written agreement lets people know what their rights are and what to expect from the service. Excellent introductory information about the service was available and this was supplemented by a welcome pack given to all users of the service. This meant that people who used the service could access key information in their own time about a range of issues. Examples included information on any service charges, how to use the community alarm system, out of hours contacts, respite services and reablement services. Inverclyde Council had updated its website recently and this had a very useful section dedicated to information about health and social care services and this registered service in particular, (see This meant that existing and prospective users and carers could easily access information about the services that might be available to them. Areas for improvement The provider should continue to monitor the very good quality of information. The provider should ensure it is rigorous in identifying any areas for improvement and implementing action plans to address these. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 page 21 of 32

22 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good Statement 2 We are confident that our staff have been recruited, and inducted, in a safe and robust manner to protect service users and staff. Service Strengths At this inspection, we found that the performance of the service was very good for this statement. We concluded this after we spoke with staff and examined a range of relevant documentation. We looked at a sample of recruitment and training records for staff that were employed in the service. This included staff who had recently been recruited by the provider. The provider had a clear and comprehensive procedure for recruitment which followed good practice. This was carried out centrally by the provider. The process included seeking appropriate references, carrying out criminal records checks and checking that staff, who were required to, were registered with appropriate professional bodies. The provider also issued staff with a comprehensive handbook which detailed the provider's key policies and procedures. This was a helpful reference resource for staff that clearly indicated the rights and responsibilities of new and existing employees. Recruitment Policy We found that Inverclyde Council had robust systems in place to ensure safe recruitment practices were followed through the implementation of Inverclyde Recruitment and Selection Policy and Procedures. Application Procedure We found a fully completed application form the files we sampled. page 22 of 32

23 Understanding the Service Aims We found good evidence that Inverclyde provides staff with appropriate information on Care and Support at Home aims and objectives. References We found that two references were in place one of which was from the previous employer. Physical and Mental Fitness A confidential health questionnaire and declaration was in place in the files we sampled. Necessary Skills The quality and detail of the interview records that we sampled varied with some hand written notes and some consisted of a checklist. We suggest that the process of how interviews are recorded should be reviewed to ensure consistency and quality. Protection of Vulnerable (PVG) Groups Checks It was good to see PVG and Disclosure checks were in place. However, we were presented with photocopies of disclosures. The provider needs to ensure that it complies with PVG procedure for the storage and confidentiality of these documents. Register Check Recording We found that appropriate register checks were taking place. e.g SSSC, NMC. Assessment Overall, we found the Inverclyde recruitment practices to be performing at a very good level. Areas for improvement The provider should continue to monitor and maintain the very good quality of recruitment. The provider should ensure it is rigorous in identifying any areas for improvement and implementing action plans to address these. page 23 of 32

24 Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service Strengths The provider continues to perform at a very good level in this quality statement. We asked the manager to give out one hundred questionnaires to staff and we got sixteen completed questionnaires back. From the twenty eight Care Inspectorate staff questionnaires (CSQs) returned all of the staff said they have sufficient training to do their job. The majority of completed CSQs indicated that staff knew about the services policies and procedures in health and safety, confidentiality, accidents and incidents, complaints, equal opportunities, whistle-blowing, restraint, harassment and bullying, racial equality and participation. A number indicated that they did not know about the services whistle-blowing and restraint policy. All completed staff CSQs indicated that their training needs were being met and they had opportunities to gain an appropriate qualification. Staff indicated that they had a copy of the Scottish Social Services Council (SSSC) Codes of conduct. The majority also indicated that they had the opportunity to meet up, had regular supervision and the service asks them for their opinion on how it can improve although some staff disagreed. Staff made the following comments in the completed and returned CSQs:- page 24 of 32

25 "Not enough time to do tasks, no travel time between jobs, too many back to jobs. This how errors happen." "Sometimes the distance between jobs are too far by walking." "If I have any concerns about my job or clients my senior is always at hand to help." "I find the training very helpful and interesting, I enjoy team meetings." "I find the training very helpful in my daily routine and the meetings are helpful for discussing things for carers. " "Training needed palliative care." "The team I work with are always there to talk to or help out in my job. Senior and manager are always there when I have any questions or need advice regarding my service users or job. This helps me to give service users 100% job satisfaction." "More training needed in palliative care." Staff had access to various training in modules through e-learning. Examples of the available training included effective writing and report writing. We found that staff were issued with a detailed and comprehensive induction pack which included very good information and detail of the service policies and procedures and good practice guidance of do's and don'ts. We suggested that the pack could be further improved by including the Care Inspectorate guides on, infection control, continence management and falls prevention. One member of staff has been trained in the communication tool 'talking mats'. We found that an 'Assessment and Support Planning' training event was planned for June 2016 for senior staff. Inspection report Many staff supported people with cognitive or memory impairments, the most page 25 of 32

26 common of these being people with a diagnosis of dementia. It was good to see the service has made a good start in providing appropriate dementia training for staff in line with Scottish Government's "Promoting Excellence" framework. We would like to see this being fully rolled out to all staff as quickly as possible. Inspection report "The NES/SSSC Promoting Excellence framework details the knowledge and skills all health and social services staff should aspire to achieve in relation to the role they play in supporting people with a diagnosis of dementia, and their families, and carers." (see /2 accessed 27 July 2015.). We signposted the service to the The Knowledge Network, Scottish Social Services Council and NHS Education for Scotland for 'Promoting Excellence'- the education framework for all social services staff working with people with dementia for information and guidance ( dementia). We were advised that the service was currently reviewing the system of supervision an appraisal and were using the publication "staff supervision in social care" by Tony Morrison as a guide. We look forward to seeing how the review of the system of supervision and appraisal is reflective and supports staff to maintain their registration with the Scottish Social Services Council (SSSC). We signposted the service to the Scottish Social Services Council (SSSC) publication, 'The Framework for Continuous Learning in Social Services' for information and guidance. We signposted the service to 'Reflective Writing Guidance notes for students' April for information and guidance. We signposted the service to the Scottish Social Services Council (SSSC) website for 'Step into leadership' Leadership learning pathways for Scotland's social page 26 of 32

27 services for information and guidance. We signposted the service to the Institute for Research and Innovation in Social Services (IRISS) publication 2015 'achieving effective supervision' for information and guidance. Areas for improvement The provider should continue to monitor and maintain the very good quality of staffing. The provider should ensure it is rigorous in identifying any areas for improvement and implementing action plans to address these. Staff did not always have an up to date training record or a training plan. The information we saw in supervisions and appraisals would not support staff to maintain their registration with Scottish Social Services Council (SSSC). It would be helpful if the service had a training matrix to show all the training staff have attended, a training plan going forward with information on which staff will attend future training. This should be clearly linked to staffs personal development plan. We found that the service had a Learn on Line e-learning resource which was available to all direct care staff, however, it was not clear what the services expectations were in terms of how staff should use this resource. We signposted the service to the British Association Occupational Therapy (BAOT) publication, 'Living well in care homes' for information and guidance. We signposted the service to Social Services Knowledge Scotland for information and guidance. We signposted the service to the Care Inspectorate publication 'Care... about physical activity Promoting physical activity in care homes in Scotland - a good practice resource pack' for information and guidance. We signposted the service to the Care Inspectorate web site 'The Hub' which provides a 'one-stop-shop' for knowledge, innovation and improvement page 27 of 32

28 ( We signposted the service to the 'NHS Lanarkshire The Newcastle Model Psychological Interventions in response to Stress and Distress in Dementia' for information and guidance. We suggest that it is important that the provider informs staff that it is an element of the Scottish Social Services Council (SSSC ) Codes of Practice 6:- "As a social service worker, you must be accountable for the quality of your work and take responsibility for maintaining and improving your knowledge and skills", that staff take equal responsibility for their own learning and development. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 page 28 of 32

29 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 There has been one complaint about the service since the last inspection. You can find information about the complaints that we have investigated on our website page 29 of 32

30 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 29 May 2015 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing 5 - Very Good Management and Leadership 5 - Very Good 30 May 2014 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing 5 - Very Good Management and Leadership 5 - Very Good 31 Oct 2012 Announced (Short Notice) Care and support Environment Staffing Management and Leadership 5 - Very Good Not Assessed 5 - Very Good 5 - Very Good 4 Oct 2011 Announced (Short Notice) Care and support Environment Staffing Management and Leadership 5 - Very Good Not Assessed 5 - Very Good Not Assessed 24 Aug 2010 Announced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed page 30 of 32

31 Management and Leadership 4 - Good 21 Aug 2009 Announced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership 4 - Good 5 Sep 2008 Announced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership 4 - Good page 31 of 32

32 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 32 of 32

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