Care service inspection report

Transcription

1 Care service inspection report Full inspection Kirkconnel Activity & Resource Centre Support Service Main Street Kirkconnel Sanquhar Inspection completed on 06 May 2016

2 Service provided by: Dumfries & Galloway 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 33

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 4 Good Quality of environment Quality of staffing N/A N/A Quality of management and leadership 4 Good What the service does well Kirkconnel Activity and Resource Centre provide a good level of support to people within the service. Members are supported to take part in a range of activities available within Kirkconnel Activity and Resource Centre premises or within the local community. Members told the inspector that they enjoy attending Kirkconnel Activity and Resource Centre and that the staff team are supportive. What the service could do better The provider and acting service manager are required to review and update members Service Agreements. We found that some of the support plans required more detail and to be more outcomes focused. Risk assessments required to be based on member individual needs. The acting service manager should ensure support plans and risk assessments are completed to a consistent standard. The information should be up to date and review meetings should take place at least once every six months. page 3 of 33

4 There are some remaining areas for improvement and recommendations which have been carried forward from the previous inspection. The acting service manager should prioritise their completion. We have reported on these further in this report. What the service has done since the last inspection Since the last inspection the previous manager had retired, a new acting service manager had been appointed. We formed the opinion that with support from the Team Manager for Learning Disability Services they would develop the service and address the areas for improvement. The service had continued to work well with members, families and other professionals. Conclusion We have concluded from the findings of our inspection that Kirkconnel Activity and Resource Centre is highly thought of by the members and families who use the service. It continues to deliver a very good quality of care and support to all of the members by a consistent and caring staff team. page 4 of 33

5 1 About the service we inspected Inspection report 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 01 April Kirkconnel Activity and Resource Centre (ARC) provide a Support Service to adults with a learning disability. The service is located at the north end of the town of Kirkconnel and is located in the old school building. The ARC provides services for people with a learning disability who may also have a physical disability. Members attending the service are picked up by the ARC bus or are brought to the service by parents or carers. The ARC currently provides a wide range of social, educational, leisure and employment training opportunities and is open Monday to Friday. Referral to the service is done via Social Services Department and, following a full assessment of need, consideration is given to the appropriateness of admission to the centre, or a member can use their self-directed support to attend the ARC. An individual activity programme is devised for each member attending and is in consultation with the person attending, staff, manager, family and other workers involved with the member's care and support. The overall aim of the service is to support and enable people with a learning disability to become as independent as they can and to access local community resources. Each member is allocated a key worker and they provide a link between the member, their parents/carers and any other agencies involved in providing that person's support. 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. page 5 of 33

6 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 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 4 - Good Quality of environment - N/A Quality of staffing - N/A Quality of management and leadership - Grade 4 - Good 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 33

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 Care Inspectorate Inspector. The inspection took place on Tuesday 03 May 2016 between 10.30am and 4pm and Wednesday 04 May 2016 between 10.30am and 4.30pm. We gave feedback to the team manager for learning disability services, the acting service manager and acting deputy manager on 06 May As part of the inspection, we took account of the completed annual return and self-assessment forms that we asked the provider to complete and submit to us. We sent twenty care standards questionnaires to the manager to distribute to service users. Eleven service users and/or carers sent us completed questionnaires. We also asked the manager to give out ten questionnaires to staff and we received six completed questionnaires. What we did during the inspection: From the 01 April 2016 the way in which we carry out an inspection has changed. We choose which quality themes and statements are inspected for better performing services, to be more proportionate and targeted in our work. In highly performing services, inspections will consider Quality Theme 1: Quality of Care and support. Quality Theme 1, Statement 3 "We ensure that service user's health and well-being needs are met" will be considered during all inspections. We will also look at one other quality theme. This service is eligible for this type of inspection and based on our knowledge and intelligence of the service we looked at Quality Theme 1, Statement 5 "We page 7 of 33

8 respond to service users' care and support needs using person centred support". We also considered Quality Theme 4, Statement 3 "To encourage good quality care, we promote leadership values throughout our workforce" and Statement 4 "We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service provided". We chose these based on our knowledge that the management of the service had changed and to follow-up on recommendations made at the last inspection. During this inspection process, we gathered evidence from various sources, including the following: We spoke with: - Team manager for learning disability services - Acting service manager - Acting deputy manager - Three relatives - Support staff - People who use the service. Inspection report We looked at: - The service's policies and procedures relevant to the quality statements examined at this inspection. - Registration and insurance certificates. - Individual support plans of people who use the service. - The service's evaluation forms that had been completed by service users and relatives. - Information provided to residents through letters and notice boards. - Activity planner. - Minutes of centre meetings, - Medication system and records. - Complaints system and records. - Accident and incident system and records. - Staff files and training records. - Minutes of staff meetings. - Repairs log and maintenance records. page 8 of 33

9 - DVD of members participating in self assessment process. - Quality assurance systems, reports and audits. The service used the term 'member' rather than service user to refer to the people who were supported by Kirkconnel Activity and Resource Centre (ARC). We will use this throughout the report. We observed a dining experience at Kirkconnel ARC. This enabled us to see how staff interacted and supported members to have an enjoyable lunch experience, and receive the appropriate level of support required. We also observed staff supporting members to participate in their chosen activities throughout the inspection and observed a large number of members enjoying these activities. Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may page 9 of 33

10 consider what action to take. You can find out more about care services' responsibilities for fire safety at Inspection report page 10 of 33

11 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 for each heading that we grade services under. Taking the views of people using the care service into account During the inspection people who use the service told us: - 'ARC does a good job and good things, proud of the staff'. - 'I like the staff and the members, I like cooking and baking'. - 'Good help and support'. - 'I attend six monthly meetings, I choose then what I want to do'. - 'Enjoy activities at ARC'. - 'I can speak to my keyworker, I am happy with my keyworker'. - 'Building is safe and warm'. - 'I would tell staff if anything was needing done'. page 11 of 33

12 - 'The staff are important people because they help a lot and help the people in the building'. - 'Enjoyed doing interviews and happy with the person chosen, got a free drink for doing well'. Taking carers' views into account Carers we spoke with and who returned questionnaires told us: - 'Very good support received'. - 'Never had any reason to complain'. - '(name) loves going to the ARC and has very good relationship with the staff'. - 'ARC at Kirkconnel provides an excellent service, (name) really enjoys going to meet all the other members and the staff all care for her so very well'. - 'The service provided by the ARC staff and management at the ARC is exemplary. It is a very safe and stimulating environment and staff are always anxious to engage with carers. - 'I feel the service is well run and my sisters needs are fully met, my sister benefits greatly from attending the ARC'. - 'All the staff are friendly, helpful and approachable'. - 'My son really enjoys going to the ARC, he looks forward to going every day. When he comes home he tells me what he's been up to. The staff are really friendly and have brought (name) out of himself and he will talk, mix and be relaxed around others, this he wouldn't do before due to his disabilities. - 'Exceptional service, I know (name) is well cared for but also has a lot of fun. All the activities are well thought out and professionally executed'. page 12 of 33

13 - '(name) is happy spending the day with her friends, an important part of her life that she doesn't get anywhere else because of her complex needs. I cannot fault the staff or the facility'. - 'I am very happy with my brothers support he gets at Kirkconnel'. page 13 of 33

14 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: 4 - Good Statement 3 We ensure that service users' health and wellbeing needs are met. 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 members, families and staff, observed practice and examined a range of relevant documentation. As part of the local authority (Dumfries and Galloway) social services provision the service operates under the council's policies. We looked at a sample of policies, procedures and operational guidance including: - Managing medication - Infection control - Health and safety Kirkconnel ARC adhered to Dumfries and Galloway Councils Adult Support and Protection Policy, this included Adult Support and Protection Guidance for staff. Staff were further supported in this area by attending training. In discussion with staff they said they were aware of their responsibilities in relation to adult protection. Each member had a support plan in place which recorded health and wellbeing needs and how these were to be met. Within the general health section we found this contained good information about members health care needs, page 14 of 33

15 including the management of nutrition and epilepsy. Risk assessments were in place to help ensure members could be as independently as possible and remain safe. Within each support plan records indicated that each member had a GP. Any other health and social care professionals who were involved were recorded in the support plans. From looking at support plans we could see that staff had liaised well with other members of the multidisciplinary team such as district nurses, General practitioners and physiotherapist, discussing any concerns and following best practice advice and guidance given. During the inspection we were told about physiotherapy involvement and observed staff encouraging a member to use her mobility aid to encourage her independence. We found that where required each member that needed to have an Adult with Incapacity Section 47 certificate had been completed and was in date. Daily diaries provided information about members day, ensuring families were aware of different aspects of day-to-day activities. Diaries were also used by families to communicate necessary information, including health and wellbeing concerns to staff members or make comment to the service. Kirkconnel ARC had a long-established staff team who had been supporting some of the members for a considerable period of time and knew them well. We spoke with staff and were confident that they were aware of the health needs of the people that they supported. Areas for improvement As mention, staff had previously attended Adult Support and Protection training. We suggested to the acting service manager that staff complete an update on this to ensure staff had a good understanding of the local Adult Support and Protection Policy and guidelines, including the referral process. We looked at the medication policy and procedure; we saw evidence of the medication policy being followed. Medication was stored securely as per policy. We discussed with the acting service manager where improvements could be made. This included members documentation on medication to be administered and accessible storage of this information. page 15 of 33

16 Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 page 16 of 33

17 Statement 5 We respond to service users' care and support needs using person centered values. Service Strengths At this inspection, we found that the performance of the service was good for this statement. We concluded this after we spoke with members, families and staff, observed practice and examined a range of relevant documentation. All members had support plans that were to be reviewed every six months or earlier if required. We reviewed a sample of support plans and saw that members, families and relevant others, if appropriate, were involved in the development of their assessment of need, personal support plan and guidelines in relation to specific health care needs. A keyworker was responsible for individual members support plans and arranged reviews. During the inspections some members were able to tell us who their keyworker was and their role; they told us they would go to them if they had a problem. The service was available over five days per week and members attendance varied over the week. Activities were planned to meet individuals interests, likes and dislikes. We saw that these could be on a one to one basis but most were within small groups. We looked at activities on offer which could be within Kirkconnel ARC premises, within the local community or further, for example within Ayr or Dumfries. Members were supported to swimming sessions or to attend the local gym and were encouraged to be as active as possible to support maintaining good health. Kirkconnel ARC had a long-established staff team who had been supporting some of the members for a considerable period of time and knew them well. The staff had developed effective ways to communicate with members who had additional communication needs. We observed staff interacting with members in a manner which members were at ease communicating with staff. Members told us that the 'members committee' still meet and an advocate attends these meetings to help support members. The Advocate is from page 17 of 33

18 Dumfries and Galloway Advocacy Service. An Advocate also attends on other occasions to be available should members wish to speak to them in private. We saw that staff promoted independence and choice. We were told about members being involved in the recruitment of staff. This ensured people had a voice and say in the quality of staff who supported them. During the inspection we spoke with members who had been involved in the interviews. They told us they enjoyed the experience and involvement. Most members with support from their relatives maintained responsibilities for their own personal monies. They were able to pay for items when out with staff as part of their support or purchase refreshments at the shop within the Kirkconnel ARC building. Members were encouraged to participate in the completion of the services self assessment and to be involved in the inspection process. We watched a DVD that had been produced by the members for the purpose of the inspection. This was facilitated by staff and members commented and gave their views on statements from the Care Inspectorate self assessment. This was a very positive activity which allowed members to voice their opinion within an environment where they felt comfortable and safe. The provision of good support meant that members were supported to have a full and active time at the day service. We felt confident that members were supported to engage within their community. This allowed them to maintain contact with friends and also to meet new people, developing their self-esteem and confidence. From observation and speaking with staff we thought there was a good staff team and staff clearly enjoyed their work and doing the best they could for those being supported. This resulted in positive health and wellbeing outcomes for members. Areas for improvement From the support plans that we looked at we found no evidence of up to date Service User Agreements in place (see Recommendation 1). We found reference to some generic risk assessments within some of the support plans. The generic risk assessments were stored within a separate page 18 of 33

19 shared file. We discussed with the acting service manager the need for all people supported to have individual risk assessments specific to their needs which would form part of their support plan (see Recommendation 2). The sample of support plans we looked at contained a large amount of information and also out of date information. This made it difficult to find some of the current information. We discussed this with the acting service manager and suggested that a system be put in place to archive the information that is no longer relevant. We were told about new support plans being introduced; we suggested that staff should attend training on person centred support planning in preparation for this. New support plans required to be more outcomes focused; they should be monitored and evaluated to ensure members outcomes are being met. Grade 4 - Good Number of requirements - 0 Recommendations Number of recommendations - 2 Inspection report 1. The acting service manager should ensure that members receive a written service agreement which clearly defines how the service will meet their needs. The acting service manager should ensure these are discussed and are routinely reviewed with members to ensure they are fully involved in this process. National Care Standards - Support Services - Standard 3 - Your legal rights. 2. The acting service manager should ensure that all members have individual risk assessment, members and if appropriate their families should be involved in developing and reviewing these. Risk assessments should be reviewed and updated as often as required and at least once in each six month period alongside reviews of individual support plans. National Care Standards - Support Services - Standard 4 - Support page 19 of 33

20 Arrangements. page 20 of 33

21 Quality Theme 2: Quality of Environment Quality theme not assessed page 21 of 33

22 Quality Theme 3: Quality of Staffing Quality theme not assessed page 22 of 33

23 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 4 - Good Statement 3 To encourage good quality care, we promote leadership values throughout the workforce. Service Strengths At this inspection, we found that the performance of the service was good for this statement. We concluded this after we spoke with members, families and staff, observed practice and examined a range of relevant documentation. The service had clear aims in place which were discussed with members, families and staff. Each staff member had clear roles and responsibilities and told us they received appropriate training to carry these out. The staff team were supported to complete a Scottish Vocational Qualification relevant to their position within the organisation. The previous manager had recently retired. We discussed with the Team Manager for Learning Disability Services the newly appointed senior staff and ensuring they held the appropriate management qualifications to meet and maintain registration with the Scottish Social Services Council (SSSC). Opportunities were available for staff to take on more responsibilities. Two senior staff members were currently in 'acting up' positions following the retirement of the previous manager. Senior staff members took on the role of keyworker for members. During the inspection we spoke with staff members who held more than one role within the organisation. The transport escort and office administrator had undertaken training to also work as support workers. Staff told us that they felt the team was supportive and staff shared their knowledge and experience. Staff were supported to develop within their work through team meetings, page 23 of 33

24 supervision and training. Staff we spoke with said they were happy to ask for further support and felt they could speak with the acting service manager. Staff could discuss areas of concern in confidence when required. Areas for improvement We saw that the service held staff meetings, all staff were encouraged to contribute to the agenda. Minutes of the meeting were produced which staff had access to. This ensured that staff who were not present at the meeting were still kept up to date. When we looked at the minutes from the staff meetings we could see that it was the same staff members who attended all the meetings. We suggested that meetings took place on alternative days/ times to ensure that all staff had the opportunity to attend and meet up as a team in order to discuss collective concerns, issues or practice. Planned supervision was in place for the staff team as were Performance Development Reviews (PDR); we looked at a sample of staff supervision and PDR notes and found some of the information recorded to be minimal. We suggested the acting service manager review the supervision agreements and effectiveness of thirty minute supervision sessions. We discussed supervision and PDR sessions being meaningful, staff having the opportunity to discuss work practice and issues or concerns. Staff supervision should also be used to evaluate training attended and what had been learned and also to review and evaluate staff competencies. A recommendation was made at the last inspection about how National Care Standards (NCS) could be referenced in the supervision notes and staff meeting minutes. We could see that this had commenced within some supervision notes but not on staff meeting minutes. We have repeated this recommendation (see Recommendation 1). During the inspection we found the service to have copies of good practice guidance and training material such as Keys to Life, Supporting Derek and Charter of Involvement. Some staff members we spoke with were not familiar with these documents. We suggested that these are put on the agenda for future team meetings. page 24 of 33

25 Grade 4 - Good Number of requirements - 0 Recommendations Number of recommendations The provider should record relevant NCS to topics raised and discussed at staff meetings and staff supervisions. National Care Standards - Support Services - Standard 2 - Management & Staffing Arrangements. page 25 of 33

26 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 At this inspection, we found that the performance of the service was good for this statement. We concluded this after we spoke with members, families and staff, observed practice and examined a range of relevant documentation. Members and families told us they were happy with the amount of information they were given and were happy with the amount of involvement they had with the service. The manager had previously sent out members, families and stakeholders questionnaires annually and then collated this information to assess satisfaction. Members, families and staff were encouraged to be involved in the inspection process through discussions and completion of the Care Standard Questionnaires. Feedback was also encouraged at members reviews to be used as part of the Care Inspectorate inspection process. The service had a complaints procedure which encouraged anyone who was feeling unsatisfied about any parts of the service being provided to express their concern. Most people we spoke with told us they knew how to make a complaint. Other members told us they would ask a staff member to help them do this. Areas for improvement During the inspection we looked at the accident and incident procedure and noted how these were completed. Management collated all accident and incident information, looking for patterns or indications of potential danger. From the information available we found that the Care Inspectorate had a low notification history since the last inspection prior to the acting service manager being in post. We discussed with the acting service manager the Care page 26 of 33

27 Inspectorate guidance on Notifications (see Recommendation 1). Although the service provider had quality assurance audits in place, it was unclear if audits were being carried out routinely and consistently completed. This made it difficult to ascertain if particular issues were being identified such as: - Quality of support plans, risk assessments and members review - Reporting of information to the Care Inspectorate - Evaluation of staff training - Staff supervision - Feedback received from members and families (see Recommendation 2). A recommendation was made at the last inspection to bring together all the different aspects of quality assurance and develop a report on how the service is performing in relation to its Aims, Purpose and Function. This recommendation has been repeated (see Recommendation 3). Grade 4 - Good Number of requirements - 0 Recommendations Number of recommendations - 3 Inspection report 1. The provider must notify the Care Inspectorate of all incidents and accident which causes or has the potential to cause harm to a members. National Care Standards - Support Services - Standard 2 - Management & Staffing Arrangements. 2. The acting service manager should ensure good quality assurance systems and processes are in place, reviewing and auditing all aspects of service delivery. Where areas are identified as needing improvement appropriate action plans should be put in place and progress towards meeting the actions required should be recorded. page 27 of 33

28 National Care Standards - Support Services - Standard 2 - Management & Staffing Arrangements. 3. The provider should introduce a quality assurance system which will provide a quality assurance report of how the service is running and how it can be further developed. National Care Standards - Support Services - Standard 2: Management & Staffing Arrangements. page 28 of 33

29 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 1. Quality Statement 2.2 We make sure that the environment is safe and service users are protected. The provider of the ARC services should develop further Health & Safety Guidance in relation to Infection Control issues that staff work with on a daily basis. National Care Standards - Support Services - Standard 2 - Management & Staffing Arrangements. This recommendation was made on 14 May 2013 The service had an Infection Control Policy in place and annual Infection Control training is completed by the staff team. The recommendation is met. 2. Quality Statement 3.1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. The provider should consider how to develop & introduce how members can provide feedback regarding individual staff practice to the management team. page 29 of 33

30 How this is used within the supervision & appraisal process. National Care Standards - Support Services - Standard 2 - Management & Staffing Arrangements. This recommendation was made on 14 May 2013 The 'members committee' with support from an advocate carried out a piece of work in relation to staff practice. This was delivered to the staff members individually. 'Members committee' meetings attended by an advocate continue to be an opportunity to discuss staff practice on an ongoing basis. During the inspection we saw evidence of feedback on individual staff as part of members review process. The recommendation is met. 3. Quality Statement 3.3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. The provider should record relevant NCS to topics raised and discussed at staff meetings and staff supervisions. National Care Standards - Support Services - Standard 2 - Management & Staffing Arrangements. This recommendation was made on 14 May 2013 We saw evidence on some previous supervision notes that this had been introduced. This practice had not continued, this had not been completed on recent supervision notes or at staff meetings. This recommendation has been repeated under Quality Statement Quality Statement 4.4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide. The provider should ensure that staff are aware of what notifications are required to be notified to the care inspectorate. Where required ensure notifications happen accordingly. National Care Standards - Support Services - Standard 2 - Management & Staffing Arrangements. page 30 of 33

31 This recommendation was made on 14 May 2013 There was a new acting service manager and acting deputy manager in post since the last inspection, we discussed the Notification Guidance during the inspection. This recommendation has been repeated within Quality Statement Quality Statement 4.4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide. The provider should introduce a quality assurance system which will provide a quality assurance report of how the service is running and how it can be further developed. National Care Standards - Support Services - Standard 2: Management & Staffing Arrangements. This recommendation was made on 14 May 2013 Inspection report The provider had developed a Quality Policy to be used within Kirkconnel ARC; further areas for development were discussed at the inspection. This recommendation has been repeated within Quality Statement Complaints No complaints have been upheld, or partially upheld, since the last inspection. 7 Enforcements We have taken no enforcement action against this care service since the last inspection. 8 Additional Information There is no additional information. page 31 of 33

32 9 Inspection and grading history Inspection report Date Type Gradings 14 May 2013 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 4 - Good 19 May 2010 Announced Care and support 5 - Very Good Environment 4 - Good Staffing Not Assessed Management and Leadership Not Assessed 15 May 2009 Announced Care and support 4 - Good Environment 3 - Adequate Staffing 5 - Very Good Management and Leadership 4 - Good 8 May 2008 Announced Care and support 4 - Good Environment 3 - Adequate Staffing 4 - Good Management and Leadership 3 - Adequate page 32 of 33

33 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 33 of 33