Crossroads Caring Scotland

Transcription

1 Crossroads Caring Scotland - Glasgow/ Blantyre/East Dunbarton Housing Support Service Blantyre Health Centre Victoria Street Blantyre G72 0BS Telephone: Type of inspection: Announced (short notice) Inspection completed on: 29 July 2016 Service provided by: Crossroads Caring Scotland Service provider number: SP Care service number: CS

2 About the service Crossroads Caring Scotland - Glasgow/Blantyre/East Dunbarton was registered by the Care Inspectorate in The service was formerly part of another registration - Crossroads Caring Scotland - South West, which was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April Crossroads Caring Scotland, the provider of the service, is a national voluntary organisation, a Scottish charity and a company limited by guarantee. The service provides a care at home and a housing support service to people living in their own homes in Glasgow, Blantyre and East Dunbartonshire. The registered manager and two service coordinators manage the services in the three areas. Support provided to service users and carers ranges from respite support to enable carers a break from their caring role, to regular support with managing daily living tasks, social support, and support to access further education. Some service users had up to 24 hour support to help them maintain their tenancy and live independently in their local community. All local services have the same mission and aims: "to relieve the stress on persons or families caring for the elderly or people with physical, mental, or sensory impairment who are living at home" and "to care in appropriate circumstances for the elderly, or people with physical, mental or sensory impairment who are living alone". What people told us We met and spoke with eleven people who used the service. They told us they were happy with the staff who provided their support. They all told us they had a support plan which reflected their needs, their likes and dislikes. They were happy to share their support plans with us and this confirmed people were being supported to work towards goals they had identified. These included support with accessing activities of interest to them in their local community, accessing further education courses and support to promote their independence with day-to-day tasks. People told us they generally had the same staff supporting them at agreed times each week. Not all people we spoke to said they received a rota, however, all said they were satisfied they knew who was supporting them and when. Their comments included: "Always know who is supporting me" "Staff member X, is good at matching right staff to me" "I am comfortable with usual consistent staff member, almost always get them apart from annual leave". People spoke highly of the staff who supported them and confirmed that they knew who to speak to if they were unhappy with any aspect of their service. Comments from people who use the service included: "Never had a problem with the service" "Excellent, love staff member X" "Very happy with the service at the moment no problem at all" "Enjoy the companionship and being able to get help with practical tasks" "Very good service". page 2 of 19

3 Twelve people gave us their views through completing Care Standard Questionnaires (CSQs). The majority of respondents 'agreed' or 'strongly agreed' with the statement "Overall I am happy with the quality of care and support this service gives me". One person 'disagreed' with this statement and one person indicated they were not aware of the service's complaints procedure. We discussed this with the manager and relevant people during the inspection. We spoke with five relatives of people who use the service. They told us about being involved in helping their relatives make decisions about the support they received. They told us they would attend review meetings to talk about the care and any changes that needed to be made. Some relatives told us they had noticed an improvement in the service. They described how previously some support visits had been missed due to reduced staff cover. They told us new staff were now being introduced to learn about their relatives needs and provide back up when regular carers were off. Relatives comments about the service included: "Never had to raise any concerns, quite confident concerns would be addressed" "Quite sure I would be listened to now" "Feel if I raised a concern X would sort out" "Communication with the office is much better, usually get straight through to coordinator on telephone and is always in touch with any changes" "See a difference in X, more staff being introduced so that care can be provided to cover short-term absences" "Staff are all very committed to X, very happy with support provided". Self assessment The self assessment had not been completed prior to the inspection taking place. This was due to the registered manager being absent from the service and manager overseeing the service misunderstanding the need for this to be completed promptly. The self assessment was completed during the inspection visits. We discussed with the regional director and coordinators that we expect that people who use the service, relatives, staff and other important people should be given the opportunity to contribute to the self assessment if they want to. This will help ensure a broad range of views are contributing to the overall appraisal of the service. From this inspection we graded this service as: Quality of care and support Quality of staffing Quality of management and leadership 3 - Adequate 3 - Adequate 3 - Adequate page 3 of 19

4 Quality of care and support Findings from the inspection We were pleased to see that staff had been working well alongside people who use the service and their relatives to ensure all people who use the service had support plans in place and that these reflected their needs and preferences. One relative told us of the positive difference this had made to their relative. They expressed how they had greater confidence in staff who they felt had clearer guidance and had undergone further training to support changes around their relatives needs. People who used the service told us there was a strong sense of continuity of staff providing support to them. We could see this helped in promoting a person centred focus. We found that the level of detail contained in support plans varied. We discussed with the regional director and coordinators the need for more detailed information about people's health needs and how this impacts on the person. We also discussed the need for a greater focus regarding the personal outcomes the individual wants to achieve. This will help ensure there is clearer guidance for staff regarding each individuals needs and the support required to help them achieve their goals (see Recommendation 1). We discussed with the regional director and coordinators the need to further develop the system of auditing support plans. This will help in ensuring that when a persons needs change, that information in the plan and in risk assessments are updated. This will help to make sure staff have up-to-date information regarding the individuals needs (see Recommendation 2). We saw evidence of staff working in partnership with health and social care professionals to support positive outcomes for individuals. The coordinators were liaising with the local college where staff supported service users to attend various courses. Further work was planned with all those involved to ensure person centred support plans were fully developed with each individual supported. This will help in providing detailed guidance on how staff should support each person. We looked at samples of medication administration records and we could see the service had worked in partnership with prescribers, families and staff to promote the safe administration of medication. We discussed with the manager and coordinators the need to embed the practice of assessing and monitoring staff competency with supporting people to manage their medications. We also discussed the need to further promote staff confidence and understanding of the providers medication policy and best practice guidance. We provided detail of resources which provide professional guidance for people working in social care who are involved in handling medicines (see Recommendation 3). On looking at samples of support plans we found that some progress had been made in updating contact details for the service. Not all support plans we looked at reflected current staffing arrangements. We thought this could lead to people who use the service being unsure of whom to contact with changes and concerns and could impede effective communication. We made a recommendation around this at the last inspection which we have repeated below (see Recommendation 4). page 4 of 19

5 We found feedback from people who use the service and their relatives to be generally positive about the direct care and support they received and the communication they had with the service. The service told us in their self assessment of their commitment to service user and carer participation. They told us how they plan, with thirdparty organisation assistance, to identify new approaches to engagement with service users and with staff. This will help ensure the views of people who use the service and their representatives contribute to developing and improving the service. Requirements Number of requirements: 0 Recommendations Number of recommendations: 4 1. The service should continue to work together with service users, their relatives and those involved in their support to ensure support plans are person centred and contain up-to-date, clear information detailing their health, wellbeing and support needs and the outcomes they wish to achieve. The following National Care Standards have been taken into account in making this recommendation: Care at Home, Standard 3.1 & 3.5: Your Personal Plan. Care at Home, Standard 4.1: Management and Staffing Arrangements. Housing Support Services, Standard 4.1, 4.2 & 4.4: Housing Support Planning. Housing Support Services, Standard 3.1: Management and Staffing Arrangements. 2. The provider should continue to develop their audit system to ensure the information in support plans is monitored and any changes effectively updated. The following National Care Standards have been taken into account in making this recommendation: Care at Home, Standard 3.1 & 3.5: Your Personal Plan. Care at Home, Standard 4.1: Management and Staffing Arrangements. Housing Support Services, Standard 4.1, 4.2 & 4.4: Housing Support Planning. Housing Support Services, Standard 3.1: Management and Staffing Arrangements. 3. The provider should continue to embed systems of monitoring staff competency and promoting staff understanding of their roles in supporting people with managing their medication. The following National Care Standards have been taken into account in making this recommendation: National Care Standards Care at Home. Standard 8: Keeping Well - Medication. Standard 4: Management and Staffing. National Care Standards Housing Support Services. Standard 3: Management and Staffing Arrangements. page 5 of 19

6 4. The provider should ensure that the information provided to service users and relatives is always kept up-to-date, for example, detailing current contact details of the registered manager, coordinator and office address. National Care Standards Care at Home. Standard 1: Informing and Deciding. Grade: 3 - adequate Quality of staffing Findings from the inspection We could see that the service had implemented their induction programme for new staff. We looked at completed induction work books and heard from new staff about their experience of induction. They told us this included completing mandatory training, learning about the needs of the individuals who use the service, shadow shifts with experienced staff, and progressing through the induction work book. We also saw evidence of regular group and individual supervision meetings with their coordinator. We thought this provided a good opportunity to promote staff understanding of their role and responsibilities, to promote best practice and to explore values underpinning practice. We heard how the service continue to work with all staff to encourage completion of practice work books. We could see this offered the opportunity for all staff to consider their understanding of various areas of practice, health and safety, and values in action. We thought this was good practice and encouraged staff to reflect on their practice with their manager and consider areas for development and learning. We found staff had undertaken a range of training related to their roles. Most recently in adult support and protection, first aid training, epilepsy, moving and handling and medication training. We saw evidence of coordinators having worked with staff to establish their training needs and arranging for mandatory training and refreshers to be completed. We discussed with the regional director and coordinators the need to continue to prioritise work with all staff to develop individual training plans and to ensure their training needs continue to be met (see Recommendation 1). This will help encourage continuous learning and ensure staff maintain the skills and knowledge necessary to confidently meet the needs of the people who use the service. On observing staff practice we found staff presented as knowledgeable in undertaking their support role and demonstrated an understanding of the needs of the people they were working with. Some staff we spoke to identified a need to increase their knowledge in working with people with dementia, and in promoting effective communication. We discussed this with the regional director and coordinators and highlighted resources available to help support learning in these areas. They confirmed they will support staff to access further training in these areas. page 6 of 19

7 We could see coordinators were prioritising undertaking more regular staff supervision and had plans to undertake regular observations of staff practice to support the professional development of staff. We found some staff we spoke to had a limited understanding of what supervision entailed and how this would benefit their professional development and enhance the support they provided. We discussed this with the regional director and coordinators who told us they planned to fully embed the supervision and appraisal processes to ensure all staff benefitted from regular support and supervision. We have repeated the previous recommendation made at the last inspection to support improvement in this area (see Recommendation 2). The service had an adult support and protection policy and procedures in place. We were pleased to see the provider had responded positively to a requirement made at the last inspection relating to staff knowledge and understanding of adult support and protection procedures. Staff we spoke to were aware of their responsibilities in reporting any concerns regarding risks to service users safety and wellbeing. We saw evidence of recent training sessions having taken place during team meetings with all staff and staff we spoke to told us they had recently been reissued the providers adult support and protection policy which had helped refresh their understanding of their roles and responsibilities. We could see from team meeting minutes that discussions had taken place around various possible scenarios which helped staff reflect on different situations which may constitute harm or risk of harm to adults. We discussed with the regional director and coordinators their plans to continue to raise awareness with staff in this area, with adult support and protection being a regular agenda item for discussion at team meetings. Overall we found staff presented as knowledgeable in undertaking their support role and demonstrated an understanding of the needs of the people they were supporting. We found staff we spoke to were motivated to develop their skills and understanding in order to enhance the support they provided to service users. Requirements Number of requirements: 0 Recommendations Number of recommendations: 2 1. The provider should continue to develop training and development plans for each employee which reflects their learning needs and how these will be met. This will help ensure staff develop and maintain the skills and knowledge needed to meet the health, welfare and safety needs of the people they support. The following National Care Standards have been taken into account in making this recommendation: Housing Support Standard 3: Management and Staffing Arrangements Care at Home Standard 4: Management and Staffing Arrangements. page 7 of 19

8 2. The service should adhere to its own policy, as well as best practice guidance and ensure that staff receive regular supervision and an annual appraisal. The following National Care Standards have been taken into account in making this recommendation: Care at Home. Standard 4: Management and Staffing Arrangements. Housing Support Standard 3: Management and Staffing Arrangements. Scottish Social Services Council - Codes of Practice for Social Service Workers and Employers. Grade: 3 - adequate Quality of management and leadership Findings from the inspection The service had experienced staffing and management changes recently, such as provider restructure of services and the service manager post becoming vacant. Interim management arrangements were in place for the service until recruitment has been completed to the service manager position. The service needs to ensure they keep service users, carers, staff and stakeholders fully appraised of changes and service developments. We discussed with the regional director and coordinators the need to further develop involvement and participation from service users, relatives, staff and stakeholders in developing the service. This will help to confirm to them their opinions are listened to and valued and can contribute to service improvement. During this inspection we saw evidence of a range of quality assurance measures undertaken by the service coordinators in partnership with people who use the service, their representatives and staff. These included: - Review meetings - Observations of staff practice - Medication audits - Records of incidents and accidents - Records of complaints and compliments - Review of staff training - Review of staff supervision and appraisal. page 8 of 19

9 In addition the provider's quality assurance system, Crossroads Quality Assurance System (CROQAS) will be undertaking another service audit which will involve the service submitting a self assessment. An inspection visit will be made to the service by the providers policy and quality staff. Quality standards will be assessed in the following areas: - Governance. - Strategy, planning and user focus. - Leadership and management. - Managing people and learning. - Finance. - Partnership and promotion. - Results. We discussed with the service the need for there to be clear evidence that actions highlighted from the CROQAS audit as areas for improvement are implemented and their progress monitored. This will help ensure improvements highlighted through this process are made and sustained. The service had returned an action plan to the Care Inspectorate which set out how they planned to meet requirements and recommendations made at the last inspection within timescales set. We could see evidence of coordinator staff and the regional director working well in taking forward these improvements across all quality themes, as discussed throughout this inspection report. We discussed with the regional director and the coordinators the need to maintain and further develop and improve the service quality across all themes. This will help ensure people using the service experience a good quality of care at home and housing support which will help them to meet their goals and outcomes. We discussed the need to build on the progress made and to develop an improvement plan for the service with clear management oversight of the plan, timescales and responsibilities for taking forward actions. This will help to clearly demonstrate and monitor the progress made toward improvement across the service as a whole. We have reframed and repeated elements of the requirement made at the previous inspection to support further improvement in this area (see Requirement 1). Requirements Number of requirements: 1 1. Supported people will experience a good quality care at home/housing support service that will help them meet their goals and outcomes in their everyday life. The provider must develop and maintain a system by which the manager of the service has comprehensive oversight of all aspects of the care provided. In order to achieve this, the provider must: a) Develop an improvement plan which demonstrates how they will address, monitor and maintain progress toward improvements across the service as a whole b) Ensure overall management oversight of the improvement plan with clear timescales of when progress is to be achieved stating clearly responsibilities for actions page 9 of 19

10 c) Ensure that the Care Inspectorate receives regular updates with regards progress toward identified goals d) Provide clear evidence of outcomes of quality assurance audits and views of service user/representatives and stakeholders contributing to continuous service improvement. This is to comply with: Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/ 210) Regulation 3 - Requirements to make proper provision for the promotion of quality and safety and respects the independence of service users, and affords them choice in the way in which the service is provided to them. Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/ 210) Regulation 4(1)(a) - Requirements to make proper provision for the health and welfare of service users. The following National Care Standards have been taken into account in making this requirement: Care at Home Standard 4: Management and Staffing Arrangements. Housing Support Standard 3: Management and Staffing Arrangements. Timescale for achieving this requirement: within six weeks of receipt of this report. Recommendations Number of recommendations: 0 Grade: 3 - adequate What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 All supported people will have a personal plan which they are involved in developing and which reflects their hopes, needs and choices. In order to achieve this, the provider must ensure that: a) Each service user has a personal plan that details how their health, welfare and safety needs are to be met. b) The information held in the personal plan in relation to risk assessments, and risk management plans are current and accurate. c) Ensure that the needs of the supported person are fully assessed, involving that person, and where appropriate any relative or appropriate professionals. page 10 of 19

11 d) Written agreements and personal plans are developed in consultation with each service user. e) Service users' personal plans are reviewed in line with all regulatory expectation, National Care Standards, best practice guidance and the provider's own procedures. f) Must ensure that appropriate actions within the personal plan are developed to meet these needs. g) Must ensure the actions are completed within agreed timescales and reviewed with all those appropriately involved. h) An effective audit system is developed to monitor the information kept in the personal plan and use this to improve how plans are updated and developed. This is in order to comply with The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011, No 210: 4(1)(a) - Requirements to make proper provision for the health and welfare of service users. The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011, No 210: 5(2)(a)(b) - Requirements to make proper provision for the review of personal plans for service users. The following National Care Standards have been taken into account in making this requirement: Care at Home. Standard 3.1 & 3.5: Your Personal Plan. Care at Home. Standard 4.1: Management and Staffing Arrangements Housing Support Services, Standard 4.1, 4.2 & 4.4: Housing Support Planning Housing Support Services, Standard 3.1: Management and Staffing Arrangements. This requirement was made on 21 March Action taken on previous requirement We found the service had worked well alongside service users and their relatives to ensure they had a personal plan which contained information on how their health, welfare and safety needs were to be met. We saw evidence which demonstrated service users and their relatives were involved in developing their personal plans. We found that personal plans contained risk assessments and these were being reviewed along with personal plans within regulatory timescales. Met - within timescales Requirement 2 The service provider must ensure that the service has enough staff employed to meet the agreed needs of the service users as set out in their personal plan. This is to comply with: SSI 2011/210 Regulation 15(a)4 Staffing and the National Care Standards Care at Home. Standard 4: Management and Staffing. This requirement was made on 21 March page 11 of 19

12 Action taken on previous requirement We found the provider had successfully recruited new staff to the service and further recruitment was ongoing to fill recent vacancies. The service were introducing new staff to people who use the service, to help ensure staff who know the individual are available to provide support in the event of short notice absences. Met - within timescales Requirement 3 The provider must ensure that where the service includes help with taking medication, that arrangements are in place to ensure service users are properly and safely supported with their medicines by staff. In order to achieve this, the provider must make sure: a) that where medication is required to be administered by staff that this is administered according to the prescribers instruction(s) b) an accurate record is maintained of all medication administered by staff c) that staff who administer medication are assessed as competent to do so d) that all staff are conversant with and clearly understand their roles and responsibilities in putting into practice the provider's medication policy e) that systems are in place to audit and monitor staff practice f) that staff have a clear understanding of the level of support required, by service users and their role in supporting them with their medicines. This is in order to comply with SSI 210: Regulations 4(1)(a); 5 and 9(2)(b) - Regulation regarding the welfare of service users, care plans and fitness of staff. National Care Standards, Care at Home, Standard 8: Keeping Well - Medication and Standard 4: Management and Staffing. National Care Standards, Housing Support Services, Standard 3: Management and Staffing Arrangements. This requirement was made on 21 March page 12 of 19

13 Action taken on previous requirement We found that the provider had taken steps to ensure that where people required help with taking their medication there were systems in place to ensure they were safely and properly supported by staff. We saw evidence of the service having worked in partnership with prescribers and relatives to ensure there was an accurate record of the medication to be prescribed and instructions for administering. We saw evidence of accurate records kept of medication administered by staff. The service had developed a system of checking recordings of medication administered and we could see from staff training records that staff had undertaken medication training. We saw some records of team meetings, and staff supervision records where discussions were held with staff regarding their understanding of their role in supporting people with managing their medication. We also saw some records of observations of staff practice including staff supporting with medication administration. Met - within timescales Requirement 4 Supported people can be confident that the service will know how to put local policies in to practice, that will protect individuals and keep them free from harm. In order to achieve this provider must: - Ensure the staff induction programme is implemented and that staff know how to protect individuals and keep them free from harm. - Staff have access to refresher training so that staff know how to report abuse. - Ensure that all staff are familiar with and know how to implement all aspects of the organisations adult protection procedure. - Ensure that all staff working in the service are familiar with all aspects of the interagency policy and procedures for support and protection of adults at risk. - Ensure that the Care Inspectorate are notified immediately of all allegations of abuse (as defined in adult support and protection legislation). This is in order to comply with: The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011, No 210: 4(1)(a) - Requirements to make proper provision for the health and welfare of service users. The following National Care Standards have been taken into account in making this requirement: Housing Support Services. Standard 3: Management and Staffing Arrangements, Care at Home. Standard 4: Management and Staffing Arrangements. This requirement was made on 21 March page 13 of 19

14 Action taken on previous requirement We found that the staff induction programme was being implemented and staff we spoke to were aware of their responsibilities in protecting individuals and keeping them free from harm. The service had ensured all staff had undertaken adult support and protection training and were familiar with the providers policy and interagency policy and procedures for support and protection of adults at risk. Staff were aware of their responsibilities in notifying the Care Inspectorate of all allegations of abuse. The service had plans to continue to raise staff awareness and understanding of adult support and protection issues. Met - within timescales Requirement 5 Each person using the service will experience quality care and support. From staff that are suitably qualified and competent and in such numbers that are needed to ensure their health welfare and safety. In order to achieve this the provider must: - Ensure that all staff have the appropriate training that will allow them to meet the needs of service users. - Ensure it embeds the programme of induction and support for all staff to ensure they feel confident and have the skills they require to undertake their roles and responsibilities. - Ensure that a training and development plan is in place, for all employees that allow them to competently meet the health welfare and safety needs of service users. This is in order to comply with: SSI 2011/210 regulation 15(a) - a regulation about staffing. The following National Care Standards have been taken into account in making this requirement: Housing Support Standard 3: Management and Staffing Arrangements, Care at Home Standard 4: Management and Staffing Arrangements. This requirement was made on 21 March Action taken on previous requirement We found staff had undertaken a range of training related to their roles. Most recently in adult support and protection, first aid training, epilepsy, moving and handling, and medication training. We saw evidence of coordinators having worked with staff to establish their training needs and arranging for mandatory training and refreshers to be completed. We have made a recommendation to help support continued improvement in this area. Met - within timescales page 14 of 19

15 Requirement 6 Supported people will experience a good quality care at home/housing support service that will help them meet their goals and outcomes in their everyday life. The provider must develop a system by which the manager of the service has comprehensive oversight of all aspects of the care provided. In order to achieve this, the provider must: a) Ensure that there is a manager in place who has the skills, knowledge and experience to manage the service. b) Develop an improvement plan which demonstrates how they will address, monitor and maintain progress toward improvements across the service as a whole. c) Provide clear evidence of outcomes of quality assurance audits and views of service user/representatives and stakeholders contributing to continuous service improvement. d) Must ensure overall management oversight of the improvement plan with clear timescales of when progress is to be achieved stating clearly responsibilities for actions. e) Ensure that the Care Inspectorate receives regular updates with regards progress toward identified goals. This is to comply with: Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) Regulation 3 - Requirements to make proper provision for the promotion of quality and safety and respects the independence of service users, and affords them choice in the way in which the service is provided to them. Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) Regulation 4(1)(a) - Requirements to make proper provision for the health and welfare of service users. Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) Regulation 7(2)(c) - Requirements A person has the skills, knowledge and experience necessary for managing the service. The following National Care Standards have been taken into account in making this requirement: Care at Home, Standard 4: Management and Staffing Arrangements, Housing Support Standard 3: Management and Staffing Arrangements. This requirement was made on 21 March Action taken on previous requirement The service had made significant progress in addressing the various elements of this requirement. An interim manager had been appointed to address the service manager vacancy. The service had developed an action plan to address the various areas for improvements, requirements and recommendations highlighted across all quality themes. Work was planned to develop an overall improvement plan for the service and to undertake further quality assurance audits. We consider there is still work being progressed to fully meet all aspects of this requirement. Therefore we have reframed and repeated aspects of this requirement. Not met page 15 of 19

16 What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 The provider should ensure that the information provided to service users and relatives is always kept up-to-date, for example, detailing current contact details of the registered manager, coordinator and office address. National Care Standards Care at Home. Standard 1: Informing and Deciding. This recommendation was made on 21 March Action taken on previous recommendation We could see that some progress had been in updating this information, however, not all support plans we looked at had been updated to reflect current contact details for the service. We have repeated this recommendation. Recommendation 2 The provider should further develop effective ways for service users and carers to participate in developing and improving the service. National Care Standards, Care at Home, Standard 11: Expressing Your Views. This recommendation was made on 21 March Action taken on previous recommendation The provider is continuing to look at effective ways to engage with people who use the service and their representatives to promote their participation in developing and improving the service. Recommendation 3 The service should adhere to its own policy, as well as best practice guidance and ensure that staff receive regular supervision and an annual appraisal. National Care Standards, Care at Home, Standard 4: Management and Staffing Arrangements. Housing Support Standard 3: Management and Staffing Arrangements. Scottish Social Services Council - Codes of Practice for Social Service Workers and Employers. This recommendation was made on 21 March page 16 of 19

17 Action taken on previous recommendation We could see that coordinators had made progress in prioritising undertaking more regular staff supervision. Plans were in place to fully embed the staff supervision and appraisal processes to ensure all staff benefitted form regular support and supervision. We have repeated this recommendation. Complaints Please see Care Inspectorate website ( for details of complaints about the service which have been upheld. Enforcement No enforcement action has been taken against this care service since the last inspection. Inspection and grading history Date Type Gradings 21 Mar 2016 Unannounced Care and support 2 - Weak Environment Not assessed Staffing 3 - Adequate Management and leadership 2 - Weak 3 Feb 2015 Re-grade Care and support 3 - Adequate Environment Not assessed Staffing Not assessed Management and leadership Not assessed 11 Aug 2014 Unannounced Care and support 2 - Weak Environment Not assessed Staffing 3 - Adequate Management and leadership 3 - Adequate 9 Aug 2013 Announced (short notice) Care and support 3 - Adequate Environment Not assessed Staffing 3 - Adequate Management and leadership 4 - Good page 17 of 19

18 Date Type Gradings 7 Nov 2012 Unannounced Care and support 3 - Adequate Environment Not assessed Staffing 4 - Good Management and leadership 4 - Good 25 Oct 2010 Announced Care and support 4 - Good Environment Not assessed Staffing Not assessed Management and leadership 5 - Very good 2 Dec 2009 Announced Care and support 5 - Very good Environment Not assessed Staffing 5 - Very good Management and leadership Not assessed page 18 of 19

19 To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can 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. You can also read more about our work online at Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com Find us on Facebook Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 19 of 19