Crail / Wilson Houses Small Group Living Services Care Home Service Adults Hansel Alliance, Hansel Village Broad Meadows Symington Kilmarnock KA1 5PU

Transcription

1 Crail / Wilson Houses Small Group Living Services Care Home Service Adults Hansel Alliance, Hansel Village Broad Meadows Symington Kilmarnock KA1 5PU Telephone: Inspected by: Sean McGeechan Type of inspection: Unannounced Inspection completed on: 4 February 2013

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 10 4 Other information 23 5 Summary of grades 24 6 Inspection and grading history 24 Service provided by: Hansel Alliance Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Sean McGeechan Telephone enquiries@careinspectorate.com Crail / Wilson Houses Small Group Living Services, page 2 of 26

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 Environment 4 Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well The standard of care provided in Crail and Wilson Houses is very good and delivered by a motivated, caring and compassionate staff team. During our inspection we observed staff engaging in a supportive and caring manner. Crail House provides a safe, supportive and caring environment for people with profound learning disabilities and/or dementia. Wilson House provides an environment that helps people to develop and grow. By providing a service that helps them to be involved in decisions about their lives. Both houses provide a very warm friendly and welcoming atmosphere and this is reflected in the comments made by the service users and carers. They were all very satisfied with the very good quality of care and support being delivered. What the service could do better The management has recognised the need to address and improve the residential service by continuing to implement best practice guidelines to ensure that people are involved in the development of the service. Crail / Wilson Houses Small Group Living Services, page 3 of 26

4 What the service has done since the last inspection Inspection report continued The service has continued to maintain and provide a very good standard of care and support. They have recognised areas for development and have implemented strategies to address any areas that require attention. Conclusion Crail/Wilson services have continued to maintain and provide a very good standard of care and support to people with varying degrees of learning disability. The service has recognised the areas that require development and continue to investigate ways that these can be improved. Who did this inspection Sean McGeechan Crail / Wilson Houses Small Group Living Services, page 4 of 26

5 1 About the service we inspected "The Care Inspectorate regulates care services in Scotland. This service was registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April Information in relation to all care services is available on our website at The Care Inspectorate will award grades for services based on findings of inspections. Grades for this service may change after this inspection if we have to take enforcement action to make the service improve, or if we uphold or partially uphold a complaint that we investigate. Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve its service, we may make a recommendation or requirement. - A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service but where failure to do so will not directly result in enforcement. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reform (Scotland) Act 2010 and Regulations and Orders made under the Act, or a condition of registration. Where there are breaches of Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Inspectorate." Crail / Wilson Small group living services was registered with the Care Inspectorate on 1 April 2011, to provide a care service to a maximum of 27 adults/older people with learning disabilities and / or dementia. 15 places in Wilson House and 12 places in Crail House. Wilson House is set over two levels and divided into two different distinct areas within the building. Each section or house provides single accommodation with communal lounge, dining and kitchen facilities. The Hansel Alliance Management Plan "Working Together to Build a Successful Future" describes the services as follows: Wilson House: Provides a specialist individualised and flexible group living supports for adults experiencing complex health related issues or who are becoming older. Incorporating a specific care services and meaningful choices for day to day activities which focus on maximising each person's potential to enjoy a full active life. Crail / Wilson Houses Small Group Living Services, page 5 of 26

6 Crail House: Provides specialist individualised flexible group living care and support specifically to older people with learning disabilities. Part of this service has been uniquely designed to create an environment which can meet the dementia related support needs, palliative care and end of life needs of older people with learning disabilities. 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 Environment - Grade 4 - Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. Crail / Wilson Houses Small Group Living Services, page 6 of 26

7 2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care. What we did during the inspection We wrote this report after an unannounced inspection carried out by care inspector, Sean McGeechan on Thursday, 31 January 2013 from 10:00 to 16:00 hours and Monday, 4 February 2013 from 14:30 to 18:00 hours. We gave feedback to the manager on Monday, 4 February As requested by us, the provider sent us an annual return. The provider also sent us a self assessment form. We received 16 questionnaires that had been completed by relatives on behalf of service users who were unable to do so due to their learning disabilities. Some carers commented on this fact and stated they had tried as best they could to ensure the service users feelings, emotions and responses were as accurate as possible in their replies. In this inspection we gathered evidence from various sources, including the relevant sections of policies, procedures, records and other documents, including: Certificate of Registration Staffing Schedule Insurance details Participation Strategy Service user meetings Service user care and support plans Records of service user and carer involvement Care files including review meeting minutes Staff communication records Complaints procedure Information about advocacy Staff training and supervision records Staff meeting records Staff rotas Accident /incident records Risk assessments Crail / Wilson Houses Small Group Living Services, page 7 of 26

8 Medication records Maintenance records Quality assurance system and records including audits, monthly manager's reports Daily checklists and handover sheets Returned Care inspectorate questionnaires The Hansel Alliance Management Plan "Working Together to Build a Successful Future." We spoke to the following people during our inspection: Five Service users Two Carers / relatives Nine support staff various roles One manager One visiting professional Inspection report continued We also observed how staff interacted with service users and looked around both Crail and Wilson Houses. 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 consider what action to take. You can find out more about care services' responsibilities for fire safety at Crail / Wilson Houses Small Group Living Services, page 8 of 26

9 The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The Care Inspectorate received a fully completed self assessment document from the service manager. The service had identified what they thought they did well, and some areas for development. Taking the views of people using the care service into account Taking carers' views into account "Care plan information has been given to me and I am very satisfied with the content and I have been kept advised of his progress. On each of my visits I have found him to be very settled and in a happy frame of mind. I have found all the staff to be very caring and friendly." "Crail staff offer (name withheld) the highest quality of care with no concerns from family members." "There are regular staff resident meetings also case reviews with (name withheld) staff, family and social work." "Staff are available to speak to 24 hrs a day and family members visit on a regular basis." "The staff are very attentive and create a relaxed atmosphere where (name withheld) has a quality of life that is conducive to his condition." Crail / Wilson Houses Small Group Living Services, page 9 of 26

10 3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths The grade achieved for this quality statement at the last inspection in December 2010 was 5 - Very Good. On the basis of the information and evidence we reviewed during this unannounced inspection visit we have decided to maintain this grade of 5 - Very Good. We decided this after we spoke to service users, carers, support staff, manager and reviewed the relevant documentation regarding how the service ensured that people where actively involved in assessing and improving the quality of care and support provided. We looked at how the service involved the service users and their relatives in assessing the quality of care and support. We found that considerable efforts had been made to involve people at different levels. The service had a well written Participation Strategy, referred to as the Charter for Involvement, which gave good information and explanations about getting residents involved in the decision making process. Service users were involved in the development of the Hansel services "Having a Say" document. This gave people a sense of being listened to and respected; this meant they were able to influence the decisions made regarding the developments of the service and how it supports them. The service was very good at welcoming new service users and helped them settle into their new home. Feedback indicated service users and carers confirmed that their Crail / Wilson Houses Small Group Living Services, page 10 of 26

11 views were listened to and addressed appropriately and promptly. This gave carers reassurances about the quality of the care and support being provided. We reviewed the minutes of several service users meetings that had taken place. There was very good systems in place to address any issues that were raised. We observed some very good interactions between service users and staff. There was clear respect and dignity shown to service user by staff, who presented as being dedicated and they clearly knew the residents well. This helped to create a positive and friendly atmosphere which helped people feel welcome and appreciated. The service had a complaints procedure in place. The staff and manager worked closely with service users and families and try to resolve any concerns or issues at the earliest stages. The service operated a policy of openness and encouraged people to speak to staff and the manager if they have any issues or concerns. Areas for improvement The service should continue to monitor and maintain the very good standards they have achieved. The service should continue to investigate and develop ways to encourage tenants to participate in the developments within the service and record and document this evidence to support this input. In the returned Care Inspectorate questionnaires 5 people stated they did not know how to make a complaint. The service should review this information and ensure that all service users and carers/relatives are aware of and able to access the appropriate complaints procedures. In the service user meetings minutes are produced to assist those with difficulty reading the use of pictures, symbols and photographs may help them to understand the content better. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued The grade achieved for this quality statement at the last inspection in December 2010 was 5 - Very Good. On the basis of the information and evidence we reviewed during this unannounced inspection visit we have decided to maintain this grade of 5 - Very Crail / Wilson Houses Small Group Living Services, page 11 of 26

12 Good. We decided this after we spoke to service users, carers, support staff, manager and reviewed the relevant documentation regarding how the service ensured that service user's health and well being needs are met. The care files we inspected showed very good interactions with other professionals, in ensuring that the physical and mental health needs of service users were appropriately addressed. We saw evidence that the service had implemented advice from health professionals by responding to the changing behavioural issues or physical health needs of service users. The service was able to react positively to these changing demands and continually focused on the best outcome for service users. There was good evidence that care plans were reviewed and updated on a regular basis and that any changes were documented. This ensured that all care and support was up to date and accurate in addressing and meeting people's needs. Medical records were kept in separate files so that in the event of hospital admission or attendance at appointments this information could readily be taken with the service users. This meant that important relevant information and consistent care was being delivered at all times. Feedback from service users and relatives indicated a very high level of satisfaction with the way the service involved them in their care and support. There was a real sense of appreciation and value given to people's opinions and this was reflected in how the manager and staff responded. Within Crail House, in particular, we saw evidence of some high level nursing care issues being addressed. This was achieved with the cooperation and involvement of other medical professionals. We spoke to one visiting professional who commented very favourably of the quality of care and support provided. This multidisciplinary approach and cooperation ensured that service users with high level nursing care requirements were being cared for and supported to a very high standard. There was good evidence in care plans reviews and communications that staff worked well with other professionals. The service ensured that staff had been given training in palliative care needs and this is supported by the manager who is part of the Link Nurse Initiative with the local hospice. This ensures the service continues to update their practice to improve the overall standard of care they provide. This ensures that service users receive the best possible support during their end of life care. Crail / Wilson Houses Small Group Living Services, page 12 of 26

13 We observed staff treating residents with dignity and respect, every effort was made to ensure that they were happy and comfortable. Service users we were able to communicate with during our visit commented favourably about the staff. This helped foster a sense of partnership and cooperation for the benefit of the service users. This further helped generate an atmosphere of well being about both services. Medication administration systems were inspected and found to be of a very good standard. Each person had their own individual locked cabinet in their bedrooms for their own personal medicines. These were administered by staff who completed the relevant documentation satisfactorily. Areas for improvement The service should continue to monitor and maintain the very good standards the have achieved in this quality statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Crail / Wilson Houses Small Group Living Services, page 13 of 26

14 Quality Theme 2: Quality of Environment Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the environment within the service. Service strengths The grade achieved for this quality statement at the last inspection in June 2010 was 5 - Very Good. On the basis of the information and evidence we reviewed during this unannounced inspection visit we have decided to maintain this grade of 5 - Very Good. Please refer to quality statement 1.1 for further information to support the grade we have awarded for this quality statement. We decided this after we spoke to service users, carers, support staff, manager and reviewed the relevant documentation regarding how the service ensured that service user's participate in assessing and improving the quality of the environment. We saw evidence of service users being involved with the choice of décor and bedroom furnishings. They were able to decorate and furnish their bedrooms to varying degrees of their choice, and people we spoke to expressed satisfaction and pride in their own individualised personal space. These provided an opportunity for residents to have their say about the home environment, meals, laundry, activities and care staff, and many other aspect of the service provided. There was evidence that this feedback from residents was also used to plan for trips, outings and other events. Areas for improvement The service should continue to document and evidence the work they are undertaking with regards to ensuring that residents and relatives participate in the developments and changes within the home environment. To assist people who cannot read from menu board, the service could implement the use of pictures or photographs of food and prepared meals for menu display. This gives people a visual representation of what is on offer and what to expect for breakfast, dinner and tea. Crail / Wilson Houses Small Group Living Services, page 14 of 26

15 The service should produce individual Personal Emergency Evacuation Procedure forms for each service user. This should clearly highlight the level of support the person requires in the event of fire or evacuation, mobility, safety and moving and handling requirement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 2 We make sure that the environment is safe and service users are protected. Service strengths The grade we have awarded for this quality statement is 4 - Good. We decided this after we spoke to service users, carers, support staff, manager and reviewed the relevant documentation regarding how the service ensured that service user's environment is safe, secure and comfortable. Staff and visitors used signing in books to ensure proper procedures for fire safety. Staffing schedules, certificate of registration, insurance certificates and fire evacuation documents were all checked, up to date and clearly displayed. The staff team had considerable knowledge of the residents and their individual support needs as well as their associated risks. There was good risk assessment documentation within the care plans which highlighted any concerns and how best these issues were to be addressed within the home environment. Moving and Handling equipment such as profile beds, hoists, baths and other items were clean, well maintained and regularly serviced as required and up to date. Crash mats and pressure alarms were in place to deal with falls from beds and people who get up during the night and are at risk of falling. This showed good evidence of proactive management to address potential risks. Accident and incident documentation was viewed and noted to be completed with good details and descriptions. Medication cabinets in service users own rooms helps to protect and secure medicines but also allows for more personal interactions when administering medicines in the privacy of your own bedroom. The service had introduced waking night staff in place of sleepovers due to increased needs of service users with dementia and high care needs. This ensured people were Crail / Wilson Houses Small Group Living Services, page 15 of 26

16 adequately supported and the service was proactive in responding to meeting the needs of the service users. Areas for improvement The service should undertake a review of all portable equipment testing procedures to ensure that all items are properly tested. The Health and Safety Executive advises that all portable electrical equipment should be subject to "regular testing" which it then states is generally interpreted as an "annual test". Heath and Safety Executive - Maintaining Portable and Transportable Electrical Equipment - HSG 107, See Recommendation 1 of Quality Statement 2.2. The service needs to ensure that there is a risk assessment undertaken for legionella by a certified contractor. This was discussed at the feedback session and the service have agreed to attend to this. They had produced Thereafter the service needs to ensure that any requirements from that risk assessment are carried by appropriately qualified contractors, as per best practice guidelines. Please refer to Requirement 1, Quality Statement 2.2. Grade awarded for this statement: 4 - Good Number of requirements: 1 Number of recommendations: 1 Requirements 1. Requirement 1. The Provider must ensure that maintenance checks are undertaken in accordance with health and safety procedures. This is in order to comply with: SSI 2011/210 Regulation 4(1)(a) - a requirement to make proper provision for the health, welfare and safety of service users. National Care Standards Care Homes for People with Learning Disabilities 4: Environment. Timescale: within two weeks of the date of report. Recommendations 1. Recommendation Inspection report continued 1.The service should review all portable equipment testing procedures to ensure that all items are properly tested and this is then conducted on an annual basis as is best practice guidelines. This is to comply with the National Care Standards Your environment. Crail / Wilson Houses Small Group Living Services, page 16 of 26

17 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths The grade achieved for this quality statement was 5 - Very Good. We decided this after we spoke to service users, carers, support staff, manager and reviewed the relevant documentation regarding how the service ensured that service user's participated in assessing and improving the quality of staffing in the service. Please refer to quality statement 1.1 and 2.1 for further information to support the grade we have awarded for this quality statement. There was a supervision system in operation, this ensured staff were able to feedback on their work performance and raise any issues or concerns. As part of this process the manager included feedback from service users about the quality of the staff. The service had involved service users and relatives in discussions when completing the self assessment. This included suggestions for involvement in the staff recruitment process. This gave service users and relatives an important role in the service development, which made them feel part of the process and that their opinions and views were valued. Feedback we received was that the manager was approachable and open to meeting and talking with people about their issues or concerns. There was also agreement and confidence that the manager would also address any issues raised. We reviewed several minutes of staff meetings and saw these were undertaken regularly with good information and a variety of relevant topics on the agenda. Staff were able to participate and contribute meaningfully to meetings in a Crail / Wilson Houses Small Group Living Services, page 17 of 26

18 collaborative manner. Any actions required were identified as were the individuals responsible to undertake these tasks. Areas for improvement The service should continue to investigate ways to involve service users in the assessment of the quality of the staff. The service has detailed in their self assessment that they are looking at ways of developing a carers group which could contribute to the participation strategy and the development of the two services. Grade awarded for this statement: 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 grade achieved for this quality statement was 5 - Very Good. Inspection report continued We decided this after we spoke to service users, carers, support staff, manager and reviewed the relevant documentation regarding how the service ensured that the staff were appropriate qualified were aware of the National Care Standards, legislation and best practices. The manager has been very pro-active in responding to the training needs of the staff to ensure that all staff had the necessary skills and knowledge to meet the needs of service users. This training had been provided by a variety of externally accredited courses and by the manager keeping up to date with best practice guidelines and ensuring the staff team were provided with this information. This meant staff were working towards the best principles of care and support for people with learning disabilities. The manager had implemented a regular supervision programme and this was valued by the staff we spoke to. They were very positive and appreciative of the value and benefit of this support and welcomed the opportunity to feel part of a team and felt listened to. Staff we spoke with confirmed, they had been supported and listened to in the process of team building and service development. Staff also told us how training requests can often be made in response to the changing needs of residents to ensure Crail / Wilson Houses Small Group Living Services, page 18 of 26

19 care delivery is safe and appropriate. This assisted the manager in evaluating the effectiveness of the care and support being delivered. This in turn led to improved outcomes for their service users. The service ensured that staff were given the appropriate training, this included mandatory requirements such as: * Food hygiene, * Moving and Handling, * Fire Safety Awareness, * Dementia, * Adult Support and Protection, * First Aid and Health and Safety. Staff received training and development on the principles of participation and philosophy of the services participation strategy. The staff have all received training in Adult Support and Protection issues. We looked at the minutes of recent staff meetings, and noted that a good range of relevant subjects were discussed and required actions identified. The service also had a range of policy documents to inform and direct staff in their daily work. Staff meetings were conducted monthly and minutes were checked. This evidenced that staff were involved in the development of the service and the minutes also highlighted any actions taken to address issues raised. The meeting minutes were distributed between the staff team and contained actions and outcomes. The staff we spoke to knew how to report any concerns they had about residents' welfare or poor practice. The staff appeared motivated to achieving good outcomes for the people they looked after. Areas for improvement The service should continue to develop their training programme to ensure that staff achieve the required level of SVQ level qualification. The service has committed to further developing the dementia training by encouraging families and carers to participate in this process along with staff. This would be helpful support to families in coping with the stress of someone with learning disabilities being diagnosed with Alzheimer's or dementia. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Crail / Wilson Houses Small Group Living Services, page 19 of 26

20 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths The grade awarded for this Quality Statement is 5 - Very Good. We concluded this after we spoke to residents, carers, the manager and staff. We also looked at how the service involved people in the developments to improve the quality of the service. Please refer to Quality Statements 1.1, 2.1 and 3.1 for further detailed information regarding the strengths of this quality statement. The service places a high level of importance on service user participation and continues to develop further methods to involve service users in the evaluation of the service. We found that there was a well written participation strategy, which we found to be embedded in the daily interactions of the staff and management. The service had ensured that all staff had undergone training in the principles of participation which further enhanced the quality of the care delivered. Comments from service users and relatives indicated a high degree of satisfaction with the quality of care and support offered within the service. This generated a sense of trust and appreciation. People held the service with high regard. The service has been pro-active in contacting relatives to ensure that they feel part of the home and have a role to play in the future developments of the two services. Areas for improvement The service should investigate ways of gaining feedback from professionals who are involved with the service. This would give additional information to evaluate the quality of care the service delivers. The service should consider ways of recording informal meetings and feedback from relatives to ensure that this information is represented as part of the services development. Crail / Wilson Houses Small Group Living Services, page 20 of 26

21 The service should consider offering the attendance of managers at service user meetings by invite of the service users. They may want to discuss things without a manager present. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 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 The grade awarded for this Quality Statement is 5 - Very Good. We concluded this after we spoke to residents, carers, manager and staff. We also looked at various quality assurance documentation that the service had in place. There was evidence that the manager completed regular audits to ensure more appropriate information was obtained to improve the quality of care. Where changes to processes or procedures were needed, these were implemented to ensure staff accountability for good service delivery. We found that a variety of quality assurance processes and systems are used to assess and improve the quality of service. Quality monitoring systems in place included: * audits of questionnaires * feedback from meetings * direct observation and feedback of staff practice * evaluation of comments and complaints * Supervision and support for staff * Performance appraisal for staff. * Feedback from other professionals * Feedback from service users and carers The service submitted an appropriately detailed self assessment which demonstrated clear evidence of involvement through feedback from service users, carers and staff. The service was proactive in detailing areas for future development within the self assessment. We found that a variety of quality assurance processes and systems are used to assess and improve the quality of service. Quality monitoring systems in place included: Crail / Wilson Houses Small Group Living Services, page 21 of 26

22 * audits of questionnaires * feedback from meetings * direct observation and feedback of staff practice * evaluation of comments and complaints * Performance appraisal for staff. * Feedback from other professionals * Feedback from service users and carers Areas for improvement The service should continue to monitor and maintain the very good standard it has achieved in this quality statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Crail / Wilson Houses Small Group Living Services, page 22 of 26

23 4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1). Crail / Wilson Houses Small Group Living Services, page 23 of 26

24 5 Summary of grades Quality of Care and Support Very Good Statement 1 Statement Very Good 5 - Very Good Quality of Environment Good Statement 1 Statement Very Good 4 - Good Quality of Staffing Very Good Statement 1 Statement Very Good 5 - Very Good Quality of Management and Leadership Very Good Statement 1 Statement Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 1 Dec 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed 1 Jun 2010 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing Not Assessed Management and Leadership Not Assessed 8 Mar 2010 Unannounced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership Not Assessed Crail / Wilson Houses Small Group Living Services, page 24 of 26

25 16 Nov 2009 Announced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership Not Assessed 24 Feb 2009 Unannounced Care and support Not Assessed Environment 5 - Very Good Staffing 4 - Good Management and Leadership 4 - Good 9 Jul 2008 Announced Care and support 5 - Very Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Crail / Wilson Houses Small Group Living Services, page 25 of 26

26 To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on This inspection report is published by the Care Inspectorate. You can get more copies of this report and others by downloading it from our website: or by telephoning Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: enquiries@careinspectorate.com Web: Crail / Wilson Houses Small Group Living Services, page 26 of 26