Care service inspection report

Care service inspection report Full inspection Inspire Huntly Housing Support Service 18 Milton Wynd Huntly Inspection completed on 11 May 2016

Service provided by: Inspire (Partnership Through Life) Ltd Service provider number: SP2003000031 Care service number: CS2010279589 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 0345 600 9527 www.careinspectorate.com @careinspect page 2 of 21

Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of care and support 6 Quality of staffing Quality of management and leadership 5 Excellent N/A Very Good What the service does well The service provided community living for the people that they supported. Support was provided in a person centred way which met the needs of the people being supported. Staff members had a very detailed knowledge of the people they support and their specific needs. What the service could do better The service should continue to encourage staff members to take a leadership role in areas where they have the necessary skills. What the service has done since the last inspection The service has continued to develop support plans. The people being supported continued to be encouraged to be as independent as possible. This was viewed and explained on a number of occasions. Conclusion This service continues to be a very high performing service which involves the people that they support. The service also ensures that the people that they page 3 of 21

support are able to try new skills, take risks in a safe manner and are part of the local community. page 4 of 21

1 About the service we inspected Inspection report Inspire Huntly provides housing support and care at home for a number of tenants who have learning and physical disabilities. Support is in place to assist tenants in sustaining their tenancy and supporting them to take an active role in their local community. Recommendations A recommendation is a statement that sets out actions that a care service provider should take to improve or develop the quality of the service, but where failure to do so would not directly result in enforcement. Recommendations are based on the National Care Standards, SSSC codes of practice and recognised good practice. These must also be outcomes-based and if the provider meets the recommendation this would improve outcomes for people receiving the service. Requirements A requirement is a statement which sets out what a care service must do to improve outcomes for people who use services and must be linked to a breach in the Public Services Reform (Scotland) Act 2010 (the "Act"), its regulations, or orders made under the Act, or a condition of registration. Requirements are enforceable in law. We make requirements where (a) there is evidence of poor outcomes for people using the service or (b) there is the potential for poor outcomes which would affect people's health, safety or welfare. Based on the findings of this inspection this service has been awarded the following grades: Quality of care and support - Grade 6 - Excellent Quality of staffing - N/A 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. page 5 of 21

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 www.careinspectorate.com or by calling us on 0345 600 9527 or visiting one of our offices. page 6 of 21

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 a short notice inspection which began on Tuesday 10 May 2016. The inspection was completed the following day Wednesday 11 May 2016. Feedback was provided to the manager and deputy manager at the end of the inspection. During the visit we gathered evidence from various sources, including written records: - current self assessment document - three Care Standard Questionnaires were completed and returned by carers on behalf of the people being supported - one Care Standard Questionnaire (CSQ) was returned by a relative of a person being supported - two support plans of people being supported - various policies. Discussions with various people, including: - two people being supported - the manager - the deputy manager - three support workers. page 7 of 21

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 report 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 www.firescotland.gov.uk page 8 of 21

The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The Care Inspectorate received a fully completed self assessment document from the provider. We were satisfied with the way the provider completed this, and with the relevant information included for each heading that we grade services under. The provider identified what it thought the service did well, some areas for development and any changes planned. Taking the views of people using the care service into account Three CSQs were returned by people using the service. They all 'strongly agreed' with the statement that overall, they were happy with the quality of care and support from the service. Two people being supported were spoken with during the inspection visit. They explained that they were very independent but received support as they required and that they were able to contact the manager or staff members as necessary. Taking carers' views into account A CSQ was received from the family of one person being supported. They state that their relative is in a perfect place with wonderful carers. page 9 of 21

3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 6 - Excellent Statement 3 We ensure that service users' health and wellbeing needs are met. Service Strengths At this inspection we found that the service was performing at an excellent standard for this statement. The people being supported were safe and were supported to live their lives in the community. Staff members from the service provided support to the people being supported in a person centred manner. The level and frequency of support was provided as assessed to meet the needs of the people being supported. Support plans provided very detailed information about the support being provided. These included regular daily routines which explained what must happen for some of the people being supported. The people being supported were encouraged to maintain and develop household skills. The support plans also explained what the person could do for themselves and also included clear behavioural guidance. A person being supported explained how they had developed their cooking skills since moving to their flat. This was also explained in the support plan. The support plans also stated that they had increased confidence and organisational skills. This was explained by the service user who travelled independently and was able to plan their day around work placements and social events. page 10 of 21

The service supported people to make contact with employability services. A few of the people being supported went to work in the local community with others attending day services. Appropriate risk assessments were in place with control measures being identified if necessary. SMART technology was used and this was included in the risk assessments as necessary. The people being supported had access to local healthcare facilities and attended as necessary with support as required. The people being supported were registered with GPs and Dentists with additional support from Allied Health Professionals as required. One person being supported had very specific support needs when attending appointments and their support plans provided this detailed information. This was further explained by the manager that they had developed very good relationships with the GP practice and the local hospital to address these issues. In conjunction with nurses, staff members had used modelling behaviours to reassure the person being supported when blood samples were required. Safe medication practices were in place with the people being supported receiving appropriate support with their medication. Some people were self medicating with one person also being responsible for taking their insulin. It was explained that staff members had received training related to Diabetes and ensured that the person's privacy and dignity was maintained as they did not like staff members present when administering their insulin. One person being supported by the service was currently receiving support in hospital in Aberdeen. Staff members from the service continued to provide support to the person on a number of sessions throughout the week. The people being supported had their wishes responded to. This enabled the people being supported to go on holiday with arrangements being made to address specific needs. In specific cases good links with the day service enabled the people being supported to go on day trips and holidays. One person being supported received additional support through their page 11 of 21

Independent Living Fund (ILF). The service was flexible with the support that they provided to enable the person to attend outings which were supported by the ILF worker. Areas for improvement The service should continue to provide support in this person centred manner. Grade 6 - Excellent Number of requirements - 0 Number of recommendations - 0 Inspection report Statement 4 We use a range of communication methods to ensure we meet the needs of service users. Service Strengths At this inspection we found that the service was performing at an excellent standard for this statement. The staff members had a very good knowledge of the people that they support communication needs. This was evident through discussion and the detailed information recorded as part of the support plans. The support plans provided information regarding the support needs of the people being supported. This helped ensure that the people being supported understood what was being communicated to them and that staff members understood them. This included a history of the person and provided information on what they liked to talk about. There was also information about photo prompts and the use of gestures and guiding to help staff communicate with the person. This also ensured a continuity of support was being provided. The use of photos and gestures were also used to explain various activities. The creation of a communication environment with staff taking the lead, being responsive to the person's needs, the use of modelling behaviour and the use of prompts were also explained. Although many of the people being supported communicated verbally a number page 12 of 21

of communication tools were being used by the staff members. These included the use of Makaton, photos, social stories and boardmaker. These tools were used for daily planners, leaflets and to explain going to the doctor or other appointments. Pictorial menus were used to help the person plan their weekly menu. There was good communication with the families of the people being supported. Visits home were planned on a regular basis for one person. A detailed routine of this visit was followed with staff being in support. Other people being supported visited or were visited by family members on a less planned basis. One person being supported regularly, kept in touch with their family members by telephone. One person being supported kept in touch with a relative who lived abroad using 'Facetime' when at home visiting their parents. We discussed if they could use this at the service. This had been discussed and this may not be appropriate as this could be confusing as it was not part of their routine. Easy read documents were used as part of the welcome pack to the service. A number of documents as part of the support plan were in an easy read format. Easy read health related leaflets were available from the Community Learning Disability Team as required. Regular handover meetings took place with staff to ensure that accurate information about the person's day was known by the staff. In one instance the handover was by telephone as they only preferred to have a single staff member in the house. We discussed how the people being supported became aware of the inspection report. A copy was available for the people being supported but it was suggested that an easy read version should be produced by the Care Inspectorate. As this was not available at this time we discussed the possibility of an audio report and we agree that we would request this and explained that this would be issued following the report being finalised. Areas for improvement The service should continue to identify the communication needs of the people that they support and to implement appropriate solutions, systems and new page 13 of 21

technologies to improve the level of communication for the people being supported. Grade 6 - Excellent Number of requirements - 0 Number of recommendations - 0 Inspection report page 14 of 21

Quality Theme 3: Quality of Staffing Quality theme not assessed page 15 of 21

Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very Good Statement 2 We involve our workforce in determining the direction and future objectives of the service. Service Strengths At this inspection we found that the service was performing at a very good standard for this statement. We found that staff members were involved in discussions about the service. This included planning for events and identifying training needs for the service. These can be related to the needs of specific people being supported or the wider service. The organisation now provided some training on a local basis which meant that the staff team could be trained altogether. Regular team meetings took place which provided staff members with the opportunity to raise issues and included planning for future years. Staff members were involved in discussing objectives for the people that they support. Staff members raised issues at these team meetings and the manager operated an open door policy which allowed staff members to contact them about concerns. Staff members had completed staff questionnaires and had identified some concerns that they had supporting an individual. The person was currently being supported away from the service and there was uncertainty about their return to the service. Managers were aware of these concerns and provided reassurance that further discussion would be held before they return. Risk assessments and proactive possibilities would be reviewed prior to their return. All staff members have received training in the use of a new style risk assessment in use at the service. This will help with the above issue. page 16 of 21

Staff road shows have been held which provided access to all staff members with the opportunity to meet senior managers of the service. Staff members completed questionnaires and one issue that was raised was that staff had difficulty receiving some information. To try to resolve this, the organisation planned to provide all staff members with an email address. Areas for improvement The service should continue to provide opportunities for staff members to be involved in the future planning of the service. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Statement 3 To encourage good quality care, we promote leadership values throughout the workforce. Service Strengths At this inspection we found that the service was performing at a very good standard for this statement. Staff members took responsibility for various management tasks. The manager delegated tasks to staff members. The company encouraged staff members to develop their skills with a view to progression through the company. The company encouraged staff members to be involved in action learning sets to develop their knowledge and skills. Action learning sets were in place for new managers to further understand and develop their role. The company was developing the management induction role. The company also ran a mentoring course to help staff understand the formalities of the role. Staff members were encouraged to take on lead roles such as key working, training roles and various systems such as COSHH and budget checks. Staff members could request additional training as the need arose. page 17 of 21

All new staff members received induction across the service. This provided them with an overview of all the people being supported. Managers regularly worked on shifts and this provided them with an opportunity to work with new staff members during their induction. This allowed the managers to lead by example and help model the behaviours of the new staff. This also provided an insight into the competency of the new staff member. This also applied when they worked with experienced staff members. The service offered a variety of training at the service. Where staff attended a training event not attended by the whole team they were encouraged to do an action plan as to how they would disseminate the knowledge or introduce this to the service. The staff members were encouraged to raise issues with the manager or assistant manager. The whistleblowing policy was discussed at a recent team meeting and it was reinforced that staff members should challenge issues. The people being supported were encouraged to lead their own reviews if possible. This was with the support of their keyworker. The person being supported and the keyworker planned the review meeting and invited people to attend. Staff members had their say about their performance and development. This was discussed at the quarterly supervision sessions, more frequently for new staff. Staff members had the option to write up their own notes or they reviewed and agreed the manager's record of the supervision session. Annual appraisal took place with the staff member being required to prepare for this and to discuss and agree issues with the manager. We discussed the Steps into Leadership course run through the Scottish Social Services Council (SSSC). More than 50% of the staff team had achieved an SVQ level 3. The assistant manager was to complete the two supervisory units at SVQ level 4. The organisation carried out regular surveys with the people they support and their families. With the introduction of the email addresses for all staff members the views of the staff members would be more easily obtained using survey monkeys. This had been discussed at team meetings. page 18 of 21

Areas for improvement The service should continue to provide leadership responsibilities to staff members at the service. The service should continue to encourage staff members to suggest areas for improvements at the service. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Inspection report 4 What the service has done to meet any requirements we made at our last inspection Previous requirements There are no outstanding requirements. 5 What the service has done to meet any recommendations we made at our last inspection Previous recommendations There are no outstanding recommendations. 6 Complaints No complaints have been upheld, or partially upheld, since the last inspection. page 19 of 21

7 Enforcements We have taken no enforcement action against this care service since the last inspection. Inspection report 8 Additional Information 9 Inspection and grading history Date Type Gradings 24 Jun 2015 Unannounced Care and support 6 - Excellent Environment Not Assessed Staffing 5 - Very Good Management and Leadership 5 - Very Good 4 Jul 2014 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing 5 - Very Good Management and Leadership 5 - Very Good 20 Aug 2013 Announced (Short Notice) Care and support Environment Staffing Management and Leadership 5 - Very Good Not Assessed 5 - Very Good 5 - Very Good 4 Feb 2013 Announced (Short Notice) Care and support Environment Staffing Management and Leadership 5 - Very Good Not Assessed 4 - Good 5 - Very Good page 20 of 21

To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. You can also read more about our work online. Contact Us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 www.careinspectorate.com @careinspect Other languages and formats This report is available in other languages and formats on request. Inspection report Tha am foillseachadh seo ri fhaighinn ann an cruthannan is c?nain eile ma nithear iarrtas. page 21 of 21