Key Community Supports - Highland (JM) Housing Support Service Old Estate Office Dochgarroch Inverness IV3 8JP Telephone:

Transcription

1 Key Community Supports - Highland (JM) Housing Support Service Old Estate Office Dochgarroch Inverness IV3 8JP Telephone: Inspected by: Elano Ross Type of inspection: Unannounced Inspection completed on: 14 December 2012

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 11 4 Other information 19 5 Summary of grades 20 6 Inspection and grading history 20 Service provided by: Key Housing Association Ltd Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Elano Ross Telephone enquiries@careinspectorate.com Key Community Supports - Highland (JM), page 2 of 21

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 5 Very Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well The service offers a very good standard of individualised care and support to people with a learning disability in their own homes. People who use the service have very good opportunities to express their views on the service and to influence the way in which the service is delivered and developed. People who use the service are very well supported to live independently and to participate in a range of social, educational and employment activities. Individual choice was promoted and service users were very well supported to participate in making decisions and choices that affected their everyday lives. People using the service receive different levels of support to meet their needs. What the service could do better The service needed to push ahead to develop outcome focused care plans for all service users. Some local services needed to review and update their policy and procedures on managing service users medicines in line with best practice and update and review the individual risk assessments for each service user. The service could improve its feedback mechanisms from care managers, health care professionals and other stakeholders. Key Community Supports - Highland (JM), page 3 of 21

4 What the service has done since the last inspection Inspection report continued The service is working in partnership with the Local Authority; NHS - Highland to pilot the new self directed support arrangements. This appears to be working very well for those service users who are part of the pilot as it offers greater flexibility and enhanced choice. The services are working towards developing outcome focused support plans for all service users which demonstrates service users involvement in developing packages of care that suit individuals. Conclusion Key Community Supports - Highland (JM) provides a very good standard of community based care for vulnerable people who have a learning disability in Sutherland. The service continues to display a commitment to putting the people who receive support at the centre of the service. Using support flexibly staff are able to support people to lead full and active lives which reflect their individual needs and interests. Overall, people using the service are very happy with the service they receive. Who did this inspection Elano Ross Key Community Supports - Highland (JM), page 4 of 21

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Prior to 1 April 2011, this function was carried out by the Care Commission. Information in relation to all care services is available on our website at This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April Requirements and recommendations If we are concerned about some aspect of a service, or think it needs to do more to improve, 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 based on best practice or the National Care Standards. - 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 ("the Act") and secondary legislation made under the Act, or a condition of registration. Where there are breaches of Regulations, Orders or conditions, a requirement may be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. The service, Key Community Supports - Highland (JM), was operated by Key Housing Association Ltd, a registered Social Landlord that provides accessible housing and support in 15 Local Authority areas across Scotland. The service provided some accommodation, personal care, support and advice to people with a learning disability. The services provided at a number of sites throughout the Highland area including Thurso in Caithness, Invergordon and Alness in Ross-shire; Fort William and two sites in Inverness. The service operates on 52 weeks per year. Overnight support can be provided to individuals that required this service. Support was available 24 hours if required. The service aimed to work alongside service users and their family to help them to live life to the full. Based on the findings of this inspection this service has been awarded the following grades: Key Community Supports - Highland (JM), page 5 of 21

6 Quality of Care and Support - Grade 5 - Very Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very Good Inspection report continued 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. Key Community Supports - Highland (JM), page 6 of 21

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 This report was written following an unannounced inspection that took place between on 24 October and 14 December 2012 and involved visits to three sites located at Thurso, Fort William and Inverness. All visits to services took place between and The findings of this inspection was fed back to the manager of the service by telephone on 14 December The inspection was carried out by Inspector Elano Ross. Before the inspection As requested by us the care service sent us an annual return. The service also sent us a self assessment form. The Care Inspectorate issue Care Standards Questionnaires (CSQs) to services and ask them to distribute them to service users and staff who then return them directly to us. For this inspection we issued the service with 15 CSQs for staff to complete and 40 CSQs for service users to complete. At the time of writing this report we have received responses from 10 staff and 27 service users. During the inspection: We gathered evidence from various sources, including the relevant sections of policies, documents and records including: Individual support plans The Information Pack including the Participation and Complaint Policies Self assessment document Annual return Staff training and supervision records Minutes from meetings, including staff meetings, local and national TAG group meetings Newsletters Essential Life Plans Review documentation Risk assessments Responses in the Care Standards Questionnaires returned to us. All of the above was taken into account in the inspection process. Key Community Supports - Highland (JM), page 7 of 21

8 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 continued 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 Key Community Supports - Highland (JM), page 8 of 21

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. We received a very comprehensive self assessment document from the service provider. We were satisfied with the way the provider had completed this and with the relevant information they gave us for each of the headings which we grade them under. The service provider identified what they thought they did well, some areas for development and any changes they planned. The provider also told us how the people who use the service had taken part in the self assessment process. Taking the views of people using the care service into account In the course of this inspection we spoke with a total of eight service users. They told us what they liked about the service they got from Key Community Supports - Highland (JM) and how they were supported in their lives. They told us they were very happy with the service and that through the support they received they were able to live independently, to make their own friends and take up hobbies and interests they would not otherwise be able to. They spoke very highly about the relationships they had formed with their key workers and other staff who supported them and it was very clear from the conversations we had that service users trusted the local managers and staff to deliver the right support to enable them to achieve their goals. Additionally we received 26 responses to our Care Service Questionnaires from people that use the service. They confirmed that they were very happy with the service provided, that they know the staff who deliver their support and that they are treated with respect at all times. Comments from service users included: Key Community Supports - Highland (JM), page 9 of 21

10 Key is the best I would recommend Key Housing to anyone I like staying at Key I am happy - I have had the same support worker for 8 years the staff genuinely care for my relative One relative summed up her feeling thus; Inspection report continued my (relative) continues to be supported in a lovely environment by staff who always treat (the service user) with respect and dignity. My whole family feel safe in the knowledge that my (relative) is very well cared for and happy and settled. Taking carers' views into account No relatives or carers became available during the course of the inspection, however some relatives assisted service users to complete Care Standards Questionnaires. Their comments are included in the service users comments. Key Community Supports - Highland (JM), page 10 of 21

11 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 organisation is fully committed to involving people in all aspects of the service. Service users are involved in developing their own support plan and can choose to be involved in the development of the service as a whole if they wish. Within their participation strategy the organisation tells people using the service and their families how they can be involved. People considering using the service are provided with a useful information pack. This pack has been revised with representatives from The Advisory Group (TAG) to ensure it contains the information people want and need. This includes information on how to use the complaints procedure and contact details for other agencies including the Care Inspectorate. People have a variety of ways they can give feedback about the service they receive. This includes: speaking to staff supporting them contacting managers completing questionnaires through the review process complaints procedure and speaking with a member of the advisory groups. Through the Regional and National Advisory Groups (TAGs) people influence the operation of the service at all levels. This includes the support provided to them as individuals and the future direction of the organisation. Through these groups they Key Community Supports - Highland (JM), page 11 of 21

12 contribute to the development of new policies such as developing and organising individual services and support planning and review. They also play an important role in developing guidance for staff. TAG is now registered as a charity. The National Advisory Group meets with the management committee every six months to discuss plans about the strategic direction of the service. The organisation has a well established process for involving people who use the service in the recruitment, selection and training of new staff. People are well supported and are provided with good quality training enabling them to play a full and active part in this process. Areas for improvement The service was performing well in the aspects covered by this statement. The manager should continue to monitor and maintain the very good standards of quality. He should continue to make sure that any areas for improvement are identified and action taken to make improvements. 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 We found that the service was performing very well in the areas covered in this statement. We concluded this after we: Spoke with several service users at three sites across the highlands Spoke with staff and local managers Sampled care files, support plans and risk assessments Checked the operational systems for medication at three sites Checked the service's systems for supporting service users with their finances We found that service users benefited from the organisations commitment to personalised support. Using personal plans and courses such as Health and Happiness, people are supported to pursue their interests, develop their independence and work towards their goals. For some this may be going out independently, finding employment or working towards achieving a personal goal. The service has a well-developed care planning process. This aims to secure service user health and well-being through a person centred approach. There was very good evidence from support plans that this system works well and that the service uses a variety of methods to promote health and well being. Specific health needs are Key Community Supports - Highland (JM), page 12 of 21

13 identified in support plans and there is clear information on how individual service users are to be supported to manage this. People who use the service were very familiar with their support plans and were very clearly involved in developing the new outcome focused support plans. These focus on individual goals and aspirations, what support will be required to help them achieve this and how they will know if they are making progress. People using the service work with staff, care managers and, where appropriate, their family to develop their support plan. As a result their plans reflect their individual needs, wishes, and interests. People know the support hours they are allocated each week and how the time should be used. Some service users were participating in the self directed support pilot within the Highland area. This offers greater flexibility and personal choice for service users as they can choose when and how to use the hours they have their support to enable them to pursue their interests. For example some may wish to use extra hours or less hours when they are ill or to have a day out at the shops or for outings or special events. Staff are clear about their role in encouraging the people they support to adopt a healthy lifestyle. There is a policy on Supporting People to Keep Healthy, Safe and Well. This includes sections on supporting people with their personal care, food safety and lifestyle risks. A wide range of social activities are used to promote healthy living. An example of this is the Health and Happiness initiative based at the Hub in Thurso which has set up and run successfully, a community cafe providing nutritious lunches at reasonable prices, an outlet for service users to make and sell nutritious meals to older people and aimed to promote healthy eating on a budget and promote the social and fun aspects of eating and entertaining. Mental wellbeing was clearly being promoted through service users participation in local leisure and sports clubs. As an organisation, Key has a number of initiatives promoting exercise and activity. Service users are supported very well to access local health services. All service users are registered with a local GP, dentist and optician and have good access to the local Learning Disability Team who can provide specialist health and social services. Areas for improvement Inspection report continued The manager needed to ensure that the service as a whole reviewed the policies and procedures for managing service users medicines so that they were following best practice. The manager was directed to the Care Inspectorate publication 'Guidance about medication, personal plans, review, monitoring and record keeping in residential care services' published in July 2012 and available on the Care Inspectorate website. The service was performing well in the aspects covered by this statement. The manager should continue to monitor and maintain the very good standards of quality. He should continue to make sure that any areas for improvement are identified and action taken to make improvements. Key Community Supports - Highland (JM), page 13 of 21

14 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Key Community Supports - Highland (JM), page 14 of 21

15 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 evidence for the grade awarded in this statement is included in Quality Theme 1, Statement 1 Areas for improvement The areas for improvement in this statement have been identified in Quality Theme 1, Statement 1. 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 Staff we spoke with clearly enjoy their work and are committed to supporting people to develop their independence and lead a full and active life. They were enthusiastic about their ongoing professional development and confirm that they receive the training they need to enable them to support individual people well. Staff tell us they feel well supported by the organisation and their local managers. A comprehensive induction programme for new staff ensures they are informed about policies, procedures and guidance. During this process they complete the 'Preparing for Practice' course. The course gives them information about communication, challenging behaviour and their role in the protection of vulnerable people. Staff spoken to were positive about the training provided and the likelihood of a positive response to any training needs staff might identify. Through a comprehensive training programme staff are supported to improve their skills and knowledge to enable them to better support people. Where individuals have specific needs, staff Key Community Supports - Highland (JM), page 15 of 21

16 supporting them receive additional training to enable them to better meet these needs. For example some staff receive training in Behavioural Support Strategies, Autism Awareness or Epilepsy. Staff also have opportunities to access Scottish Vocational Qualifications to enable them to meet the requirements of the Scottish Social Services Council for registration. The Scottish Social Services Council's (SSSC) Codes of Practice are issued to all new staff. Staff are well supported through regular supervision sessions with their local coordinators. This gives them an opportunity to discuss practice issues, regional or national developments and any training needs they may have. Within the service's own questionnaires there is a regular question, checking that service users think staff have the right skills to help them. In the responses to our Care Standards Questionnaires staff agreed that they felt very well supported by their managers and the organisation. Most staff felt that they had very good training opportunities and were instrumental in identifying their own training needs. Areas for improvement Some staff told us that they would like the opportunity for further specific training and the opportunity to study for formal qualifications in order to meet the registration criteria with the Scottish Social Services Council. The training records we sampled showed that most training was delivered 'in house' by an accredited trainer employed with the organisation. There was no evidence that the service had evaluated the effectiveness of the training delivered. The manager should consider implementing a system for evaluating training and demonstrating improvement in staff knowledge and practice as an outcome of each training. This would complete the cycle for analysis delivery and evaluation which leads to better performance. The service was performing well in the aspects covered by this statement. The manager should continue to monitor and maintain the very good standards of quality. He should continue to make sure that any areas for improvement are identified and action taken to make improvements. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Key Community Supports - Highland (JM), page 16 of 21

17 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 evidence for the grade awarded in this statement is included in Quality Theme 1, Statement 1. Areas for improvement The areas for improvement in this statement have been identified in Quality Theme 1, Statement 1. 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 organisation is proactive in developing ways for people to be involved in the ongoing development of the service they receive and of the wider service. Using a range of quality assurance mechanisms including, operational reviews, financial and support plan audits, incident and accident monitoring and questionnaires the organisation monitors the quality of service people receive. There was evidence that the operational review for this service had recently been completed. Action plans were also in evidence where these were required. There was evidence of an audit system on involvement in service users' finances. There is a Serious Incident Reporting policy and procedure. This defines serious incidents and also action, to encompass any learning following such an incident. The organisation has achieved the European Foundation for Quality Management (EFQM) Committed to Excellence Award. TAG recently achieved charitable status and is Key Community Supports - Highland (JM), page 17 of 21

18 in the process of developing their own website to share information with interested parties. National TAG has been heavily involved in reviewing the organisations quality assurance systems and Central TAG are becoming more involved on a local basis. For example they are becoming more involved in agreeing and monitoring improvements being made as a result of feedback through questionnaires. Areas for improvement The service was performing well in the aspects covered by this statement. The manager should continue to monitor and maintain the very good standards of quality. He should continue to make sure that any areas for improvement are identified and action taken to make improvements. He needed to evidence the action taken locally in response to feedback from other stakeholders. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Key Community Supports - Highland (JM), page 18 of 21

19 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). Key Community Supports - Highland (JM), page 19 of 21

20 5 Summary of grades Quality of Care and Support Very Good Statement 1 Statement Very Good 5 - Very 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 15 Oct 2010 Announced Care and support 6 - Excellent Staffing Not Assessed Management and Leadership Not Assessed 9 Mar 2010 Announced Care and support 6 - Excellent Staffing 4 - Good Management and Leadership 5 - Very Good 26 Mar 2009 Announced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Key Community Supports - Highland (JM), page 20 of 21

21 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: Key Community Supports - Highland (JM), page 21 of 21