Caring Hearts Limited Support Service Care at Home Studio 260 Embroidery Mill Building Abbey Mill Business Building Paisley PA1 1TJ Telephone: 0141

Transcription

1 Caring Hearts Limited Support Service Care at Home Studio 260 Embroidery Mill Building Abbey Mill Business Building Paisley PA1 1TJ Telephone: Type of inspection: Unannounced Inspection completed on: 31 October 2014

2 Contents Page No Summary 3 1 About the service we inspected 4 2 How we inspected this service 6 3 The inspection 9 4 Other information 19 5 Summary of grades 20 6 Inspection and grading history 20 Service provided by: Caring Hearts Limited Service provider number: SP Care service number: CS If you wish to contact the Care Inspectorate about this inspection report, please call us on or us at enquiries@careinspectorate.com Caring Hearts Limited, 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 3 Adequate Quality of Staffing 2 Weak Quality of Management and Leadership 3 Adequate What the service does well At the time of this inspection, Caring Hearts was providing support to two service users and their relatives/main carers. We spoke with the main carers and one service user. We were informed that the support provided was to a very high standard with very positive comments made about the staff providing the support and the attentiveness and professionalism of the provider. We could see that the service had a comprehensive range of policies and procedures to support staff in their role. Staff were provided with an Employee Handbook which provided summaries of essential policies and procedures and useful guidance. What the service could do better The provider must ensure that staff induction training is improved to ensure that staff have the necessary training required to support individuals. What the service has done since the last inspection This was the first inspection. Conclusion The provider was very committed to building a business which provided the highest quality of care and was open to any advice and guidance provided by the Inspector. Caring Hearts Limited, page 3 of 21

4 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 The Care Inspectorate will award grades for services based on findings of inspections. Grades for this care service may change after this inspection due to other regulatory activity; for example, if we have to take enforcement action to make the service improve, or if we uphold or partially uphold a complaint we investigate. If we are concerned about some aspect of a service, or think it could do more to improve its service, we may make a requirement or a recommendation. * 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 or Orders made under the Act or conditions 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 Care Inspectorate. Caring Hearts is a privately owned company and was registered with the Care Inspectorate on 6 March 2014, to provide a Support Service with Care at Home. This was the first inspection of the service. At the time of this inspection, there were 2 people being supported by the service and there were 2 members of staff, in addition to the provider who also assisted with the support of service users. The provider had been engaged in marketing the business through leaflet drops, website advertising and discussions with Local Authority Social Services and hoped that the business would continue to grow in the coming months. The service has a 'Philosophy of Care' included in the service leaflet provided to prospective service users and service users which includes the statement; ''To provide personal care and support in ways which have positive outcomes for our clients and promote their active participation'. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 3 - Adequate Quality of Staffing - Grade 2 - Weak Quality of Management and Leadership - Grade 3 - Adequate Caring Hearts Limited, page 4 of 21

5 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. Caring Hearts Limited, page 5 of 21

6 2 How we inspected this service The level of inspection we carried out In this service we carried out a high intensity inspection. We carry out these inspections where we have assessed the service may need a more intense inspection. What we did during the inspection This inspection took place between 15th October 2014 with final feedback provided on In the inspection we gathered evidence from various sources, including the relevant sections of policies, procedures, records and other documents including; * evidence from the self-assessment document completed as part of the inspection process * personal plans of people who use the service * participation and consultation methods * review process * training records * individual and service training plans * complaints policies and procedures * information pack * discussions with various people including; provider, member of staff, 2 relatives and 1 service user 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. Caring Hearts Limited, page 6 of 21

7 Fire safety issues Inspection report continued 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 Caring Hearts Limited, page 7 of 21

8 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: No 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 fully completed self assessment document from the service provider. We were satisfied with the way the service provider had completed this and with the relevant information they had given us for each of the headings that we grade them under. Taking the views of people using the care service into account We visited a service user at home. The service user's communication was limited however, he did express his satisfaction with the quality of care and support he was receiving from Caring Hearts. We spoke with in main carer (see carers views) Taking carers' views into account We spoke with the main carers of the 2 service users currently being supported by the service. The comments were very positive. Carers were delighted with the quality and flexibility of the service. Carers were very complementary about the staff providing the support and the professionalism of the provider. Caring Hearts Limited, page 8 of 21

9 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: 3 - Adequate 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 We found the service performance for this quality statement to be 4 - Good. We concluded this from discussions with the provider and service users' main carers. Other sampled evidence included: Personal plans Review system Evidence of Home visits and contact with service users and their carers Participation policy The provider did have a participation policy, which recognised the importance of seeking service user and carers' views on the quality of the service and how this would be done. At the time of this inspection, the service was supporting 2 service users. We were informed by the main carers of one service user, that the provider had kept in regular contact, to ensure that the quality of service was to his satisfaction. Contact had been made by telephone and . Another carer who had daily contact with the provider, was involved in providing direct care and support to the service user. We were informed that service users and their main carers were consulted on the 'staff matching process' and were able to have 'trial visits' to ensure that an appropriate 'match' had been made. Staff could be changed at the service user's and/or main carer's request, if it was considered not to be an appropriate 'match'. Service users being involved in selecting their own support team is considered good practice. Caring Hearts Limited, page 9 of 21

10 We could see that the provider had developed satisfaction surveys to seek the views of service users and carers. Due to the low numbers of service users receiving support at the time of this inspection, there were good levels of consultation achieved without this method being used. Quality surveys will be a useful way of seeking service users' views as the business grows and the number of service users increase. We saw from the service diary that a service user's first 4 week review had been scheduled to take place in the following week. The grade achieved for this quality statement is based on the frequency of direct contact between the provider and service user and/or main carers. This may be difficult to sustain when the number of service users increase and therefore other methods of consultation and involvement will have to be developed and used. Areas for improvement We were informed by a service user's main carers that the provider kept in frequent contact by telephone. The provider confirmed contact by telephone and . The provider should ensure that all contacts with service users and/or their carers are recorded including a brief note of the elements of service they are satisfied with and any issues raised and how these were addressed. We will consider in the next inspection how participation and involvement methods are developed as the number of service users increase. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths We found the service performance for this quality statement to be 3 - Adequate. We concluded this from discussions with the provider and service users' main carers. Other sampled evidence included: Personal plans Individual risk assessments The service had systems in place for the assessment, support planning, and review of the service provided. The initial assessment tool was comprehensive and completed to a good standard. Caring Hearts Limited, page 10 of 21

11 We could see from the assessment document how this was used to compile the personal plan. The personal plans provided information about individuals' daily routines and the care tasks to be completed on each visit. They contained sufficient information to provide direction to staff on how service users' needs should be met, based on the service users' expressed preferences. Risk assessments were in place, which considered individuals' care and support needs and the environment. It was noted that the provider responded to the advice of the inspector and introduced a separate and more care focused tool, to assess individuals' moving and handling needs with risk reduction measures. There was good information provided to service users about the service and a service agreement was signed by both parties. The main carers of service users told us that they were very happy with the quality of service received. Carers told us that the service was very professional and that carers were reliable, caring and had the skills required to carry out their role. We could see that there was very good outcomes for service users. Areas for improvement The grade for this statement was influenced by the fact that a member of staff had not completed up to date moving and handling training prior to supporting service users. (See Quality Theme 3 Statement 3). The provider responded to this issue appropriately when brought to their attention and ensured that the required training was completed at the earliest opportunity. The provider should ensure that all assessment documentation and risk assessments are signed and dated by the assessor and service user or their representative. The provider should continue to develop the personal plan process. This will be required as the number of service users increase and where care needs are complex and particularly where there are no carers/relatives available to assist in directing staff on how to provide care. Grade awarded for this statement: 3 - Adequate Number of requirements: 0 Number of recommendations: 1 Inspection report continued Caring Hearts Limited, page 11 of 21

12 Recommendations Inspection report continued 1. The provider should ensure that all assessment documentation and risk assessments are signed and dated by the assessor and service user or their representative. National Care Standards. Support Services Care at Home. Standard 5 Management and Staffing Arrangements. Caring Hearts Limited, page 12 of 21

13 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 2 - Weak Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths The areas of strengths outlined in Quality Theme 1 Statement 1 are also relevant to this quality statement. Areas for improvement The areas for improvement outlined in Quality Theme 1 Statement 1 are also relevant to this quality statement. Grade awarded for this statement: 4 - 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 We found the service performance for this quality statement to be 2 - Weak. We concluded this from discussions with the provider and service users' main carers. Other sampled evidence included; Training Records Supervision Records Recruitment records Induction records Employee handbook The service had a range of policies and procedures which included recruitment, induction and training and development. At the time of this inspection there were 2 members of staff. Recruitment was Caring Hearts Limited, page 13 of 21

14 underway to increase the staff team. The service had an induction training plan to support new staff to be inducted into the service and confirm competency in key skills. An employee handbook was available to staff, providing summaries of a range of policies and procedures and relevant guidance to support them in their role. Areas for improvement The grade for this quality statement is influenced by the fact that a member of staff did not have up-dated moving and handling training to ensure they had the required skills to carry out the tasks related to their role. The provider had not carried out the required checks to confirm the training completed, identify training needs and ensure the required training was completed. We were very disappointed at the overall approach to staff training and development. This was even more disappointing given that there were only 2 members of staff employed by the service. This should have allowed the provider to put the comprehensive range of policies and procedures, specifically relating to induction and staff training and development, into practice. It would also have allowed an opportunity to evaluate the systems used and make any changes required in advance of the business growing and the staff group increasing. The provider must ensure that new staff complete the induction training as stated in the induction policy and procedures. Induction training must include, but not restricted to, training in; moving and handling, infection control, food hygiene, adult support and protection. (See requirement 1 for this quality statement) All staff must be provided with Adult Support and Protection training. (See requirement 2 for this quality statement) The service's Adult Support and Protection policy and procedure must be reviewed to include reporting procedures and the contact information for the appropriate Local Authority Social Services Department. (See requirement 3 for this quality statement) The provider should compile an annual training plan for the service based on the aims and objectives of the service and the training and development needs of staff required to meet service users' needs. Caring Hearts Limited, page 14 of 21

15 (See recommendation 1 for this quality statement) The provider should ensure that staff appraisals are carried out and each member of staff have regular planned one to tone supervision. Staff should have an individual training plan based on the findings of appraisal and supervision and have individual training records with evidence of all training completed. (See recommendation 2 for this quality statement) The provider should consider introducing individual training evaluations and reflective learning accounts to be completed by staff at the end of each training event considering how this training will influence practice. (See recommendation 3 for this quality statement) Grade awarded for this statement: 2 - Weak Number of requirements: 3 Number of recommendations: 3 Requirements Inspection report continued 1. The provider must ensure that all new staff complete induction training as stated in the induction policy and procedures. Induction training must include, but not restricted to, training in moving and handling, infection control, food hygiene, adult support and protection. This is in order to comply with; SSI 2011/210 (b) - ensure that persons employed in the provision of the care service receive- (i) training appropriate to the work they are to perform; and (ii) suitable assistance, including time off work, for the purpose of obtaining further qualifications appropriate to such work. Timescale for implementation: 1 month from the publication of this report. 2. The provider must ensure that all staff complete training in Adult Support and Protection. This is in order to comply with; SSI 2011/ (b) - ensure that persons employed in the provision of the care service receive- (i) training appropriate to the work they are to perform. Timescale for implementation: 1 month from the publication of this report. Caring Hearts Limited, page 15 of 21

16 3. The provider must ensure that the policies and procedures relating to Adult Support and Protection are reviewed to include appropriate reporting procedures and the contact information for the relevant Local Authority Social Services Department. This is in order to comply with; SSI 2011/210 4 (1) (a) Recommendations 1. The provider should compile an annual training plan for the service based on the aims and objectives of the service and the training and development needs of staff required to meet service users' needs. National Care Standards. Support Services Care at Home. Standard 5 Management and Staffing Arrangements 2. The provider should ensure that; Inspection report continued * staff appraisals are carried out and each member of staff have regular planned one to one supervision * staff should have an individual training plan based on the findings of appraisal and supervision and have individual training records with evidence of all training completed. National Care Standards. Support Services Care at Home. Standard 5 Management and Staffing Arrangements 3. The provider should consider introducing individual training evaluations and reflective learning accounts to be completed by staff at the end of each training event considering how this training will influence practice. National Care Standards. Support Services Care at Home. Standard 5 Management and Staffing Arrangements Caring Hearts Limited, page 16 of 21

17 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 3 - Adequate 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 areas of strength outlined in Quality Theme 1 Statement 1 are also relevant to this quality statement. Areas for improvement The areas for improvement outlined in Quality Theme 1 Statement 1 are also relevant to this quality statement. Grade awarded for this statement: 4 - 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 We found the service performance for this quality statement to be 3 - Adequate. We concluded this from discussions with the provider and service users' main carers. Other sampled evidence included; Participation methods Self Assessment process for Care inspectorate The participation and consultation methods outlined in Quality Theme 1 Statement 1 informs the service Quality Assurance systems. This was in main was done by regular face to face and telephone contact with service users and their main carers. Areas for improvement The service must develop audit systems to support the Quality Assurance processes these should include but not restricted to: Caring Hearts Limited, page 17 of 21

18 * audits to ensure that assessments and care plans are completed appropriately and include all relevant information including dates and signatures. * audits of medication records if/when staff are responsible for administering medication * audits of training records to ensure staff have completed the training required for their role and to meet the needs of service users If appropriate auditing processes were in place the situation of the member of staff not having up to date moving and handling training would have been identified. (See recommendation 1 for this Quality Statement) Grade awarded for this statement: 3 - Adequate Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The service should develop audit systems to support the Quality Assurance processes these should include but not restricted to; * audits to ensure that assessments and care plans are completed appropriately and include all relevant information including dates and signatures. * audits of medication records if/when staff are responsible for administering medication * audits of training records to ensure staff have completed the training required for their role and to meet the needs of service users National Care Standards. Support Services Care at Home. Standard 5 Management and Staffing Arrangements. Caring Hearts Limited, 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 the Care Inspectorate re-grading a Quality Statement within the Quality of Management and Leadership Theme (or for childminders, Quality of Staffing Theme) as unsatisfactory (1). This will result in the Quality Theme being re-graded as unsatisfactory (1). Caring Hearts Limited, page 19 of 21

20 5 Summary of grades Quality of Care and Support Adequate Statement 1 Statement Good 3 - Adequate Quality of Staffing Weak Statement 1 Statement Good 2 - Weak Quality of Management and Leadership Adequate Statement 1 Statement Good 3 - Adequate 6 Inspection and grading history All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Caring Hearts Limited, 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: Caring Hearts Limited, page 21 of 21