Kippen Care Services Support Service Care at Home Tayview Industrial Estate Friarton Road Perth PH2 8DG Telephone:

Transcription

1 Kippen Care Services Support Service Care at Home Tayview Industrial Estate Friarton Road Perth PH2 8DG Telephone: Type of inspection: Announced (Short Notice) Inspection completed on: 19 March 2015

2 Contents Page No Summary 3 1 About the service we inspected 4 2 How we inspected this service 6 3 The inspection 10 4 Other information 21 5 Summary of grades 22 6 Inspection and grading history 22 Service provided by: Kippen House Ltd 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 Kippen Care Services, page 2 of 24

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 4 Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well Services users can be confident that the service will meet their care needs and personal preferences. Service users can be confident that staff will look out for changes in their health and care needs. The service responded constructively to any issues raised by service users and relatives. What the service could do better Three recommendations are made about care planning and one further recommendation about following care plan directions. What the service has done since the last inspection The service had met one requirement and one requirement is continued as a recommendation. Conclusion All service users and relatives who we met were very happy with the quality of the service. Kippen Care Services, page 3 of 24

4 1 About the service we inspected Kippen Care Service is registered by the Care Inspectorate to provide a support service care at home. It provides a range of care at home services, from domestic help to assistance with personal tasks. The service is available to people from the age of 18 years upwards including those with disability or mental health issues but mainly covers older people in the Perth city area and the rural area south of Perth. A twenty-four hour on-call service is provided. At the time of the inspection the service supported 140 clients mostly older people, with by 33 staff, three senior and one coordinator. The service shared the same manager, office premises and policies and procedure and training programme as Rigifa Home Care Service. 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 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. The history of grades which services have been awarded is available on our website. You can find the most up-to-date grades for this service by visiting our website, by calling us on or visiting one of our offices. 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 Reforms (Scotland) Act 2010 and Regulations or Orders made under the Act, or a condition of registration. Where there are breaches of the Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Inspectorate." Kippen Care Services, page 4 of 24

5 Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - 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. Kippen Care Services, page 5 of 24

6 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 following a short notice inspection between 16 and 18 March We provided feedback to the management of the service, in a meeting on 18 March. In this inspection, we gathered evidence from various sources, including the relevant sections of policies, procedures, records and other documents. We sampled three service users' personal care plans. We spoke with; Three service users and two relatives face to face. The manager, a care co-ordinator, two senior support staff and two support staff. 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. Kippen Care Services, page 6 of 24

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 Kippen Care Services, page 7 of 24

8 What the service has done to meet any requirements we made at our last inspection The requirement The Providers are required to ensure that all service users have the opportunity to be involved in developing and agreeing their plan of care and support. This must be reviewed when requested to do so by the service user or any representative, when there is a significant change in a service user's health, welfare or safety needs; and at least once in every six month period whilst the service user is in receipt of the service. This is in order to comply with The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) Regulation 5 Personal Plans and 4 Welfare of users. Timescale: Within three months of receipt of this report the Provider must submit evidence to the Care Inspectorate to demonstrate that this requirement has been met. What the service did to meet the requirement In most instances we found that the service had completed personal plans with service users. However in one instance this had not been done. A recommendation is made for the service to ensure it prepares plans with service users. See Quality of Care and Support, Statement 3, Recommendation 3. The requirement is: Not Met Kippen Care Services, page 8 of 24

9 The requirement The Providers are required to review the effectiveness of the complaints procedure to ensure that it enables service users to easily raise complaints. The complaints procedure should make reference to informal resolution as a first line approach, when appropriate, and how this will be implemented. The Manager must ensure that all staff understand their responsibility to record and pass on any complaints or concerns raised by service users. This is in order to comply with The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) Regulation 4(1)(a) Welfare of users. What the service did to meet the requirement We saw instances of the service acting on concerns raised by service users or relatives and checking back that they were satisfied with the resolution. The requirement is: Met - Within Timescales Inspection report continued 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. An appropriately completed self assessment was received. Taking the views of people using the care service into account We spoke to three service users and two relatives as part of this inspection. Their views are included in the body of the report. Taking carers' views into account We spoke to three service users and two relatives as part of this inspection. Their views are included in the body of the report. Kippen Care Services, page 9 of 24

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: 4 - 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 service used several methods to ensure that service users and their relatives had a say in how their service met their needs and preferences and responded to their individual circumstances. Here are some examples; The service held review meetings, at least once in every six months with service users and their relatives about their care arrangements. We found examples where these meetings had been as a result of changing needs or a service user or relative had wanted changes to the care arrangements. The service has responded to requests for a change in the time of visits when it had capacity to do so. Where the service has found service uses needs are changing and increasing they have referred the service user back to the local social work service. The service used a satisfaction survey with service users and relatives to get feedback on how well the service met care needs, and the quality of staff and management. Service users also made comments on the quality of the service. The management analysed the questionnaires. The service received very good feedback from service users and relatives. The management visited service users' homes when staff were providing a service to observe that the service was being provided as expected. The management also feedback from service users and relatives about the service during these visits. Kippen Care Services, page 10 of 24

11 The service responded constructively to concerns raised by service users. There were action sheets completed after issues have been raised and how they had been resolved which is evidenced how the service had responded to concerns constructively. As an example a service user commented that they felt rushed by one staff member. The service took action and the service user subsequently told the service that they were happy that the matter had been resolved. There is a newsletter sent out to service users and relatives two or three times a year which set out how the service ensured the quality of the service, as above. The service is to hold a focus group for service users and relatives in the summer. The newsletter informed them of the progress staff have made with their vocation training. The service had very good outcomes in this quality statement as it used several approached to find out service users and relatives views and responded constructively to any issues raised. Areas for improvement The service asks service users and their relatives if certain values and outcomes are being met such as privacy and dignity. This is often noted as yes or no answer. It would better demonstrate how the service and its staff are meeting better outcomes for service users if an example was provided. The service could tell service users and relatives about the feedback it gets from its questionnaires and what it had done about it in its newsletters. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Kippen Care Services, page 11 of 24

12 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths We examined the service's practices and outcomes for service users through visiting three service users' homes, examining the care plans for these service users and speaking to staff. Services users can be confident that the service will meet their care needs and personal preferences. Service users told us they knew the staff who were providing their care and that the staff knew about their care needs. The service kept to a minimum the number of staff who visit each service users for greater continuity of care and knowledge of service user's needs by staff. Examples of very good outcomes for service users were; One service user told us: "The service tries to provide the same staff but sometimes there are last-minute changes. The service provides my main social contact." Staff told us they worked with a small group of service users who they regularly supported and who they got to know and to know how they how liked their care and support to be provided. Service users can be confident that staff will look out for changes in their health and care needs. Where the service has found service uses needs are changing and increasing they have referred the service user back to the local social work service. Service users told us staff knew them well and noticed when their health and care needs had changed and promoted them to get healthcare advice. As examples of this; A service user wrote in a questionnaire to the service; "The staff give me advice and remind me to call my GP. The staff definitely pay attention to my health and they encouraging me to drink fluids when they are here. A member of staff from a sheltered housing service commented in a review that since the service had started a service user's wellbeing had improved and the staff reported any problems to the sheltered housing service. Staff confirmed they contacted healthcare staff when they were concerned about a change in service users' welfare. Kippen Care Services, page 12 of 24

13 The service developed personal plans that set out service users' needs. These were of a reasonable standard and were clearly linked to assessment and care plans written by the local social work service. Service users and their relatives had signed the plans and a copy was kept in service users' homes. Staff are encouraged to do offer to do small tasks around the home that will help the service user and their families such as tidying up and drying up, putting on the laundry and then hanging up to dry. Service user confirmed they found the staff very willing to help with tasks other than personal care. The service's practice ensured that service users' health and wellbeing needs are met with very good quality outcomes. However there was an areas for development in the service's care planning and aspects of care for one service user that meant that a higher grade could not be given at this time. Areas for improvement The service's personal plans lacked detail about; a) What routines would be followed at each visit and how long each visit would last and the times of each visit. b) What service users and relatives want from the service, which are the desired outcomes. c) How staff are to meet service user's needs and preferences consistently. Recommendation 1. The partner of one service user also received personal care support about twice a week. The service had not prepared any personal plans for this service user as required by regulation. Recommendation 2. A service user's moving and transferring equipment needed cleaning. It was part of the service's care package for staff to attend to the cleanliness of this equipment. The service needs to ensure that these duties are carried out. Recommendation 3. A service user's personal plan stated they required a modified diet prescribed by a healthcare professional. However the service user and their carer said they had an unmodified diet, and the service user was assisted to eat by staff. As there are risks to the service user with not following a prescribed diet the service user's decision and knowledge of the risk should be discussed with healthcare staff and recorded in the personal plan. Recommendation 4. For one service user with complex needs it was difficult to determine from the service's written records how their care had been provided. The service could prepare a specific recording sheet for this service user to clarify routines to be carried out on each visit and what the staff observations had been. Kippen Care Services, page 13 of 24

14 Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 4 Recommendations Inspection report continued 1. For better outcomes for service users the service should record; a) What routines would be followed at each visit and how long each visit would last and the times of each visit. b) What service users and relatives want from the service, which are the desired outcomes. c) How staff are to meet service user's needs and preferences consistently. National Care Standards, Care at home, Standard 3, Your personal plan. 2. The service should ensure that all service users have a personal plan prepared with them setting out how their personal needs and preferences will be met within 28 days of starting the service setting. National Care Standards, Care at home, Standard 3, Your personal plan. 3. The service should ensure that any personal equipment is kept clean by staff as part of ensuring service users' welfare and dignity. National Care Standards, Care at home, Standard 3, Your personal plan. 4. A service should record in the personal plan a service user's decision not to follow a prescribed diet after taking advice from their healthcare staff about the associated risks. National Care Standards, Care at home, Standard 3, Your personal plan. Kippen Care Services, page 14 of 24

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 evaluation of this quality statement is also based upon the strengths identified in Quality of Care and Support, Statement 1. Areas for improvement The evaluation of this quality statement is also based upon the strengths identified in Quality of Care and Support, Statement 1. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Kippen Care Services, page 15 of 24

16 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths We examined how the service supported staff in their work with service users, how it trained staff to meet service users' needs and involved staff in improving outcomes for service users. We spoke to the manager, the service's coordinator, two senior carers and two support staff and examined the service's staff records. Service users can be confident that the service provides staff with training to meet their needs. Examples of this practice included: The service had a comprehensive induction programme for staff to complete in the first few weeks of their employment which covered a suitable range of care practices, knowledge of policies, procedures and expected conduct. The staff we spoke to confirmed that they felt well-trained and supported to meet service users' care needs. The service provided staff with good opportunities to have training and development beyond above the minimum required training. For example a senior staff member had been to a dementia course and wanted to pass on what they had learnt to the rest of the staff team. The service had a summary training record for all staff to show what training each staff member had received and when that this training would need to be periodically refreshed. This was a useful management tool to monitor the overall state of training for all staff. The service was supporting staff to obtain vocational qualifications in care, such as SVQ 2 and 3, in preparation for applying to the Scottish Social Service Council register. Staff felt supported by senior staff in their work with service users, so that they could readily ask for advice or assistance. The staff we spoke to said that the management were approachable if they were having difficulties. To ensure this outcome the service a coordinator, and senior support staff to assist the manager in the overall management and direction of the service. The manager and senior staff provided oncall support via a 24 hour mobile number to support and reassure staff and service users. The manager and all the senior staff also provided direct support to service users so they could see for themselves any changes in service users' needs. The service listened to the views of its staff to assist it in improving outcomes from the service. Staff members confirmed that they have the opportunity to take part in Kippen Care Services, page 16 of 24

17 team meetings where care staff discussed working with service users' needs. Staff members confirmed they had regular individual supervision meetings with their line manager to discuss working with individual service users and their training needs. The staff confirmed that the manager and senior staff were very approachable. The service had very good quality outcomes with its support and development of staff which contributed to good quality care outcomes for service users and their relatives. Areas for improvement The staff induction records, supervision records and staff observations visits would be improved by citing examples of staff practice with service users and evaluating how well the practice met good practice guidance and expected practice by the service. There is an opportunity for the service to make use of the meetings staff have with care coordinators for developmental time on codes of practice, national care standards, policies and procedures, and good practice guidance. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Kippen Care Services, page 17 of 24

18 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 evaluation of this quality statement is also based upon the strengths identified in Quality of Care and Support, Statement 1. Areas for improvement The evaluation of this quality statement is also based upon the strengths identified in Quality of Care and Support, Statement 1. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Kippen Care Services, page 18 of 24

19 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 examined what methods the service used to get feedback on its performance and how it used this information to make improvements. The service used the following methods to ensure the quality of the service and to continue to improve; The service involved service users and their relatives in monitoring and improving the service through individual care reviews, questionnaires and spot visits. The service then evidenced it had acted on the feedback and whether service users were satisfied with their outcome. The service had a good commitment to staff support and development and team working that all contribute to better and consistent outcomes for service users. The staff meetings are used to issues and find solutions with the staff team and to maintain staff morale. All the senior staff including the manager provide direct care as necessary to support both service users and their support staff. There were now meetings for senior staff to coordinate the support of service users and staff and to develop the roles of the senior support staff and coordinators. The service had identified that there had been difficulties in maintain consistency of staff supporting service users and of supporting staff. The service is relatively large supporting about 140 service users with about 33 support staff. It has set up distinct teams of support staff, each with a senior support worker, and smaller geographical areas to improve continuity for service users and improved oversight by a senior member of staff. The service's constructive approach to involving service users, relatives, and its senior staff all contributed to good care outcomes for service users and relatives and continued improvement. Areas for improvement The service would benefit from an annual service plan setting out areas for improvement, with specific goals, actions to be taken, timescales and persons responsible. Recommendation 1. Kippen Care Services, page 19 of 24

20 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. The provider should prepare a service plan for improvement setting out areas for improvement, with specific goals, actions to be taken, timescales and persons responsible. National Care Standards, Care at home, Standard 4, Management and staffing. Kippen Care Services, page 20 of 24

21 4 Other information Complaints One complaint was partially upheld since the last inspection. Details of the findings can be found next to the entry about this service on Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information No additional information noted. 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). Kippen Care Services, page 21 of 24

22 5 Summary of grades Quality of Care and Support 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 10 Mar 2014 Announced (Short Notice) Care and support Staffing Management and Leadership 5 - Very Good 5 - Very Good 5 - Very Good 4 Oct 2012 Announced (Short Notice) Care and support Staffing Management and Leadership 5 - Very Good 5 - Very Good 5 - Very Good 14 Jul 2011 Unannounced Care and support 5 - Very Good Staffing Not Assessed Management and Leadership 4 - Good 12 Jul 2010 Announced Care and support 4 - Good Staffing 4 - Good Management and Leadership 4 - Good 9 Sep 2009 Unannounced Care and support 3 - Adequate Staffing 4 - Good Kippen Care Services, page 22 of 24

23 Management and Leadership 3 - Adequate 2 Dec 2008 Announced Care and support 3 - Adequate Staffing 2 - Weak Management and Leadership 3 - Adequate All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Kippen Care Services, page 23 of 24

24 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: Kippen Care Services, page 24 of 24