Fred Martin Supported Living Services Housing Support Service Quarriers Fred Martin Office Anniesland Business Park Netherton Road Glasgow G13 1EU

Transcription

1 Fred Martin Supported Living Services Housing Support Service Quarriers Fred Martin Office Anniesland Business Park Netherton Road Glasgow G13 1EU Telephone: Inspected by: Julia Bowditch Iain McLellan Type of inspection: Announced (Short Notice) Inspection completed on: 27 March 2014

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 12 4 Other information 23 5 Summary of grades 24 6 Inspection and grading history 24 Service provided by: Quarriers Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Julia Bowditch Telephone enquiries@careinspectorate.com Fred Martin Supported Living Services, page 2 of 26

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 4 Good Quality of Staffing 4 Good Quality of Management and Leadership 4 Good What the service does well The staff in this service know the people who use it very well and are very good at responding to their healthcare needs. They have good links with healthcare professionals. There has been good work done on consulting with people who use the service to ensure appropriate and enjoyable activity programmes. There are good systems in place to monitor the quality of the service. What the service could do better All support plans need to reflect the needs of the people using the service. Medication must be stored appropriately. An overall service improvement plan should be drawn up. What the service has done since the last inspection The service has met five of the seven recommendations we made at the last inspection. As a result improvements have been made to the frequency of reviews, medication systems and team meetings. Fred Martin Supported Living Services, page 3 of 26

4 Conclusion Inspection report continued Overall the service is continuing to perform well and people continue to be supported in a person centred way by staff who are clearly committed to providing good outcomes for them. However issues with the quality of information in support plans need to be addressed. Who did this inspection Julia Bowditch Iain McLellan Fred Martin Supported Living Services, page 4 of 26

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 provides housing support and care at home to adults with learning disabilities and offers support for adults with learning disabilities at seven sites across Glasgow - Maryhill, Yoker and Bearsden. There are currently 18 people using this service. The daily running of each site is managed by a team leader who implements the daily care and support needs with a team of support workers. The manager has overall responsibility for the service and is based at the provider's office in Anniesland. The service aims to provide a "relaxed and homely atmosphere where people can be themselves and live the kind of lives they would want to live." 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 4 - Good Quality of Management and Leadership - Grade 4 - Good Fred Martin Supported Living Services, page 5 of 26

6 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. Fred Martin Supported Living Services, page 6 of 26

7 2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care. What we did during the inspection We wrote this report following an unannounced inspection which was carried out on 24 March 2014 between 9:30 am and 5:30 pm and on 25 March between 10:00 am and 3:45 pm. During the inspection we visited the provider's office in Anniesland, Glasgow and three of the houses, one in the Yoker area of Glasgow and two in the Maryhill area. The inspection was carried out by two Inspectors, Julia Bowditch with Iain McLellan on the second day. We gave feedback to the Manager by telephone on 27 March. This report is a summary of our findings. As requested by us, the care service sent us an annual return. The service also sent us a self assessment form. We sent 8 questionnaires to the manager to distribute to service users and/or friends, relatives or carers of people who use the service and received 2 completed before the inspection. We also sent 25 questionnaires to staff and received 15 completed. In this inspection we gathered information from a number of sources, including the relevant sections of policies, procedures, records and other documents and by meeting people who use the service and staff who support them. We met/spoke with: - six people who use the service - the manager - one team leader - six support workers - the group activity coordinator We looked at: - the service's most recent self assessment - annual return - registration certificate - insurance certificate - five care plans Fred Martin Supported Living Services, page 7 of 26

8 - minutes of reviews - medication folder - risk assessments - minutes of team meetings - minutes of team management meetings - staff training records - accident/incident records - supervision records - quality monitoring Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at Fred Martin Supported Living Services, page 8 of 26

9 What the service has done to meet any recommendations we made at our last inspection We made seven recommendations at the last inspection: 1. The provider should now ensure that formal reviews of care plans to which care managers, service users, carers and any other relevant parties are invited are held at least every six months. National Care Standards Care at Home, Standard 3: Your personal plan This recommendation has been met. 2. The manager should regularly monitor that six-monthly reviews have been held as planned in each of the houses. National Care Standards for Care at Home, Standard 4: Management and staffing This recommendation has been met. 3. Medication procedures should be reviewed in line with best practice guidance to ensure that any changes to MAR sheets are properly documented and copies of prescriptions are kept by the service. National Care Standards for Care at Home, Standard 8: Keeping well - medication, and Standard 4: Management and staffing arrangements This recommendation has been met. 4. The manager should ensure that service users who require support with decisionmaking for medical treatments have a current AWI section 47 certificate in place. National Care Standards for Care at Home, Standard 8: Keeping well - medication, and Standard 4: Management and staffing arrangements This recommendation has been met. 5. Staff should be given regular opportunities to meet to discuss all areas of the service. Minutes of meetings should clearly show what has been decided and the Fred Martin Supported Living Services, page 9 of 26

10 person responsible for carrying out any actions. Inspection report continued National Care Standards for Care at Home, Standard 4: Management and staffing arrangements Part of this recommendation has been met. Please see quality statement 1.3 for further information. 6. The manager should ensure that the progress of actions identified in action plans is monitored to ensure that they are completed. National Care Standards for Care at Home, Standard 4: Management and staffing arrangements This recommendation has not been met. Please see quality statement 4.4 for further information. 7. A comprehensive service improvement plan should be drawn up from quality audits with the involvement of staff and other stakeholders such as service users and carers. National Care Standards for Care at Home, Standard 4: Management and staffing arrangements This recommendation has not been met. Please see quality statement 4.4 for further information. 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 completed self assessment document from the service manager who identified what they thought they did well, some areas for development and any changes they planned. We would have liked more detail under each of the headings that we grade them under as the information included did not do justice to the work the service was doing. As well as more detail, future self assessments could be strengthened by examples of where the service's strengths have led to positive Fred Martin Supported Living Services, page 10 of 26

11 outcomes for service users to show what the service does to bring about improvements or change in people's lives. Taking the views of people using the care service into account During the inspection we met six people who use the service and observed interactions with staff. Staff knew them and their needs well and had built up positive relationships with them. Everyone appeared relaxed and happy and comfortable with staff who responded respectfully to their needs. Taking carers' views into account We received two completed questionnaires from carers. Both were overall very happy with the quality of service their relative received. Fred Martin Supported Living Services, page 11 of 26

12 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 We found that this service was very good at involving the people who use it in the assessment and development of their care and support. We decided this after talking with people who use the service, the manager and support staff. We also looked at five care plans and other written evidence. We found that staff in this service tried to involve people who use it in decisions about their care and support as much as possible. We saw information in support plans on how to include people in areas such as shopping, personal care, menu planning and activities and observed them being offered day to day choices. Staff knew the people they supported and their communication well and told us they could 'read the signs' which meant they knew by the person's reactions whether they were happy or not. Support plans were now being regularly reviewed. The manager had developed a plan to ensure that reviews took place every six months and was monitoring this. The two recommendations we made about reviews at the last inspection have now been met. We saw from the minutes of reviews that people who use the service and carers attended and gave their views on all areas of the service. In some support plans we sampled we saw very good protocols for involving the person in their own review including producing the review report in a suitable format. There had been some good consultation with people who use the service on group activities. Quarriers Group Activity Coordinator met with people in their homes and with the support of staff identified what activities people did and did not enjoy. Also Quarriers Community Connections facilitated a development day to find out their Fred Martin Supported Living Services, page 12 of 26

13 views on the current group programme and we saw that as a result more trips had been arranged and changes had been made to workshops to give people more options and better structure to keep them engaged. In addition to this staff supported them to give feedback on activities annually using a questionnaire and results were fed back using the service's newsletter. The changes we saw as a result of these methods of consultation showed us that the service was committed to developing a programme of activities that was meaningful and appropriate to the people taking part. Please see Quality Statement 1.3 for more information on the types of activities people were involved in. The provider, Quarriers, had issued a Parents and Carers Survey asking them for feedback on all areas of the service including staffing, facilities and overall satisfaction. It also asked them if they would like to be involved in staff recruitment and Care Inspectorate inspections. Responses were generally very positive about staff and the service in general. Where issues were raised we saw a good response by managers to address them and some improvements as a result. This showed us that the service took people's views seriously. Areas for improvement We saw that the service has arranged a Development Day for people who use the service, families and staff to contribute to a new brochure and give their views on the service overall. The day will be facilitated by Quarriers Community Connections. We will look at outcomes from the day at the next inspection. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Fred Martin Supported Living Services, page 13 of 26

14 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued We found that performance by this service was adequate in the areas covered by this statement. We concluded this after we looked at support plans and related recordings and spoke with the manager and staff about health and wellbeing. The support plans we sampled contained some good person centred information on how best to support the person to identify and achieve their goals. There was clear information on daily routines and we saw some very good detail in specific areas such as healthy eating and promoting positive behaviour. Staff we spoke to were knowledgeable about the health and wellbeing needs of the people they supported. We heard of occasions where people received medical procedures at home with the support of staff rather than attend hospital or clinics as the experience was less stressful for them in a familiar environment. We saw from support plans that the service had good links with a range of healthcare professionals such as the community learning disability nurse, dentist, physiotherapist, speech and language therapist and dietician to maintain people's health. Where there were concerns we saw a good response from the service, for example, an autism specialist had been consulted and was working with staff to develop strategies to support one person. We saw that staff had received training in autism awareness, dysphagia and Makaton to support people with specific needs. As we said in Quality Statement 1.1 above people had been consulted about activity programmes. The review of day services in Glasgow had meant that many people no longer attended day centres. Quarriers as an organisation had responded well to this by arranging regular activities that people enjoyed such as music, drama, art, dance, gym, computing and massage. People were supported by staff to go on holiday and take part in individual activities such as swimming. It was good to hear that staff tried to source activities that they thought or knew people would particularly enjoy such as disabled cycling and developing friendships outwith the service. These had resulted in good experiences for people. There was an emphasis on people being as independent as possible and we saw a good range of risk assessments to help to ensure their safety when carrying out daily living activities as well as other activities inside and outside their home. There was a system in place for reporting incidents and accidents and we saw that copies were kept in the service so that staff were aware of the incident or accident and any action agreed to minimise the chance of it happening again. Accident and incidents were monitored by the manager and forwarded to the organisation's Health Fred Martin Supported Living Services, page 14 of 26

15 and Safety department. The recommendation we made at the last inspection about medication has been met. The manager had reviewed the procedures, developed new checks and discussed Quarriers medication standard with staff to remind them of their responsibilities. We saw current Adults with Incapacity Section 47 certificates in the files we looked at, to support appropriate decision-making for people who have been assessed to lack capacity on health treatments. The recommendation we made about this at the last inspection has been met. Areas for improvement Each person's medication was stored in a cabinet inside a cupboard in their bedroom. In one house we visited neither the cabinet nor the cupboard was locked. This presented an area of risk to people using the service and must be addressed. (See Requirement 1 under this statement) We found that there was no standardisation of information in support plans between the three houses we visited. It was sometimes difficult to find support information and unclear when it had last been updated. The manager told us that Quarriers had begun to move to a computer-based system of care planning called Q Star. This system focussed on outcomes for people using the service and would mean that support plans were standardised throughout. Staff were still to be trained in its use before it was implemented in this service. We will follow up on progress at the next inspection. However current support plans need to contain information that reflects the needs of people using the service and we found that this was not always the case. For example we saw that the behaviour of one person in a house could have a negative effect on others but we did not see any support plans or risk assessments to show how the service was minimising this. It was good that there was input from outside agencies such as social work, the community learning disability nurse and occupational therapist to address the issues around people's behaviour but support plans need to be developed to guide staff on how to deal with the effect on others in the house to ensure their safety and wellbeing. (See Requirement 2 under this statement) We also found in a support plan that it had been identified that the person was at risk of choking. Although we saw that there were measures in place to reduce the risk such as using thickeners in drinks on the advice of the Speech and Language Therapist, there was no risk assessment in place to ensure that all staff were aware of all the risks and how to work in a consistent way to minimise them. This information must be included in care plans. (See Requirement 2 under this statement) Fred Martin Supported Living Services, page 15 of 26

16 Grade awarded for this statement: 3 - Adequate Number of requirements: 2 Number of recommendations: 0 Requirements 1. The provider must ensure that there are safe procedures in place for storing medication. This is in order to comply with: The Social Care and Social Work Improvement Scotland (requirement for Care Services) Regulations 2011 (SSI 2011/210) Regulation 4 (1) (a) Health & Welfare. Timescale: immediately on receipt of this report. 2. The provider must ensure that all support plans contain information that reflects the needs of each service user. This should include appropriate risk assessments. This is to comply with The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011(SS1 2011/2010) Regulation 5 Personal Plans and Regulation 4 (1) (a) Health & Welfare. Timescales: within 1 month from receipt of this report Inspection report continued Fred Martin Supported Living Services, page 16 of 26

17 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 4 - 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 performance for service user and carer involvement under this statement was found to be good. The evidence relating to this has been included under Quality Theme 1, Statement 1. In addition to this we heard that some people who use the service and some carers had been involved in the recent recruitment of new staff. Areas for improvement Areas for improvement made under Quality Theme 1, Statement 1 in this report also apply to this statement. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Fred Martin Supported Living Services, page 17 of 26

18 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths We considered the performance of the service to be very good in the areas we looked at under this statement. We looked at evidence relating to the quality of staff training, supervision and team meetings. We also observed staff practices and spoke to staff about their work. We observed good interactions between staff and people who use the service. Staff appeared motivated to suggest ideas for improving people's quality of life. Those we spoke to generally felt they received good support from management and each other. Regular team meetings were held and we saw from minutes that there was a good mix of service, staff and service user issues and there was evidence that staff were given opportunities to make suggestions about the service as well as opportunities to discuss practice. We made a recommendation at the last inspection about team meetings being regular in all services and we saw that there had been an improvement. This part of the recommendation has been met. (See Areas for improvement below for further comment on the recommendation) Staff told us that they received regular one to one supervision with their line manager. This was important for their development as it gave them dedicated individual time to discuss any issues about people who use the service, practice issues, training needs and any support they required. Annual performance appraisal and development reviews (PADR) were held where staff identified their objectives for the coming year. Each member of staff was responsible for keeping their own Continuous Professional Development Plan up to date. Staff we spoke to told us they received good training to support people using the service and we saw that they had received training in response to the needs of the people they supported, for example autism, dysphagia and Makaton, or were awaiting a date for training. As we said elsewhere in this report the community learning disability nurse and other specialists supported staff with training and advice about specific needs. Mandatory training in safer handling, health and safety, food safety, medication and Adult Protection was up to date. We saw that where there were particular practice issues these were addressed promptly by discussion in supervision and team meetings and/or through additional training. Areas for improvement Inspection report continued Part of the recommendation we made at the last inspection about team meetings has not been met. It remained unclear from the minutes of meetings what had been decided and whether any actions from the previous meeting had been completed. We have made another recommendation to cover these points. (See Recommendation 1 Fred Martin Supported Living Services, page 18 of 26

19 under this statement) None of the recordings of PADRs we saw had the date or signature of those taking part. We discussed this with the manager and asked her to address this so that it was clear when they had been done and that staff involved agreed with any decisions made. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. Minutes of meetings should clearly show what has been decided and the person responsible for carrying out any actions. They should also show any progress on actions identified at the previous meeting. National Care Standards for Care at Home, Standard 4: Management and staffing arrangements Fred Martin Supported Living Services, page 19 of 26

20 Quality Theme 4: Quality of Management and Leadership 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 management and leadership of the service. Service strengths The performance for service user and carer involvement under this statement was found to be good. The evidence relating to this has been included under Quality Theme 1, Statement 1. We saw that a parent had been involved in helping to develop a new questionnaire for obtaining feedback on the service which was now in use. As we said elsewhere in this report Quarriers Community Connections would be holding an event to invite people who use the service, carers and staff to give their views on the service and help to develop a new brochure. Areas for improvement Areas for improvement made under Quality Theme 1, Statement 1 in this report also apply to this statement. Opportunities for people to give their views on the quality of management and leadership in this service were limited. The manager should consider ways in which this can be addressed. (See Recommendation 1 under this statement) Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The manager should consider ways in which people can give feedback on the management and leadership of the service. National Care Standards for Care at Home, Standard 11: Expressing your views Fred Martin Supported Living Services, page 20 of 26

21 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 Inspection report continued We considered the performance of the service to be good in the areas of quality monitoring, audit and associated reporting. From the evidence we have seen at this inspection and in talking to the manager and staff we can see that there is a commitment to improving the service and therefore the quality of life for people using it. Methods of participation highlighted elsewhere in this report have resulted in service users, carers and staff having input into assessing the quality of service, for example through reviews, staff supervision and appraisals and team meetings. Quarriers Community Connections and Planning had facilitated a consultation event with staff on what was good in the service and what needed to improve. From this an action plan had been developed and we that the areas they had identified had been met, such as regular meetings being set up, and some areas ongoing such as improving communication. The service carried out a range of quality checks in each of the houses: Daily finance and medication checks were carried out by support staff and there was a good system for monthly checks by team leaders in each of the houses we visited. These covered areas such as finances, health and safety, medication, team meetings, supervision and support plans to ensure that they were up to date and were a good way of monitoring staff practice. As a further check the manager sampled these to ensure that they had been completed and that any identified actions had been carried out. Team Leaders from this service continued to meet with the manager monthly to discuss management, staffing and service user issues in each of the houses. This helped to ensure consistency of practice across the whole service. The manager provided regular reports to social work services who commissioned the service. This meant that performance of the service in key areas was being monitored externally. An evaluation tool, the Q Quality Management System, linked to Quarriers policies and standards, monitored quality in areas such as care planning, health and safety, safeguarding, diversity and inclusion and involvement. We could see that as a result of a recent audit an action identified to include people more was to make a brochure for Fred Martin Supported Living Services, page 21 of 26

22 the houses and that there was soon to be an event for service users, carers and relatives to participate in this. Areas for improvement We said at the last inspection that it was not always clear whether actions identified in action plans had been completed. We found this still to be the case and so have repeated the recommendation. (See Recommendation 1 under this statement) Also at the last inspection we said that while there were good systems in place for monitoring all areas of the service we would like to have seen the information from audits fed into an overall service improvement plan that identified short and long term goals with dates for completion and the person(s) responsible, and included the views of staff, service users and carers. As we did not see an overall plan we have repeated this recommendation. (See Recommendation 2 under this statement) The self assessment the manager submitted to us before this inspection would have been improved by examples of where processes had led to positive outcomes for people using the service. We would also like to have seen more information on the quality assurance carried out by the service as the information given under Statement 4.4 did not reflect the range we found during the inspection. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 2 Recommendations Inspection report continued 1. The manager should ensure that the progress of actions identified in action plans is monitored to ensure that they are completed. National Care Standards for Care at Home, Standard 4: Management and staffing arrangements 2. A comprehensive service improvement plan should be drawn up from quality audits with the involvement of staff and other stakeholders such as service users and carers. National Care Standards for Care at Home, Standard 4: Management and staffing arrangements Fred Martin Supported Living Services, page 22 of 26

23 4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in 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). Fred Martin Supported Living Services, page 23 of 26

24 5 Summary of grades Quality of Care and Support Good Statement 1 Statement Very Good 3 - Adequate Quality of Staffing Good Statement 1 Statement Good 5 - Very Good Quality of Management and Leadership Good Statement 1 Statement Good 4 - Good 6 Inspection and grading history Date Type Gradings 19 Feb 2013 Announced (Short Notice) Care and support Staffing Management and Leadership 4 - Good 4 - Good 4 - Good 19 Oct 2011 Unannounced Care and support 5 - Very Good Staffing Not Assessed Management and Leadership 4 - Good 17 Jun 2010 Announced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership Not Assessed 29 Jun 2009 Announced Care and support 5 - Very Good Staffing 4 - Good Management and Leadership 4 - Good 14 Aug 2008 Announced Care and support 5 - Very Good Staffing 4 - Good Fred Martin Supported Living Services, page 24 of 26

25 Management and Leadership 4 - Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Fred Martin Supported Living Services, page 25 of 26

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