The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk Housing Support Service Office 1 Enterprise House Springkerse Business Park

Transcription

1 The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk Housing Support Service Office 1 Enterprise House Springkerse Business Park Stirling FK7 7UF Type of inspection: Announced (Short Notice) Inspection completed on: 21 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 10 4 Other information 23 5 Summary of grades 24 6 Inspection and grading history 24 Service provided by: The Richmond Fellowship Scotland 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 The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 2 of

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 5 Very Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well We saw that staff supported people using the service well and there were caring relationships in place. People that we met seemed to be enjoying their time with support staff. People using the service had a range of opportunities to take part in improving the service and their own lives. What the service could do better The service should ensure that care plans and risk assessments are reviewed as required. What the service has done since the last inspection The service has responded well to the changing needs that some people have had. This work has included developing staff skills and knowledge. The service has grown slightly since the last inspection and supports more people. Conclusion People using the service seemed pleased with the support and care they received and we saw there were good relationships with staff. Many staff said they felt well supported by their managers and that they were well trained. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 3 of

4 1 About the service we inspected The Richmond Fellowship Scotland is a charity providing community based services for people who require support in their lives. The organisation's aims include working in person-centred ways to offer choice, promote inclusion and enable people to live as independently as possible within their own homes and communities. The service in Stirling, Clackmannanshire and Falkirk provides housing support and care at home services for people with learning disabilities and mental health problems. People the service supports may be living alone or in shared accommodation. At the time of this inspection about 68 people were using the 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 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 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 Care Inspectorate. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 5 - Very Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very Good The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 4 of

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. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 5 of

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 an announced (short notice) inspection. The inspection was carried out by one Care Inspectorate Inspector. This took place on 24 September 2014 between 9.30am and 5pm, on 28 September 2014 between 9.30am and 5.10pm and on 29 September 2014 between 9.30 am and 5pm. We told the Managers what we found at the inspection on 21 October As requested by us the care service sent us an annual return. The service also completed a self assessment form. In this inspection we gathered evidence from various sources including the relevant sections of policies, procedures and other documents including: - Sampled support and care plans - Reviews of support and care plans - Risk assessments - Support agreements - Communication books and diaries - Team meeting minutes - Recruitment records - Support and supervision records - Appraisal records - Staff training records - Incident and accidents - Complaint records - Quality assurance information - Complaints policy - Minutes of meetings for People using the services Discussions with: - The Registered Manager - Three Team Managers - Senior Support Workers The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 6 of

7 - Nine staff We visited local services and people living in their own homes in different parts of Stirling and Larbert. We observed staff as they worked with some of the people being supported. We also visited a craft and activity group run by staff from The Richmond Fellowship and met people using the service and the staff supporting them. 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 The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 7 of

8 What the service has done to meet any recommendations we made at our last inspection No recommendations were made at the last inspection. 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 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. The service provider identified what they thought they did well, some areas for development and any changes they planned. Local managers were involved in the self-assessment. The service graded itself and we agreed with some of these. Taking the views of people using the care service into account We sent out 60 Care Inspectorate Care Standard Questionnaires and nine were returned to us before the start of the inspection by people using the service. Everyone agreed that 'overall, I am happy with the quality of care and support this service gives me'. People made the following comments: 'I like the girls. I like living here in my own house'. Other comments may be found in other parts of the report. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 8 of

9 Taking carers' views into account We sent out 60 Care Inspectorate Care Standard Questionnaires and seven were returned to us before the start of the inspection by peoples' families. Sixteen people strongly agreed and five people agreed that 'overall, I am happy with the quality of care and support this service gives me'. People made the following comments: 'Richmond provide a good service. Always friendly and helpful'. 'Would like more males to support the male residents/to best help with gender related needs'. '(If I had any) complaints or issues would pick up with the team directly'. We did not meet any families or carers during this inspection. Inspection report continued The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 9 of

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: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths We saw that people using the service were encouraged to make choices about everyday living, activities and outings. We saw that the communication methods used were tailored to each individual, recognising each person's abilities and understanding. This meant the service helped people make choices about how they were supported in all aspects of their lives. Staff told us about some difficulties they had in involving the people using the service in decision-making and about the methods they used to help people make their wishes known. We saw that very good contact was kept with peoples' families, whether in person, by telephone or in more formal meetings. Reviews of the care were held regularly with family involvement. This meant that suggestions, comments and feedback were included when planning all aspects of care and everyday living. The keyworker discusses the support being provided with the individual and how this has been going. This could involve discussions with other staff and the families, as well as a review of records. These and other issues were discussed with the staff team in the monthly meeting. This meant that everyone was kept up to date with any changes to the service. The service had a participation and involvement policy. This outlined the expectations held for user involvement throughout the organisation. The organisation had many ways to ensure that people using the service and their relatives could comment on the quality of services. Staff we spoke with were aware of the policy and spoke about how they involved the people in improving their service. Some people using the service took part in a small group and helped plan a number of activities, for example. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 10 of

11 The service was very keen that people were involved in helping develop the service they lived in. For example, 'participatory funding' had been made available by the organisation. In bidding for this money, people were able to discuss with each other what would make their lives better or more enjoyable. We saw that they had come up with a range of individual and group activities or purchases that would be beneficial. These had included garden equipment, days away and establishing an activities group everyone could come to. The Richmond Fellowship had an annual satisfaction questionnaire that they sent to families and relatives. There was also a survey for people using the service called' How well are we doing'. We looked at the results of these and saw that people were happy with the service they received. Information about advocacy services was available. Advocacy and advocacy workers help people to think about and tell others their opinions about what is important to them. This can be useful where people have difficulties with communicating their wishes to others. The service had a complaints procedure. This provided opportunities for people to raise issues formally if they were unhappy with the service. The complaints leaflet was available in a picture version that people could understand more easily. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 11 of

12 Areas for improvement The service should continue to develop ways to help the people using the service and staff communicate to give people opportunities to be involved in assessing the quality of care. In its self-assessment the service said it hoped to develop their use of electronic systems to make it easier for people using the service to participate in quality improvement. We saw that a few support and care plans had not been reviewed formally at least every six months. We did see that a monthly summary was prepared each month for each person by support workers. We were also told that it had been difficult to organise some reviews. We reminded staff it was the service's responsibility to ensure an evaluative review took place so that everyone with an interest could have their say (see recommendation 1). Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The service should ensure that all personal plans are reviewed at least once in every six month period and where there is significant change in a service user's health, welfare or safety needs or when requested to do so by the service user or their representative. National Care Standards, Housing Support Services, Standard 4 - Support arrangements and Care at Home, Standard 3 - Your personal plan. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 12 of

13 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued People using the service had detailed support, care plans. These were called Personal Support and Development Agreements. Plans were of a very good standard. These contained information about the health needs each person had and the health professionals and staff members responsible for their care. Support workers were responsible for ensuring care plans were up to date and that people using the service and their relatives were involved in regular reviews. We looked at eight support files. We saw that these contained well written guidelines for staff about how to help people using the service meet their health and well-being needs. These included: * Managing personal care * Managing routines throughout the day * information about medical conditions * supporting people with GP and other health professional appointments and supporting people to manage appointments or procedures they found difficult, for example, attending hospital. Each person had a useful guide to take with them to help hospital staff provide good care during their stay, sometimes called a 'hospital passport'. In some services we saw that outcome focussed support plans were in use. Each person had specific goals they were working on to help develop new skills and behaviours or achieve particular goals. This meant people using the service and staff had clear targets to work towards The working file was put together with family, relatives and health professionals' help as the person being supported was not able to provide information. We found that people using the service had good contact with a range of health professionals, speech and language therapists, occupational therapists and community learning disability nurses. This meant a more holistic care plan was developed. Staff we spoke with said they were familiar with the health needs of people using the service. Some staff clearly had in-depth knowledge and knew people really well. Staff were able to discuss health problems that had affected people using the service, which health professionals were involved and how they had dealt with any concerns. File notes showed the range of health professionals people using the service had recent contact with. One relative said 'the home (name) is in is homely and can cater for his needs with The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 13 of

14 very caring staff. Staff protect and preserve his dignity as much as possible'. Another said '(name) has excellent care. No complaints whatsoever'. Food and nutrition issues were described in great detail. Staff were aware of the need to monitor and support the diets and eating patterns of the people in the service. We saw that individual care plans had been developed. These included strategies to help manage a range of issues and concerns. People using the service were assisted to take part in outdoor activities and take exercise. Different kinds of activities were encouraged to help improve peoples' wellbeing. Staff were sensitive to peoples' need to socialise with others and ways to achieve this. Activities were monitored to ensure that these took place and there was variety. Staff were responsible for helping many people take their medication. The Richmond Fellowship had a medication policy and procedure and required staff to complete training. Staff we spoke with said they were confident with managing medication and had been given training. Areas for improvement Inspection report continued We looked at a sample of medication administration records. We found that these had been completed correctly on the whole though there were a few gaps in recording. However when we looked at team meeting minutes and incident records we saw that other medication errors had been referred to. Although we did see that actions had been taken to, for example, contact a person's GP or NHS 24 for advice about any actions required, we have made a recommendation about the need to take care when administering medication (see recommendation 1). Overall, risk assessments had been completed annually though some had not been reviewed for over one year. Some did not have review dates included. It was also not clear how some risk assessments were reviewed and decisions made about whether changes were needed. It was also unclear if risk assessments were always discussed with the person using the service (see recommendation 2). We saw that the service used fluid balance records to keep track of the amount of liquids an identified person was taking in, where this was a specific support requirement. There were also weight charts in use. Most were well completed. However some were recorded inconsistently. The service should ensure that when they are in use the purpose is clear for all staff and that they are monitored. Where a chart is no longer in use then that should be stated. At feedback we suggested that the information recorded in the monthly reviews of support should clearly evaluate the work carried out and how this helped people meet their goals. These records could then be used to inform the reviews of the care plan. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 14 of

15 Some staff said they were anxious about using tracking hoists. We discussed this with the manager. At feedback we were told that up to date training had taken place to ensure all staff felt confident using the equipment. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 2 Recommendations 1. The service should ensure that staff are aware and reminded of the need to take care when medication is being administered, and that this is recorded correctly. National Care Standards, care at Home, Standard 8 - Keeping well - medication. 2. The service should ensure that risk assessments are reviewed as required and at least by the set date for review. Where possible, risks which apply to the person using the service are recorded in ways that help people understand the risks in their lives and promotes ways to help people manage these. People should be involved in determining the risks. National Care Standards, Housing Support Services, Standard 3 - Management and staffing arrangements and Standard 4 - Housing support planning. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 15 of

16 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 Please also see statement 1.1. People using the service and their carers were able to take part in the recruitment of staff. This might include identifying the qualities staff need, meeting applicants during interview and taking part in the interview meeting. Areas for improvement The service should continue to develop how the people they support take part in recruitment and staff development. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 16 of

17 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Inspection report continued The service told us that all staff completed induction training over a four week period. This included training days that introduced staff to the organisation, the service, its policies, aims and objectives. Staff were trained in managing medication, moving and assisting, food hygiene and managing behaviours positively. Dependant on the needs of people in a service staff might also be trained in mental health first aid or CALM. New staff also shadowed experienced workers in the service they were to work in during this period. This meant staff were able to observe others in work and begin to understand how to communicate with people using the service. A training needs analysis system was in place, held centrally. This meant there was a training record for each staff member. This meant the service was aware what training staff had done or were required to do and could help ensure all staff were up to date with the training the service expected them to have. A training calendar let staff know when training was planned in the coming year. Staff said that the service was good at providing them with training. We saw that they discussed their needs in support and supervision meetings or in the annual appraisal. This included refresher days for mandatory training as well as training directly relevant to the work they were doing. A wide range of relevant training was offered. The Richmond Fellowship was committed to helping staff gain Scottish Vocational Qualifications (SVQs) at level 2/3. This would mean they had a relevant qualification when they had to register with the Scottish Social Services Council. Some staff had completed the award. The organisation had its own assessment centre and some senior staff were trained as assessors. Staff we spoke with said they had support and supervision with their manager regularly in line with the organisation's support and supervision policy. They said they found the meetings helpful. We saw that a record of meetings was kept and that these were signed. An appraisal of performance took place each year. Staff said they would discuss if they had achieved their own objectives from the previous year, set new ones and plan their training for the year. Staff said they could speak to their manager or senior if they had problems or issues and would not wait for a supervision meeting. They said that the support they received from managers was very good, whether in person or by phone. They also said they felt able to report poor practice and were aware the service had a policy that would support them to do this. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 17 of

18 We asked staff about morale in the service. Some said morale was very good while others thought it was more mixed. We thought this was about how consistent every member of staff was in carrying out work tasks. This was also related to confidence in work. Senior staff told us about the things they did to help build peoples' confidence, including practical demonstrations, monitoring staff in work and providing direct care as part of the support team. Areas for improvement We looked at a number of staff files. We saw that a some staff were not supervised in line with policy. We also saw that some staff working set patterns did not receive supervision regularly nor were they able to attend team meetings. We discussed this with the service and they agreed that they would resolve this with those concerned. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 18 of

19 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 Please see statements 1.1 and 3.1. We found that people the service supports and their families have opportunities to influence and control the management of their individual service. The organisation carried out surveys which give families, relatives and people receiving support other ways to have a say about what the service could do better. People using the service were able to influence how 'participatory funding' was used to improve opportunities and activities where they lived. This gave people more choice about what they could do locally, or to take part in specific events. Some people also took part in a local forum where they help decide activities in the area, improving opportunities for others using the service. Areas for improvement It was less clear how people being supported or their family's influence the review and development of the service at local or organisational levels. The service could think about how to develop this further. It is also important that all people using the service have opportunities to help shape the wider policies and developments within this service. This means that while there may be communication challenges for meaningful consultation with some people the service could ensure that participation systems capture as many peoples' views as possible. This might also, for example, see people who use the service take part in assessing their own and other services. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 19 of

20 Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide Service strengths The strengths we found in statements 1.1, 3.1 and 4.1 may also apply in this statement. We saw that the systems to check, maintain and improve the quality of the service were well. These included: * Staff support and supervision meetings * Monthly team meetings * Incident and accident records * Complaints Inspection report continued We saw that spot checks to measure staff performance could also be carried out. This helped local managers assess the quality of service and whether staff needed additional support or training. The service uses a National Evaluation Tool (NET) that is completed by team managers. This asked them to measure their own teams' performance against how well they carry out person centred planning, continuous learning development and planning, policies, procedures and documentation and health and safety. Areas for development are then included in an action plan. We spoke with managers, seniors and staff and asked them how they knew that the service they were providing was good enough. They said they knew the people using the service. This meant they became quickly aware if anything was wrong and could take action as necessary. We saw that the managers and staff had built up good relationships with the people using the service and with many relatives. When something goes wrong in a service, for example, if a service user has a serious accident, the Manager has to tell the Care Inspectorate. This is called a notification. Managers were aware of their responsibility. The Care Inspectorate fully supports the principles of the Learning Disability national strategy - The Keys to Life. The service had copies of the strategy and the inspector discussed with staff the importance of implementing the recommendations in order to support continuous service improvements and better outcomes for people using the service. We will be assessing progress during our inspections in 2015/16. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 20 of

21 Areas for improvement One service we visited had an 'office' within the home. Staff are visitors to peoples' homes and are not entitled to have office space. This should be provided elsewhere, by the organisation. This means the minimum amount of files and records are kept at the person's home, sufficient to provide a service. These may be locked in a cupboard to provide security as required. A laptop computer may be kept where records are held electronically. Staff told us that occasionally team meetings and support and supervision meetings took place in one house. Sometimes this was when people using the service were not present. All staff meetings must take place away from peoples' homes (see recommendation 1). Further, when all the tenants are away from their home staff should not be in the house nor use the facilities. We looked at some financial records for people using the service. We saw that there had been some problems with how these were recorded. However during the inspection the manager and senior worker agreed to ensure that all transactions have two signatures, one being the service users whenever possible. Training was also to be given to staff to ensure they understood the importance of accurate record keeping. We looked at another financial concern. We saw how the service had dealt with the issue and the staff concerned. We thought this had been managed adequately but made some suggestions to ensure that staff understood the need to follow financial procedures. We also said this should have been notified to the Care Inspectorate (see recommendations 2 and 3). One notification made to the Care Inspectorate had not been updated. The service agreed to do this. At feedback we also discussed whether local managers, based on their job responsibilities, should now be registered with the SSSC. The Area Manager for the service said they would investigate this further. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 3 Recommendations Inspection report continued 1. The service should ensure that it adheres to the conditions of registration by ensuring that staff do not use a service user's home as an office base or as a venue for supervision/ appraisal or other staff meetings. Staff should not be in the house when the tenants are out. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 21 of

22 National Care Standards - Housing Support Services, Standard 3 - Management and staffing arrangements and Standard 7 - Exercising your rights and Care at Home, Standard 9 - Private Life. 2. The service should ensure that all staff understand the organisations procedures for managing money, and that these are adhered to. National Care Standards, Care at Home, Standard 4 - Management and staffing. 3. The service should ensure that it notifies the Care Inspectorate, and updates notifications, in line with the guidance and time scales. National Care Standards, Care at Home, Standard 4 - Management and staffing. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 22 of

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). The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 23 of

24 5 Summary of grades Quality of Care and Support Very Good Statement 1 Statement Very Good 5 - Very Good Quality of Staffing Very Good Statement 1 Statement Very Good 5 - Very Good Quality of Management and Leadership Very Good Statement 1 Statement Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 24 Jan 2014 Unannounced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 23 Oct 2012 Announced (Short Notice) Care and support Staffing Management and Leadership 5 - Very Good 6 - Excellent 5 - Very Good 14 Jun 2010 Announced Care and support 5 - Very Good Staffing Not Assessed Management and Leadership 5 - Very Good 30 Oct 2009 Announced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership Not Assessed 3 Nov 2008 Announced Care and support 4 - Good Staffing 4 - Good The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 24 of

25 Management and Leadership 5 - Very Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 25 of

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: The Richmond Fellowship Scotland - Stirling, Clackmannanshire and Falkirk, page 26 of