Hanover Care at Home / Housing Support Service - Dalry Support Service Care at Home Morris Court James Street Dalry KA24 5FB

Transcription

1 Hanover Care at Home / Housing Support Service - Dalry Support Service Care at Home Morris Court James Street Dalry KA24 5FB Inspected by: Kirsty Porter undefined Type of inspection: Unannounced Inspection completed on: 23 May 2013

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 10 4 Other information 18 5 Summary of grades 19 6 Inspection and grading history 19 Service provided by: Hanover (Scotland) Housing Association Ltd Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Kirsty Porter Telephone enquiries@careinspectorate.com Hanover Care at Home / Housing Support Service - Dalry, page 2 of 20

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 Service users continue to express satisfaction on the quality of service they receive. The service provides a housing support service and where needed, care to individuals in their own homes. Socialisation opportunities are available. The on-site staff offer a responsive and flexible service. Service users value the Independence and security that living in Morris Court affords them. Hanover continues to place value on gathering the views of people who live in Morris Court. The areas we looked at during this inspection showed that the health and well being needs of service users continue to be well managed. Staff training and development processes remain very good. Quality assurance systems in the service were well established and of a very good standard. What the service could do better The service should develop recording systems to enable them to evidence the full extent of the flexible and responsive nature of the support provided at Morris Court. What the service has done since the last inspection The service has maintained the very good standards in place. The service had introduced electronic training methods. Hanover Care at Home / Housing Support Service - Dalry, page 3 of 20

4 Conclusion Inspection report continued The service continues to achieve a very good level of performance across all of the statements we looked at. The management and staff continue to offer a very good quality care at home and housing support service. Providing a flexible person centred service remains a priority of the management team. The management plan to introduce ways of evidencing the full extent of this flexible support arrangement. Hanover continue to involve service users and their families in assessing and improving the service to ensure their ongoing satisfaction. Service users and their relatives continue speak highly of the quality of service received at Morris Court. Who did this inspection Kirsty Porter undefined Hanover Care at Home / Housing Support Service - Dalry, page 4 of 20

5 1 About the service we inspected Social Care and Social Work Improvement Scotland (Care Inspectorate) is the new regulatory body for care services in Scotland. It will award grades for services based on the findings of inspections. The history of grades that services were previously awarded by the Care Commission is also available on the Care Inspectorate website. Hanover Housing Support / Care at Home Service - Dalry provide a support service to older people and people with physical disabilities who live in their own homes in Morris Court. The service is provided from a purpose built premises in a residential area of Dalry, North Ayrshire. The service was registered with Social Care and Social Work Improvement Scotland on 01 April 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 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. Hanover Care at Home / Housing Support Service - Dalry, page 5 of 20

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 This report was written following an unannounced inspection on 23 May 2013 between the hours of 11:00 am - 7 pm. During this inspection evidence was gathered from a number of sources including: Sampled care files Reviews Home Care visit schedule Minutes of residents, relatives and staff meetings Training & Supervision records Registration and Insurance certificates Accident & Incident records Complaints comments systems Audit systems and records Observation of Interaction between service users and staff Discussion with service users, staff and managers Care services quality surveys Care Standard Questionnaires Care Services self assessment 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 Hanover Care at Home / Housing Support Service - Dalry, page 6 of 20

7 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 Hanover Care at Home / Housing Support Service - Dalry, page 7 of 20

8 The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: 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 for 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 heading we grade them under. The service provider identified what they thought they did well, some areas of development and any changes they had planned. Taking the views of people using the care service into account We received 4 completed questionnaires from service users. One respondent strongly agreed and 2 agreed, that overall, they were happy with the quality of the care service. One respondent did not know. One comment was made: "Since Hanover has taken over responsibility for care in Morris Court, the service has improved considerably and is of the highest standard." We met 7 service users on the day of the inspection. Everyone told us that they were happy with their arrangements. They all made positive comments about the staff who work in the service. They said that they had regular care staff who were reliable. If they were going to be late they were informed. People told us that they could join in with the arranged social events and share their meals in the dining room with other tenants if they wanted to. Service users spoke very positively about the environment. They commented on feeling reassured that staff were on site an that they responded quickly if help was required. One person commented that most people stayed in their rooms and that it could be a bit boring. Comments included: Hanover Care at Home / Housing Support Service - Dalry, page 8 of 20

9 "ideal, care is excellent, " you know who is coming" "very happy, well maintained grounds, pleasant staff, meals good, no complaints" "staff attentive, more like friends, well maintained, no complaints" "good staff - friendly" "sometimes times and carers change, no complaints at all" "happy here" Taking carers' views into account We received 5 completed questionnaires from relatives. One questionnaire was incomplete and was not used. Four respondents strongly agreed and 1 agreed, that overall, they were happy with the quality of the care service. One relative said that they were happy with the way that staff had helped their family member overcome a health condition. Another said, "Once again I can only say I am so thankful that my [relative] lives in this complex. The staff are great and I know my [relative] is in a safe and secure environment". Hanover Care at Home / Housing Support Service - Dalry, page 9 of 20

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 The grade awarded at the last inspection on 11 December 2012 was 5 - Very Good. This grade had been maintained. The provider had a dedicated Tenant Participation Officer. Written information about the organisation's participation strategy was provided in a folder in service users homes. The self assessment identified that the provider had been consulting with service users about their new Tenant Participation Strategy. This showed that the organisation placed value on participation. There was evidence that the service gave importance to obtaining the views of service users. People who used the service told us that the management and staff were approachable and they could discuss their care and support needs with them. We saw records of monthly visits that the manager made to each individual service user to ask them for their comments on the quality of the service. There was a meeting schedule and we could see that the service took account of comments made. Service users also had the opportunity to attend an annual Tenant's Meeting. There were separate regional focus group meetings held by the organisation. No one from this service chose to attend this meeting with senior managers from the company. The service used questionnaires to gather the views of service users. Service users had support plans detailing their housing support or care at home Hanover Care at Home / Housing Support Service - Dalry, page 10 of 20

11 needs. There was evidence that they had been involved in this process. There was evidence of formal care reviews to evaluate the care / support provided. Hanover had a magazine which gave service users information about service developments. The service also used social media methods to communicate information. Service users had paperwork in their homes telling them how to complain or make a comment or suggestion and how to obtain support from the local advocacy service. The service supported people with dementia. The service had arranged to have input from an individual with a professional interest in dementia to help them to gather the views of individuals who have cognitive impairment or other communication difficulties. Areas for improvement Inspection report continued The provider planned to develop a questionnaire to gather the views of stakeholders such as social workers and health professionals who are involved in the service. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths The grade awarded at the last inspection on 11 December 2012 was 5 - Very Good. This grade had been maintained. We looked at some personal plans for people who received a housing support service and a care in their home. We found that they contained satisfactory detail to direct staff about each persons support needs and preferences. Service users, or their representative, had signed their support plans. Personal plans had been evaluated and audited every month. Copies of these were stored in each individuals home. Medication records were completed where staff supported service users with prescribed medicines. We could see that the service completed risk assessments where they had identified specific issues. These aimed to reduce risk and promote safety whilst taking account of the choices made by service users. The service had a staff "sleepover" arrangement in place to deal with situations overnight. The people who use the service found it reassuring that a known member Hanover Care at Home / Housing Support Service - Dalry, page 11 of 20

12 of staff was only a phone call away if they needed help. Inspection report continued The service had a stable team of housing support and care staff. This was also reassuring for service users. They told us that they knew when and what staff member to expect to support them. They were told if a staff member was behind schedule or if there was a change to their regular worker. The service users told us that they got on well with the staff. Staff completed records of visits made; they included the time of arrival and a brief description of the support given. Records did not show when the staff member left. We were told that this was due to a flexible service being provided and that all stakeholders were happy with this arrangement. This meant that some service users had their allocated time spread across the day rather than all at once as detailed in their agreement. The management stressed the advantages of this arrangement as it meant that service users got care and support when they needed it. Housing support staff checked on individuals wellbeing with a telephone call or a visit at an agreed time. Staff completed records of this type of contact made. Staff also checked that the alert system used to summon assistance was working every month. This helped to promote a feeling of safety and security for people living in Morris Court. There was an appropriate process for reporting accidents and any incidents where people had required help overnight. There was also a brief handover between shifts. There was evidence that socialisation was encouraged at Morris Court. Records showed activities including regular musical entertainment, beauty treatments, DVD shows etc. Service users told us that they benefited from having the privacy of their own home and the opportunity to socialise with others if they chose in the public lounges and in the dining room at mealtimes. The service arranged weekly social events. The service had arranged a summer fete to raise funds for social activities. Areas for improvement At the last inspection we made a recommendation: Record keeping must be improved to evidence the full extent of care and support offered to service users. National Care Standards: Care at Home Standard 4 Management and Staffing Arrangements. We looked at staff rotas/visit sheets. We compared these to peoples service agreements and allocated care hours. We found that the visit sheets did not always concur with the individuals agreed care time. It appeared that some people did not receive their full allocation of care hours. We could not confirm how long staff spent with service users as they recorded only the time when they entered the service users Hanover Care at Home / Housing Support Service - Dalry, page 12 of 20

13 home and not when they left. It is acknowledged that no service users reported any concerns to us. The manager explained that peoples care could be spread across the day in accordance with their preferred routines and need. We accepted that the on site nature of the care at home service facilitated a more flexible approach to care at home/housing support. We acknowledge the positive outcomes of this approach for service users. However, it remains our view that record keeping must be improved to evidence the full extent of care and support offered to service users. The management accepted this comment and are keen to demonstrate the level of service provided. The management had arranged for input from senior staff within the organisation to support them with this process. They planned to implement a new style of personal planning to facilitate this. This recommendation is repeated. See recommendation 1. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. Record keeping must be improved to evidence the full extent of care and support offered to service users. National Care Standards: Care at Home - Standard 4: Management and Staffing Arrangements. Hanover Care at Home / Housing Support Service - Dalry, page 13 of 20

14 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 grade awarded at the last inspection on 11 December 2012 was 5 - Very Good. We found that the care service had made improvements to how they consulted service users and relatives about the quality of staffing in the service. The grade awarded is 5 - Very Good. The evidence stated in Quality Theme 1, Statement 1 is also relevant for this Quality Statement. Service users are able to express their views about the staff in satisfaction surveys and during the manager's monthly visit that was made to service users in their homes. There was evidence that service users had been invited to participate in recruiting staff. Areas for improvement The manager should continue to build upon very good practice in place. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths The grade awarded at the last inspection on 11 December 2012 was 5 - Very Good. We found that the care service had maintained this grade. Staff had access to a range of company policy documents to direct them in their day to day working practice. Staff had signed to confirm that they were aware of updates to policy documents. Best practice guidance information was also available to them. Hanover Care at Home / Housing Support Service - Dalry, page 14 of 20

15 Staff meetings took place on a monthly basis. The staff reported "good team work" within the service. They felt well supported by the manager. This contributed to a motivated staff team. Staff had regular supervision with the manager and an annual performance appraisal. This process was used to establish staff training needs. This information was passed to the organisations Learning and Development Officer and used to update the Learning and Development programme. We heard that the organisation planned to change the existing staff appraisal system to a competency based performance review. The training provided to the staff team included mandatory health and safety related training and other subjects relevant to the needs of the service users such as: fire safety, health and safety, medication administration, dementia awareness, moving and handling, food hygiene, first aid and adult support and protection. We heard that the manager had attended an instructors course to allow her to provide moving and handling training to the staff. The organisation had introduced "e learning" computer based training and planned to develop Staff had achieved or were working toward a minimum SVQ Level III award. This met the requirements of the Scottish Social Services Council (SSSC). A staff survey had been completed by the organisation. Once again it showed that staff employed by the organisation thought that Hanover was good to work for. The organisation published a staff Newsletter to keep the workforce up to date with organisational changes and developments. The association had a staff award scheme to acknowledge and reward contributions made by individual staff members. Staff told us that they knew how to report a complaint or concern and of the service whistle-blowing procedures. All of people who returned questionnaires to us indicated that they thought that the staff had the skills to support service users. Areas for improvement The service management should continue to build on the very good practice in place to ensure that staff training and development needs are met. The service should consider the introduction of a process of formal evaluation and reflection of how training undertaken may improve practice and outcomes for service users. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Hanover Care at Home / Housing Support Service - Dalry, page 15 of 20

16 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 grade awarded at the last inspection on 11 December 2012 was 5 - Very Good. We found that this grade is maintained. The evidence stated in Quality Theme 1, Statement 1 is also relevant for this Quality Statement. As discussed previously, service users at Morris Court are afforded opportunities throughout the year to meet with members of the senior management team. Areas for improvement The service should continue to build upon the existing good practice in place. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide Service strengths The grade awarded at the last inspection on 11 December 2012 was 5 - Very Good. We found that the care service had maintained this grade. Strengths in statement 1.1 also apply to this statement. We found very good quality assurance systems in place. The service manager completed a monthly audit of care records. This was done by visiting service users in their homes. This took account of contact sheets, medication administration records, risk assessments and support plans. This included a section for service user or relative views or comment form other stakeholders such as health professionals. Any action that needed to be taken was recorded. The external manager also completed monthly audits. This took account of staff training,and development processes and vacancies. Monitoring of service users Hanover Care at Home / Housing Support Service - Dalry, page 16 of 20

17 wellbeing took the form of sampling support plans, service user meetings and discussion about individual tenants. Comments cards and information about how to make a complaint had been given to service users. Areas for improvement We suggested that the monthly audits conducted by the manager could be more detailed to show what aspects of record keeping the manager was actually checking. The services self assessment indicated that they were developing a stakeholder questionnaire to gather the views of individuals from external agencies who have an interest in the care service. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Hanover Care at Home / Housing Support Service - Dalry, page 17 of 20

18 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). Hanover Care at Home / Housing Support Service - Dalry, page 18 of 20

19 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 11 Dec 2012 Unannounced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 12 Oct 2011 Announced Care and support 5 - Very Good Staffing 4 - Good 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. Hanover Care at Home / Housing Support Service - Dalry, page 19 of 20

20 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: Hanover Care at Home / Housing Support Service - Dalry, page 20 of 20