Streets Ahead (Borders) - Galashiels/ Melrose Housing Support Service Eildon House Dingleton Road Melrose TD6 9QY Telephone:

Transcription

1 Streets Ahead (Borders) - Galashiels/ Melrose Housing Support Service Eildon House Dingleton Road Melrose TD6 9QY Telephone: Inspected by: Therese Glendinning Type of inspection: Announced (Short Notice) Inspection completed on: 4 February 2013

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 11 4 Other information 26 5 Summary of grades 27 6 Inspection and grading history 27 Service provided by: Streets Ahead (Borders) Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Therese Glendinning Telephone enquiries@careinspectorate.com Streets Ahead (Borders) - Galashiels/Melrose, page 2 of 28

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 4 Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well Support was being provided in a person centred and outcomes focused manner. The service valued the involvement and views of people supported and their relatives. There were very good communication networks with relatives and other professionals and health services. Management had extensive knowledge and understanding of each person supported which enabled the workers to be effectively supported in their roles. What the service could do better The service should progress with the areas of improvement identified in this report. The service should review how they support people with their financial transactions. What the service has done since the last inspection The registered manager of the service had been supporting another service but this was not at the detriment of this service. The deputy manager had been acting up in the management position effectively. Two neighbourhood workers were acting up as senior staff. The organisation was currently reviewing the management cover for all their services from which a decision will be made as to the registered manager of this service. Streets Ahead (Borders) - Galashiels/Melrose, page 3 of 28

4 Conclusion This is a well managed service, provided by a team of committed staff. The service should continue to build on its strengths while taking forward areas for improvement identified in this report. Who did this inspection Therese Glendinning Streets Ahead (Borders) - Galashiels/Melrose, page 4 of 28

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 in August 2004 as a combined Housing Support and Care at Home Service and transferred its registration to the Care Inspectorate on 1 April 2011 Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve its service, we may make a recommendation or requirement. - A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service but where failure to do so will not directly result in enforcement. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reforms (Scotland) Act 2010 and Regulations or Orders made under the Act, or a condition of registration. Where there are breaches of the Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Inspectorate. Streets Ahead (Borders) Ltd provides a Housing Support and Care at Home service to people with learning disabilities and/or mental health problems who live in the Scottish Borders area. The main office is located in Hawick with the Galashiels/ Melrose branch operating from an office in Melrose. The service referred to users of the service as "people supported". Therefore in this report we make the same reference. There were 19 people receiving a service from the Galashiels/Melrose branch at the time of the inspection. Of these 11 received twenty four hour support in several localities including Galashiels, Tweedbank, Melrose, St Boswells and Jedburgh. Visiting support was provided to eight people who had individual hours of support each week based on their specific support needs. The service provides person centred support to service users in their own homes or in their family homes. An on call service out with office hours was provided. The Organisation's philosophy of care is based on the "Five Accomplishments", which aims to assist people with severe disabilities to form and maintain the variety of ties and connections that constitute community life. Streets Ahead (Borders) - Galashiels/Melrose, page 5 of 28

6 The Organisation aims to "offer support, guidance and practical help in a way that ensures that the Rights, Dignity and Individuality of each person are the foundation of the plans we develop and agree." Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 4 - Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. Streets Ahead (Borders) - Galashiels/Melrose, page 6 of 28

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 a short notice announced inspection that took place on Wednesday 30 January between 09:15 and 16:15 and Thursday 31st January 2013 between 09:15 and 15:45. Feedback was given to the service on Monday 4th February 2013.The inspection was undertaken by Therese Glendinning, Inspector, Care Inspectorate. As requested by us, the service sent us a completed annual return. The service also sent us a completed self assessment form. We sent out seven care standards questionnaires to people getting support and received six completed forms back prior to the inspection. We sent out 20 care standards questionnaires to staff and received eight completed forms back prior to the inspection. During the inspection we met and had discussions with the registered manager, acting manager and executive director. We had discussions with two neighbourhood workers and met two additional workers when visiting people supported in their homes. We met with three people who were supported by the service in their own homes in the Galashiels, and St.Boswells localities. During these visits we observed the interaction between the people supported and support staff and management. We spoke with two relatives of people supported. Streets Ahead (Borders) - Galashiels/Melrose, page 7 of 28

8 In this inspection we gathered evidence from various sources, including: Registration certificate Service annual return and self assessment Insurance certificate Service Information brochure Newsletters Support Plans Medication and financial records Diaries Communication books On- call records Health & safety checklists Staff training and supervision records Staff files Minutes of team and other organisational meetings Policies and procedures Satisfaction surveys 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 Streets Ahead (Borders) - Galashiels/Melrose, page 8 of 28

9 What the service has done to meet any requirements we made at our last inspection The requirement Requirement 1: The Provider's medication procedure must be reviewed and updated. Royal Pharmaceutical Society guidelines must be followed in respect of administration, recording and disposal of medicines. The updated procedures must be rolled out to staff. This is to comply with: Scottish Statutory Instrument 2002 No 114 The Regulation of Care (Requirements as to Care Services) (Scotland) Regulations 2002 Regulation 4 (1) (b) which is a requirement that services make proper provision for the health and welfare of service users. Timescale: within 1 month of receipt of this report. What the service did to meet the requirement The services medication policy and procedures had been reviewed and revised following the last inspection. The last review had been undertaken in January 2012 and a 2013 review was planned. Medication training based on the revised procedures had been held on four occasions since the last inspection. With services where twenty four hour support was provided a daily night time check on medication was undertaken. The requirement is: Met What the service has done to meet any recommendations we made at our last inspection There was one recommendation from the previous report which has been repeated. Further details are reported in quality statement 1.1. 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 Streets Ahead (Borders) - Galashiels/Melrose, page 9 of 28

10 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. The Care Inspectorate 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 we grade them under. The service provider identified what they thought they did well, some areas for development and any changes that they had planned. Taking the views of people using the care service into account People who used the service gave positive replies to our care inspectorate questionnaires. Questionnaire results showed that 100% of responses from service users either strongly agreed or agreed they were happy with the quality of support the service provided. The service users we met during the inspection all told us they were happy with the service they received. Additional references to service user's views have been made in this report. Taking carers' views into account We spoke with two relatives during this inspection. Both expressed very good satisfaction with the service provided. Comments included:- "They are very knowledgeable about my relatives needs". "The support service gives me peace of mind". "They have created a programme of support that suits his needs". Additional references to relatives views have been made in this report Streets Ahead (Borders) - Galashiels/Melrose, page 10 of 28

11 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 Streets Ahead had signed up to the National Involvement Networks "Charter for Involvement" which was written by a group of people who use services in Scotland, and, includes 13 statements saying how they want to be involved in how organisations provide support, plan and run the services. The organisation had a participation strategy. We saw an action plan for 2013 for further participation in relation to people supported, and, relatives participation in staff induction, staff meetings, and staff appraisals. A pictorial questionnaire to gauge the person's views on their support workers had been piloted in a sister project and was due to be rolled out in this service for staff appraisals. The organisation provided recruitment training for people supported. Some of the people supported had undertaken the training and had been part of the interview process for new staff. Through this process the views of people supported influenced the recruitment of future support workers. Some family members and carers of people supported by the organisation were on the management board and participated in decision making relating to the organisation. Streets Ahead (Borders) - Galashiels/Melrose, page 11 of 28

12 We saw good evidence of family and carers working together with the service for the benefit of their relatives who were receiving the service. We saw evidence in staff communication books, team meeting minutes, support plan records and s. Communication covered staff cover for the coming weeks, planning reviews, holiday arrangements and passing on information about care and health needs. Management would visit relatives, where required, to give updates and discuss any concerns they had. Relatives we spoke with told us they were kept regularly informed and that the service listened to their views. On commencement of the service a written support agreement between the service and supported person was drawn up. This document was user friendly, using graphics and plain language to ensure the agreement was understood by the person who was to be supported. The service ensured that each person had a full review of their support service every six months. We saw the review planner for 2013 which had the reviews planned out for the year. We saw that relatives, social work and other professionals attended the review meetings. The format of the review enabled the person supported to voice their views on all aspects of the service. We saw evidence from meeting minutes that the service would organise meetings with the person supported at any time to discuss any concerns either party may have. The organisation had commenced publishing a newsletter since the last inspection. We saw the second and third editions for April and November 2012 respectively. The newsletter gave people supported an avenue to participate in organisational news, the giving of information and a sense of community. The main news reporter for the newsletter was a person supported by Streets Ahead. News items included information about the history of Streets Ahead, names on photographs of staff who had recently completed SVQ qualifications, competitions, recipes, articles about activities and holidays people supported had undertaken. There was an interview with a local authority representative to find out about self direct support. The newsletter was posted out to people supported, family, staff and other stakeholders. Each week people supported would be informed as to which support workers would be providing support to them for the next again week which provided reassurance and positive anticipation. Streets Ahead (Borders) - Galashiels/Melrose, page 12 of 28

13 Completed Care Inspectorate satisfaction questionnaire responses showed that100% of people supported either strongly agreed or agreed the service checked regularly to ensure they were meeting the person's needs. Of the six responses five agreed the service asked for the person's opinions on how it could improve whilst one did not know. Areas for improvement At the last inspection the following recommendation had been carried forward from the previous inspection. It is recommended that the service develop its introductory pack to include the information as stated in National Care Standards: Care at Home and Housing Support. Progress:- The organisations information brochure gave details about the organisation but was not specifically aimed for potential and new people to be supported. A pack had not been developed. Through discussions with the service we were told new people supported were given copies of the complaints procedures and other information with the brochure. A formal pack would ensure the service gave all appropriate information to each new person and provide evidence this was undertaken. This recommendation will be repeated. (see Recommendation 1). This support agreement should include details about arrangements to end the support agreement by both parties. (see Recommendation 2). Following the full review of the support service the review document was typed up and put in the person's support plan. From those sampled, we could not see a signature from the person supported to show the document had been checked and read through with the person to show agreement that the review record was a true reflection of the meeting. (see Recommendation 3). Streets Ahead (Borders) - Galashiels/Melrose, page 13 of 28

14 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 3 Recommendations 1. It is recommended that the provider develops an introductory pack to include the information as stated in National Care Standards: Care at Home and Housing Support - Standard 1:1 National Care Standards. Care at Home & Housing Support - Standard 1.1: Informing and deciding. 2. The provider should ensure the written support agreement between themselves, as provider, and each user of the service, includes details about arrangements for ending the agreement by both parties. National Care Standards. Care at Home & Housing Support - Standard 2: The written agreement. 3. The provider should ensure completed support review documents are checked and read through with the person supported and signed by the person, to show agreement with the details recorded from the review meeting. National Care Standards. Care at Home - Standard 3: Your personal plan. Housing Support - Standard 4: Housing support planning. Streets Ahead (Borders) - Galashiels/Melrose, page 14 of 28

15 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Each person supported had a support plan which we could see was a live document and updated when support needs changed. This was confirmed by support workers who told us support plans were reviewed at team meetings and where changes were identified plans were updated speedily. During the inspection we sampled three support plans The plans were sectioned out which enabled information to be easily accessed. The plans included the support agreement, personal details, "my support review", details in case the person went missing, "keeping myself safe" and other appropriate plans in relation to health and emotional well being. The plans were well detailed and provided a very good record of how to support the person in relation to all their support needs. Most people supported had a personal diary in which support staff would record, with the person, the day's events. For people who received less support the service had a specific document to record the support and events and a monthly summary was completed. We found all recordings to be respectful to the person and gave a good reflection of events. Throughout this inspection we could see the service's main focus was always on the individual needs of the people supported. The service provided a variety of support for each individual. These included support with personal care, medication, social activities, accessing other services, financial and welfare benefits support, doctor and hospital visits, mail and letters, attending appointments, emotional support, tenancy and household management, shopping and daily living skills. The service provided support to some people with their finances. This included support to go to the bank to withdraw money, to pay bills and to budget. Where 24 hour support was being provided we found appropriate records were held to track the movement of monies. Where appropriate, support was given in menu planning, and examples seen evidenced that nutritious meals and plenty of fresh fruit were promoted. Daily planners were also used with some people. Support workers followed a weekly planner based on the person's individual routines. In this way people maintained their routines which were very important for their emotional wellbeing. Streets Ahead (Borders) - Galashiels/Melrose, page 15 of 28

16 Throughout the inspection we were given substantial evidence of the service working effectively with other professionals, including the social work learning disability team and other service providers to ensure the physical health and emotional needs of people supported were met. Evidence was gained through accessing s, communication books, team meeting minutes and support plans. Through discussion we could see the management of the service had extensive knowledge and understanding of each person supported which enabled the workers to be effectively supported in their role. During the inspection we observed the interaction between support workers and management with people supported. We found workers and management to present in a respectful manner, giving encouragement with the use of appropriate humour. We could see very good rapport which showed the positive relationships that were established. People supported were encouraged to be a part of the community. The payment of rent and bills was often undertaken by going into the town to make those payments which gave people additional purpose for the day. Role play about what, when and how events would happen was undertaken prior to going out and undertaking an activity to ensure success for the person. To further ensure the success of outings or short breaks a "planned short break or planned outing" analysis was undertaken. These included considering the cost, mode of transport and associated risks. People supported were encouraged to undertake activities and to socialise. Just prior to the inspection one of the people supported whom we met had hosted a "Burns Supper" night which had been most successful for all who attended. Areas for improvement Where 24 hour support was being provided we found support workers had custody of the person's cash money which was held in a secure money tin in the sleepover room. There was no legal status e.g. corporate appointeeship, guardianship or financial power of attorney to support the service having custody of people's cash money except in two cases. We were told one person's parents were legal guardians and another person was under corporate appointeeship with a solicitor being the appointee. However, there was no written documentation to support this. (see Requirement 1). Streets Ahead (Borders) - Galashiels/Melrose, page 16 of 28

17 All support plans we sampled showed they had been reviewed and updated over the last six months as per legal requirements. However, there was no evidence to show that people supported were involved in the updating of information in their support plans. The service should ensure that people supported are fully involved in the updating of their support plan and sign either the plan itself or corresponding document to show involvement and agreement with the plan. (see Recommendation 1). When a new person commenced receiving support the service would use the information provided from the funding authority in relation to medication support needs. We recommend the service undertakes a specific medication risk assessment when the service commences and subsequent risk assessments every six months or more frequently when it is identified the person's needs have changed. (see Recommendation 2). Grade awarded for this statement: 4 - Good Number of requirements: 1 Number of recommendations: 2 Requirements 1. The provider must cease having custody of service users' cash money where there is no legal requirement or status to do so. Risk assessments must be undertaken to assess the risk in relation to each person having possession of their own cash money and where substantial high risks are identified, action should be taken with the person, family and funding authority to minimise risk. Where the service works with the person's appointee or guardian to ensure the financial safety of that person, appropriate risk assessments and signed agreements must be in place and regularly reviewed. A copy of the appointee/ guardianship certificate should be held by the service. This is in order to comply with The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011(SSI 2011/210) Regulation 4 (1) (a) Welfare of users - a requirement that the provider ensures the health, welfare and safety of service users. Timescales for implementation - within three months of receipt of this report. Streets Ahead (Borders) - Galashiels/Melrose, page 17 of 28

18 Recommendations 1. The provider should ensure that people supported are fully involved in the updating of their support plan and sign either the plan itself or corresponding document to show involvement and agreement with the plan. National Care Standards. Care at Home - Standard 3: Your personal plan. Housing Support - Standard 4: Housing support planning. 2. It is recommended that the provider undertakes a specific medication risk assessment at the commencement of a support service and subsequent risk assessments every six months or more frequently when it is identified the person's needs have changed. National Care Standards. Care at Home - Standard 8:Keeping well - Medication. Streets Ahead (Borders) - Galashiels/Melrose, page 18 of 28

19 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 comments we wrote in Quality Statement 1.1 also apply to this statement. We have given this statement the same grade as Quality Statement 1.1 Areas for improvement The comments we wrote in Quality Statement 1.1 also apply to this statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Streets Ahead (Borders) - Galashiels/Melrose, page 19 of 28

20 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Through discussions and sampling of staff files we could see the induction process for new support workers was intensive and thorough. Induction could last from six months to one year depending on the support needed for both parties to be confident the staff member had the required skills and knowledge. As part of the induction process an induction diary was completed to enhance development into the role of support worker. We found the service had a strong ethos for professional growth and development through reflective practice and subsequent learning. Each support worker had a yearly appraisal and a personal development plan in place. A programme of supervision sessions was currently being undertaken and workers were encouraged to complete a reflective practice record to gain learning from supporting experiences. We saw copies of completed reflective accounts which showed the worker had learnt from the experience and how practice would be adjusted. Records showed 35% of support workers had either SVQ2 or SVQ3 qualifications. There were three workers currently undertaking this qualification. There was mandatory training for support workers to complete. These included: what is a learning disability, communication and engagement, medication, food hygiene, infection control, first aid, adult protection, physical intervention, fire and health and safety, support planning and moving and handling where required. There was a staff training plan prepared for Support workers told us training opportunities were also made available in relation to specific needs of people supported, which ensured workers were able to provide the appropriate and needed support. Team meetings took place every month. Support workers told us they were able to contribute to the agenda, they were able to voice their views at the meetings and that decisions made at the meetings were based on collective discussions and decision making. Minutes of the meetings were made available to workers. Support workers told us, and questionnaire responses confirmed, that workers knew about the services whistleblowing, adult protection and participation policies and procedures. Streets Ahead (Borders) - Galashiels/Melrose, page 20 of 28

21 The type of support provided by this Streets Ahead service required a high level of lone working. The service ensured the safety of both people supported and workers by having an effective on-call system. This included telephone and text contact between the on-call and worker at the end of each support session when in the community and at the end and the start of each day for workers providing twenty four hour support. Where people were supported to go on short breaks extensive plans and itineraries were prepared and regular telephone contact was maintained throughout the time period. All support workers who completed Care Inspectorate questionnaires stated they felt safe at work. Completed Care Inspectorate satisfaction questionnaire responses showed that five people either strongly agreed or agreed that they were confident staff had the skills to provide the support and that staff treated the person with respect. One person did not know. From Care Inspectorate satisfaction questionnaires completed by support workers and from workers we met during the inspection we were told their training needs were met, they had regular supervision and team meetings and the service asked their opinion on how it could improve. One worker told us "I have worked within the company for 11 years and my training needs, opinions and thoughts have always been listened to and met over the years". Areas for improvement The service had a high percentage of support workers who required training in food hygiene and infection control. This training was scheduled to be delivered in April and June 2013 respectively. We discussed the service reviewing the training schedule to ensure this training is given at an earlier date with management. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Streets Ahead (Borders) - Galashiels/Melrose, page 21 of 28

22 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 comments we wrote in Quality Statement 1.1 also apply to this statement. We have given this statement the same grade as Quality Statement 1.1 Areas for improvement The comments we wrote in Quality Statement 1.1 also apply to this statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Streets Ahead (Borders) - Galashiels/Melrose, page 22 of 28

23 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 Evidence from all previous quality statements also apply to this statement in relation to people supported and workers being involved in assessing the quality of the service provided. The service was supported with appropriate policies and procedures which had been reviewed and revised in January These included an appropriate medication policy and procedure which used the Boots Medisure System. Where people had high levels of support, support workers completed a daily checklist both in the morning and evening. The checklist covered security and health and safety of the property to ensure the safety of people supported. The service undertook a monthly health and safety checklist which recorded the number of accidents and incidents that had occurred. Details were summarised, actions taken and further actions required were recorded. This included whether the Care Inspectorate required notification. This audit information was passed to the organisations health and safety committee which met every three months. Since the last inspection a relatives satisfaction survey had been undertaken. We saw the completed questionnaires which showed relatives were very satisfied with the support provided by the service. Comments included:- "Manager and support staff work together to fulfil my requests that I ask for". "I believe that my relative is receiving the best possible care and I am greatly indebted to you all". "I have plenty of contact with staff who look after my relative". "I am very satisfied with the way we are kept informed of events". Management had an "open door" policy, with people supported and relatives often visiting the office on a planned and unplanned basis. Management evidenced they were skilled in problem solving and finding positive solutions for people supported. The organisation was currently reviewing all quality assurance processes with an aim to have maximum participation through a comprehensive survey of people supported, family and other stakeholders. Streets Ahead (Borders) - Galashiels/Melrose, page 23 of 28

24 Through discussions with management and people supported we were aware management visited people supported on a regular basis, particularly the services were 24 hour support was provided. During those visits the manager would check on the person's satisfaction with the service and all the supporting systems and recordings. Areas for improvement We discussed the quality assurance visits with management who agreed it would be beneficial to formally record the findings from each visit and any actions required as part of the service's quality assurance processes. We will follow this up at the next inspection. The organisational complaints procedure gave a description of the processes the people supported should take when making a complaint. Complaining to the Care Inspectorate was given as an option if complaining through the organisation was found to not be satisfactory. People can complain to the Care Inspectorate at any time. (see Recommendation 1). Both the comments and complaints policy and procedures and the introductory brochure had reference to the former Care Commission. The complaints document also had the incorrect address and telephone number of the Care Inspectorate. (see Recommendation 2). Information from the completed relatives surveys should be collated, analysed and reported on with an appropriate action plan and outcomes reviewed to ensure the continual development of the service. (see Recommendation 3). Streets Ahead (Borders) - Galashiels/Melrose, page 24 of 28

25 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 3 Recommendations 1. The provider should make arrangements to amend all literature related to the complaints procedure to make it clear that complaints can be made to the Care Inspectorate at any time, without using the service's own procedure first. National Care Standards. Care at Home - Standard Expressing your views. Housing Support - Standard Expressing your views. 2. The provider should update its literature and change references to the former Care Commission to the Care Inspectorate with the correct address and telephone number. National Care Standards. Care at Home - Standard 4: Management and staffing. Housing Support - Standard 3: management and staffing. 3. The provider should ensure information gathered from all satisfaction surveys is collated, analysed and reported on with an appropriate action plan and outcomes reviewed to ensure the continual development of the service. National Care Standards. Care at Home - Standard 11: Expressing your views and Standard 4: Management and staffing. Housing Support - Standard 8 - Expressing your views and Standard 3: Management and staffing Streets Ahead (Borders) - Galashiels/Melrose, page 25 of 28

26 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 The service gave us an appropriate action plan. 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 SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1). Streets Ahead (Borders) - Galashiels/Melrose, page 26 of 28

27 5 Summary of grades Quality of Care and Support Good Statement 1 Statement Very Good 4 - Good Quality of Staffing Very Good Statement 1 Statement Very Good 5 - Very Good Quality of Management and Leadership Very Good Statement 1 Statement Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 18 Jan 2011 Announced Care and support 4 - Good Staffing Not Assessed Management and Leadership Not Assessed 9 Feb 2010 Announced Care and support 4 - Good Staffing 4 - Good Management and Leadership Not Assessed 19 Jan 2009 Announced Care and support 4 - 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. Streets Ahead (Borders) - Galashiels/Melrose, page 27 of 28

28 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: Streets Ahead (Borders) - Galashiels/Melrose, page 28 of 28