Real Care Agency Housing Support Service Glenburn House 35 Glenburn Road East Kilbride Glasgow G74 5BA Telephone:

Transcription

1 Real Care Agency Housing Support Service Glenburn House 35 Glenburn Road East Kilbride Glasgow G74 5BA Telephone: Inspected by: Jim Brannigan Type of inspection: Unannounced Inspection completed on: 24 August 2012

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 12 4 Other information 28 5 Summary of grades 29 6 Inspection and grading history 29 Service provided by: Real Care Agency Ltd Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Jim Brannigan Telephone enquiries@careinspectorate.com Real Care Agency, page 2 of 31

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 4 Good Quality of Staffing 4 Good Quality of Management and Leadership 4 Good What the service does well The service involves people in their care and support where possible. Care staff offer good, reliable support to people using the service and the service regularly checks that people using the service are happy. Information received from people using the service is audited and used to improve the service provided. What the service could do better The service could improve the system of supervision and appraisal and how staff are involved in the service. The service could review staff training and development to ensure that staff have the opportunity to further develop their skills. The service could improve how it involves carers in the running of the service. What the service has done since the last inspection The service has developed opportunities for people using the service to be involved in their care and support, the service has collated this information and taken action where necessary to resolve any issues.the service has introduced new personal support plans for service users, these contain good detail and people using the service had been involved in developing these.regular supervision was taking place and attendance at staff meetings has improved Real Care Agency, page 3 of 31

4 Conclusion Inspection report continued We saw that the service provides people with good quality care and support. People using the service stated that they were happy with the support provided and felt that care staff met their needs well. Who did this inspection Jim Brannigan Real Care Agency, page 4 of 31

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 The Care Inspectorate will award grades for services based on findings of inspections. Grades for this service may change after this inspection if we have to take enforcement action to make the service improve, or if we uphold or partially uphold a complaint that we investigate. The history of grades which services have been awarded is available on our website. You can find the most up-to-date grades for this service by visiting our website, by calling us on or visiting one of our offices. Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve its service, we may make a recommendation or requirement. - A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service but where failure to do so will not directly result in enforcement. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reforms (Scotland) Act 2010 and Regulations or Orders made under the Act, or a condition of registration. Where there are breaches of the Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Inspectorate. Real Care agency is a service, which provides care at home, and housing support services to people who live in their own homes. The service supports people who have a wide range of support needs. The service aims "to provide high quality care to help support people who live at home for as long as possible and is their wish to do so". Before 1 April 2011 this service was registered with the Care Commission. On this date the new scrutiny body, Social Care and Social Work Improvement Scotland (SCSWIS), took over the work of the Care Commission, including the registration of care services. This means that from 1 April 2011 this service continued its registration under the new body, SCSWIS. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 4 - Good Quality of Staffing - Grade 4 - Good Quality of Management and Leadership - Grade 4 - Good Real Care Agency, page 5 of 31

6 This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. Real Care Agency, page 6 of 31

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 COMPLETED We compiled the report following an unannounced inspection. The inspection was carried out by Care Inspector Jim Brannigan. We wrote this report after an unannounced inspection that took place between am and pm on 24 August As requested by us, the provider sent us an annual return. The provider also sent us a self assessment form. We issued 80 questionnaires people who use the service and to friends, relatives or carers of people who used the service. Twenty five completed questionnaires were returned before the inspection. We issued fifty nine questionnaires to staff. Nineteen completed questionnaires were returned before the inspection. In this inspection we gathered evidence from various sources, including the relevant sections of policies, procedures, records and other documents: evidence from the service's most recent self assessment; action plan; personal plans of people who use the service; care worker induction pack; induction training plan; staff files; staff training certificates; staff training evaluation form; staff training plan; service leaflet; Real Care Agency, page 7 of 31

8 feedback sheets; support plans; analysis of in house service user questionnaires; samples of completed in house service users questionnaires; staff meeting minutes; participation strategy; recruitment policy; information pack; written agreement; questionnaires that had been requested, filled in and returned to the care service from people who use the service and their relatives; questionnaires that had been requested, filled in and returned to the care service from staff; and discussion with various people including: - the manager the office manager and; - care staff; Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. 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 Real Care Agency, page 8 of 31

9 What the service has done to meet any recommendations we made at our last inspection Outstanding recommendations are commented on under the relevant Quality Themes and Statements. 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. 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 that we grade them under. The service provider identified what they thought they did well, some areas for development and any changes they had planned. The service provider told us how the people who used the care service had taken part in the self assessment process. Taking the views of people using the care service into account We sent out eighty questionnaires and thirteen were completed and returned to us before our inspection. When asked about the overall quality they receive in this service: eight people indicated that they were very satisfied; five people indicated that they were satisfied; one person indicated that they were not satisfied; six people who use the service said that they did not know about the services complaints procedure and did not know that they could make a complaint to the Care Inspectorate; three people said that the service does not ask for their opinions; Real Care Agency, page 9 of 31

10 three people said that staff did not have enough time to carry out the agreed support and care; four people said their needs and preferences were not detailed in their personal plan; four people said their personal plan did not contain information about their support needs; two people said that they were not confident that staff had the skills to support them; two people said that the service does not check regularly with them that they are meeting their needs. These issues were brought to the attention of the service. We received the following comments: ' If you get a different carer they do not identify themselves to you and very often they don't know how to deal with your needs. ( They do not shadow long enough and if you question them long enough they tell you they are going on a training course.in my opinion that should be done before they are let loose on the public.' ' I have had the same carers for the last five years,providing continuity of service and have always had the opportunity to meet new carers prior to them being allocated to me. The standard of care I receive is exemplary. Any concerns which I have expressed have always been dealt with timeously and efficiently by the agency and to my entire satisfaction.' ' Real Care Ltd. provides good quality care and is very user friendly.' ' I am very happy with my care and carers.' ' Very happy with my care assistant.' 'All the girls that come into my home and provide my care are lovely and just like family to me. All my carers go an extra mile for me.' Taking carers' views into account Carers include parents, guardians, relatives, friends and advocates. They do not include care staff. Real Care Agency, page 10 of 31

11 We sent out eighty questionnaires and twelve were completed and returned to us before our inspection. When asked about the overall quality they receive in this service: six people indicated they were very satisfied; six people indicated they were satisfied; six people who use the service said that they did not know about the services complaints procedure and did not know that they could make a complaint to the Care Inspectorate; two people said that the service does not ask for their opinions; one person said that staff did not have enough time to carry out the agreed support and care; one person said their needs and preferences were not detailed in their personal plan; three people said that the service does not check regularly with them that they are meeting their needs; one person said they did not know the names of the staff providing their care. These issues were brought to the attention of the service. We received the following comments in questionnaires:- ' The staff who attend my relative are very good. The carers who attend my relative have the skills to deal with his needs. The carers have always kept up to date with my relatives needs. They communicate well with my relative. They always treat my relative with respect and kindness which is important to me.' ' Real Care supply a first class care package.any minor complaints are immediately dealt with'. ' Plan has not been updated in a year and my relative has changed significantly in that time.i have not spoken to anyone from the company in over a year although I have regular correspondence with the woman who come into care for my relative.' ' We would like to be notified of names of carers who are covering for our regular carers when they go on holiday. This request has been made on several occasions including their written questionnaires but still has made no difference. Other than that they are always very helpful and reliable.' ' Sometimes there is a lack of consistency if the regular carer has to go to another job. This can be difficult for my relative to cope with. If it is a different person the alloted is insufficient as they have to get to the next client.' Real Care Agency, page 11 of 31

12 3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths We found that this service was performing well in the areas covered by this statement. We concluded this after we: spoke to the manager; the office manager; care staff; reviewed care plans; The care service involved the people who use the service and their relatives and carers and asked for their views in several ways. These included: in house questionnaires, which are distributed annually, to ask people who use the service and their relatives about a range of issues, including the quality of care and support they receive; We saw a range responses from the questionnaires that had been completed. The majority were satisfied with the service they received with a minority raising some concerns;we saw good evidence of the service responding to service concerns for example, some service users said they did not have a care plan or log book and some were unsure how to make a complaint and the service was responding appropriately to address these issues; client quality assurance questionnaires, which are distributed annually, to ask people who use the service and their relatives about a range of issues, including the quality of care and support they receive; We saw a range responses from the Real Care Agency, page 12 of 31

13 questionnaires that had been completed;we saw good evidence of the service responding to service concerns for example, one service user wanted to know who would be covering her care when her carer went on holiday and this information was given to the service user contact response forms;we saw good evidence that staff were able to raise issues in response to comments and concerns raised by people who use the service, for example, a care worker was concerned that a service user did not have the correct hoist equipment. This was addressed by the service and the correct hoist was supplied; field supervisor visits;which are carried out regularly and people and carers are asked for their views and opinions during the visit; service user home visit form;where people who use the service are visited periodically and asked for their views and opinions and we saw good evidence of any issues raised being addressed for example a change of care hours and change of care worker; people who use the service played an active part in the inspection through the completion of Care Inspectorate questionnaires. we saw that the service now records how it responds to request made from service users by telephone e.g.requests to change times, providing additional care due to a change in circumstances,changing the care carried out at service users request; regular review meetings; and regular one to one discussions with people who use the service. We saw that an appropriate written a participation strategy was in place which details how the service involves service users in all aspects of how they are looked after for example client quality assurance questionnaires and service users questionnaires. We sampled two care plans which detailed individual preferences and these were reviewed regularly. It was clear that staff encouraged and valued service users to express their comments and opinions. We saw that the service had developed a good range of opportunities for service users and carers to participate in assessing and improving the quality of care and support provided through the service users questionnaires and discussions with staff. Areas for improvement Inspection report continued The service is maintaining current good standards and continuing to improve. The care service should continue to monitor and maintain the standards of quality. They should ensure they are rigorous in identifying any areas for improvement and implementing action plans to address these. Real Care Agency, page 13 of 31

14 We said at the last inspection that the number of people responding to in 'Client Feedback Summary' was relatively small when compared to total number of people who use the service. We saw at this inspection that this had increased to twenty eight out of a total of seventy eight service users.however,it was not clear how many of the twenty eight respondents were people who use the service. We saw at this inspection that a total of thirty two people out of seventy eight people who use the service responded to the Quality Assurance Questionnaire. This was a significant improvement on the previous year. We made one recommendation at the last inspection as detailed below:- The ways in which the service involved people who use the service and their carers was limited and could be improved. We said at the last inspection that the manager was still exploring ways to improve service user and carer involvement. The service had yet to access the documents signposted at the last inspection,the National Standards for Community Engagement and the Ladder of Participation. Improving participation was discussed during the inspection and some ideas were identified,e.g. improving the number of respondents to in house surveys,improving the quality and detail of the information recorded in Field Supervisor Home Visits and developing service user and relatives meetings. We saw some improvement at this inspection,however,we thought that there was still areas where further improvements could be made as previously discussed and detailed above. This recommendation was not met and is restated. (see Recommendation 1) Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. The service should develop the range of ways in which they involve the people who use the service and their carers in all aspects of the service which takes into account all the quality themes and statements.we signposted the service to the National Standards for Community Engagement and the Ladder of Participation for Real Care Agency, page 14 of 31

15 information, ideas and guidance. (National Care Standards, Care at Home, Standard 4 Management and Staffing). Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued We found this service was performing at a good level in the areas covered by this statement. The care service ensured that people's health and wellbeing needs were being met in several ways: These included: we thought that the care plans which we saw had good information about service users' health care needs, and how they should be met; e.g. two care staff to hoist,prompt to take medication,medication stored in fridge; we thought that the information for staff in care plans on the tasks to be carried out was detailed and informative and person centred. e.g.service User will decide if food is to be thrown out; we thought that the way care plans were written supported peoples choices and promoted Independence; we saw good evidence from the plans that advice and assistance continued to be obtained from the community medical and nursing services, as required e.g. Community Nurse administers insulin; we saw that regular reviews were being carried out; we thought that the information in care plans was person centred and promoted independence; we saw some good examples of some people taking part in activities which promoted self worth, and psychological well being e.g. Going shopping. Areas for improvement The service is maintaining good standards. The care service should continue to monitor and maintain the standards of quality. They should ensure they are rigorous in identifying any areas for improvement and implementing action plans to address these. Real Care Agency, page 15 of 31

16 Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 6 People who use, or would like to use the service, and those who are ceasing the service, are fully informed as to what the service provides. Service strengths Inspection report continued This statement focuses on progress made to address recommendations from the last inspection and the information below is included for clarity. We found that this service was performing well in the areas covered by this statement. We concluded this after we: spoke to the manager; the office manager; examined completed questionnaires;and reviewed the information given to people who use the service and their carers; The care service informs the people who use the service and their relatives and carers as to what the service provides in several ways. These included: the service user agreement which included detailed information on the services aims and objectives,code of values,service users rights, tasks that care workers will and will not carry out; the agreement included a timetable of when and on what days care would be provided; we saw that the service user agreement was signed by the service user and by Real Care; we saw a sheet with details of Real Care charges; a client handbook which included detailed information on confidentiality, recruitment, personal finances and key holding, withdrawal of service and how to complain, including the name, address and telephone number of SCSWIS; we saw appropriate policies for managing risk and recording accidents and incidents; we saw the information included contact telephone numbers for the service. Real Care Agency, page 16 of 31

17 Areas for improvement The service is maintaining current very good standards and continuing to improve. The care service should continue to monitor and maintain the standards of quality. They should ensure they are rigorous in identifying any areas for improvement and implementing action plans to address these. The information we saw did not include the latest inspection report from SCSWIS. We saw at this inspection that the inspection report was not included in the information pack. This recommendation is not met is restated and re-worded. ( 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 the information provided to people who use the service and their carers includes the Care Inspectorate web site address to access the most recent Care Inspectorate inspection report. (National Care Standards, Care at Home, Standard 1-1:Informing and Deciding ). Real Care Agency, page 17 of 31

18 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths See comments under Quality Theme 1.1. Areas for improvement See comments under Quality Theme 1.1. We saw at this inspection that the manager has tried to involve service users in the recruitment process with limited success. We thought this was a good start and should continue. One recommendation was made at the last inspection in relation to recruitment and this is restated. (see Recommendation 1). Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The service should consider and develop service user participation in the recruitment process. The service recruitment policy should be adapted to reflect service user and carer involvement. (National Care Standards, Care at Home, Standard 4 Management and Staffing). Statement 2 We are confident that our staff have been recruited, and inducted, in a safe and robust manner to protect service users and staff. Service strengths This statement focuses on progress made to address recommendations from the last inspection and the information below Real Care Agency, page 18 of 31

19 is included for clarity. We found that this service was performing well in the areas covered by this statement. We concluded this after we: we looked at number of staff files to assess how effectively the provider implemented safer recruitment; the recruitment process included seeking at least two references, one of which was from the candidate's previous employer; recruitment for core staff involved a formal interview with management; staff were aware of the aims and objectives of the service; we saw that a staff handbook was in place to ensure staff understood the services aims and objectives and policies and procedures; we saw that staff files contained copies of staffs qualifications to ensure that qualification requirements of Scottish Social Services Council (SS SC) were being met; enhanced disclosures were in place for staff; the service is a counter-signatory under the Protection of Vulnerable Groups Scheme' Areas for improvement The service is maintaining good standards. The care service should continue to monitor and maintain the standards of quality. They should ensure they are rigorous in identifying any areas for improvement and implementing action plans to address these. One recommendation was made at the last inspection in relation to the recruitment policy. The services recruitment policy was not up to date with best practice. We saw at the last inspection that the recruitment policy had not yet been updated. We saw that the recruitment policy had been reviewed and updated in May We were satisfied that this recommendation has been met,however, the policy should include the at least one reference must be from a previous employer and what the service will do if they have any concerns as a result of disclosures or references, in line with best practice. Real Care Agency, page 19 of 31

20 We saw that the service had a copy of 'Safer Recruitment through Better Recruitment'-Scottish Government (2007). This recommendation was met. Grade awarded for this statement: 4 - 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 Inspection report continued We found this service was performing at a good level in the areas covered by this statement. We concluded this after we: we saw that a supervision policy was in place which was attached to the supervision records; we saw that the service had a good induction programme and a induction handbook was issued to new staff; we saw some examples of training certificates in staff files, e.g moving and handling,adult protection; we saw good examples in the staff files that we looked at of regular supervision taking place and these were recorded and signed by staff and management; staff that we spoke with said that regular supervision took place; staff that we spoke with had a good knowledge of, whistleblowing,confidentiality and adult protection; staff spoken with were familiar with the national care standards and the Scottish Social Services Council (SSSC) codes of practice; we saw that some staff had obtained a Scottish Vocational Qualification (SVQ) level II and/or III in Health and Social Care, equivalent or above; we saw that a rolling programme was in place for staff to achieve an SVQ Level II in Health and Social Care, equivalent or above; the majority of staff said in Care Inspectorate questionnaires that they had access to training opportunities in the last 12 months and that their training needs were being met. Areas for improvement We found that the service was performing at a good level in this Quality Statement. Real Care Agency, page 20 of 31

21 The care service should continue to monitor and maintain the standards of quality. They should ensure they are rigorous in identifying any areas for improvement and implementing action plans to address these. We did not see any annual appraisals in place. ( see Recommendation 1 ) The staff files that we saw did not have an individual training record,individual training plan,individual personal development plan and did not have copies of all certificates of training attended. ( see Recommendation 2 ) We signposted the service to the Scottish Social Services Council (SSSC) publication, 'The Framework for Continuous Learning in Social Services' for information and guidance. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 2 Recommendations Inspection report continued 1. The manager should ensure that annual appraisals take place for all staff. ( National Care Standards, Care at home - Standard 4: Management and Staffing Arrangements,National Care Standards, Housing Support Services - Standard 3:Management and Staffing Arrangements) 2. The manager should ensure that all staff have an accurate and up to date individual training record,individual training plan and individual personal development plan. Copies of any training certificates attended/awarded should be held in individual files. ( National Care Standards, Care at home - Standard 4: Management and Staffing Arrangements,National Care Standards, Housing Support Services - Standard 3:Management and Staffing Arrangements) Real Care Agency, page 21 of 31

22 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths See comments under Quality Theme 1.1. Areas for improvement See comments under Quality Theme 1.1. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 2 We involve our workforce in determining the direction and future objectives of the service. Service strengths This statement focuses on progress made to address recommendations from the last inspection and the information below is included for clarity. We found this service was performing at a good level in the areas covered by this statement. We concluded this after we: saw some evidence of regular staff meetings taking place with good evidence of staff being able to raise issues for example service user issues; we saw that attendance at staff meetings had improved; the manager has made a start in developing ways in which staff can influence the service through staff meetings; staff indicated that they had access to and received suitable training to do their job; we saw that the service has a supervision procedure in place, however, this was not currently being implemented and this was confirmed by staff; Real Care Agency, page 22 of 31

23 staff indicated that management were approachable and they were able to raise any issues or concerns that they had.they said they were confident in management and they addressed any issues raised. Areas for improvement The service is maintaining good standards. The care service should continue to monitor and maintain the standards of quality. They should ensure they are rigorous in identifying any areas for improvement and implementing action plans to address these. We made three recommendations at previous inspections. None of the recommendations had been met at the last inspection and were restated. This was discussed at some length during the last inspection and the manager acknowledged the importance of addressing the outstanding recommendations and has made a firm commitment to do so. All staff had not received regular supervision or appraisal. All staff did not have a personal development plan. This has been reported on under Quality Statement 3.3 and a recommendation has been made. This recommendation will be removed. Some staff attended staff meetings, however, the manager acknowledged these were poorly attended. We saw at this inspection that attendance at staff meetings had improved.however,we thought this could be further developed and improved. This recommendation is not met and is restated (see Recommendation 1) It was not clear how staff were keeping up to date with developments in the care sector. (see Recommendation 2) Real Care Agency, page 23 of 31

24 Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 2 Recommendations 1. The manager should encourage all care staff to attend staff meetings. The service should develop ways to involve staff in the management of the service, for example, staff questionnaires. (National Care Standards, Care at Home, Standard 4 Management and Staffing). 2. The manager should ensure that staff keep up to date with developments in the care sector. (National Care Standards, Care at Home, Standard 4 Management and Staffing). Statement 3 To encourage good quality care, we promote leadership values throughout the workforce. Service strengths Inspection report continued This statement focuses on progress made to address recommendations from the last inspection and the information below is included for clarity. The service was found to be performing at a good standard in this quality statement. We concluded this after: we saw that staff received thorough induction training which included SSSC codes of practice, working with dementia handbook, the home care workers handbook, emergency first aid and food hygiene handbook; we saw that staff received an induction pack and this was signed by staff to confirm they had read and understood the services policies and procedures; we saw that the service carried out regular spot checks and these were recorded; we saw that staff were skilled in carrying out there duties; staff indicated that they had access to the services policies and procedures and to training opportunities; we saw that the service had clear information on the training staff had received; we saw that staff had a copy of SSSC Codes of Practice; Real Care Agency, page 24 of 31

25 we saw that the service has a supervision procedure in place and supervision had now taken place for the majority of care staff; the majority of staff indicated that their training needs were being met by the service. Areas for improvement The service is maintaining good standards. The care service should continue to monitor and maintain the standards of quality. They should ensure they are rigorous in identifying any areas for improvement and implementing action plans to address these. The implementation of the recommendations made under Quality Theme 4.2 will strengthen performance in this statement. One recommendation was made at the last inspection. This was discussed at the last inspection and the manager shared some of his ideas to address this recommendation, for example, developing a library. We saw at this inspection that this was still being developed This recommendation was not met and is restated. The service did not have a culture which encouraged staff to develop and learn.staff were not proactive in their own individual development, as detailed in the SSSC Codes of Practice for employers and employees. (see Recommendation 1) Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The manager should promote leadership values throughout the workforce as detailed in SSSC codes of practice. (National Care Standards, Care at Home, Standard 4 Management and Staffing ). SSSC codes of practice Employers of Social Services Workers : Training and development Real Care Agency, page 25 of 31

26 SSSC codes of practice Social Service Workers : Improving knowledge and skills Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide Service strengths Inspection report continued We found this service was performing at a good level in the areas covered by this statement. We concluded this after we saw: The Manager was now aware of the services responsibility to report to Scottish Social Services Council (SSSC) any staff dismissed on the grounds of misconduct; The Manager was also aware that the service must provide SSSC information it may require about members of staff; we saw that the service had copies of the Care Commission Notification Guidance and the Manager knew of her responsibility to notify the Care Commission of matters of misconduct including theft; the service obtained feedback from service users, carers, staff and other stakeholders through questionnaires and visits; we saw that regular meetings were held with staff and these were minuted; we saw that that relative/carers questionnaires had been issued; Staff said they received regular supervision and this was recorded; Staff participated in regular training; we saw that the service had an appropriate complaints procedure; the service had a process to advise service users if their were any changes to their care package. Areas for improvement The service is maintaining good standards. The care service should continue to monitor and maintain the standards of quality. They should ensure they are rigorous in identifying any areas for improvement and implementing action plans to address these. How staff, service users, carers and other stakeholders are involved in assessing the quality of the service could be further developed. (see Recommendation 1 ) Real Care Agency, page 26 of 31

27 The service could improve how it records what action it has taken to address concerns raised. ( see Recommendation 2 ) Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 2 Recommendations Inspection report continued The service should further develop ways to demonstrate that staff, service users, carers and other stakeholders are involved in the quality assurance process and identify issues which are raised and how these are addressed. The Officer recommends accessing the Scottish Government publication 'How Good is Our Team '. ( National Care Standards, Care at home - Standard 11:Expressing Your Views,National Care Standards, Housing Support Services - Standard 8: Expressing Your Views ) The manager should ensure that clear records are in place to respond to the service evaluations, these are clearly dated and record what action has been taken to address any issues identified. ( National Care Standards, Care at home - Standard 11:Expressing Your Views,National Care Standards, Housing Support Services - Standard 8: Expressing Your Views ) Real Care Agency, page 27 of 31

28 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 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). Real Care Agency, page 28 of 31

29 5 Summary of grades Quality of Care and Support Good Statement 1 Statement 3 Statement Good 4 - Good 5 - Very Good Quality of Staffing Good Statement 1 Statement 2 Statement Good 4 - Good 4 - Good Quality of Management and Leadership Good Statement 1 Statement 2 Statement 3 Statement Good 4 - Good 4 - Good 4 - Good 6 Inspection and grading history Date Type Gradings 21 Jul 2011 Unannounced Care and support 4 - Good Staffing 4 - Good Management and Leadership 3 - Adequate 5 Nov 2010 Announced Care and support 4 - Good Staffing 4 - Good Management and Leadership 3 - Adequate 15 Sep 2009 Announced Care and support 4 - Good Staffing 3 - Adequate Management and Leadership 4 - Good Real Care Agency, page 29 of 31

30 28 Nov 2008 Announced Care and support 3 - Adequate Staffing 3 - Adequate Management and Leadership 3 - Adequate All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Real Care Agency, page 30 of 31

31 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: Real Care Agency, page 31 of 31