Independent Living Services - ILS Clyde Valley & Lanarkshire Housing Support Service Dalziel Building G5, 7 Scott Street Motherwell ML1 1PN

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1 Independent Living Services - ILS Clyde Valley & Lanarkshire Housing Support Service Dalziel Building G5, 7 Scott Street Motherwell ML1 1PN Inspected by: Kirsty Porter Mina Cassidy Type of inspection: Unannounced Inspection completed on: 19 December 2011

2 Inspection report continued Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 13 4 Other information 29 5 Summary of grades 30 6 Inspection and grading history 30 Service provided by: Independent Living Services (ILS) Ltd Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Kirsty Porter Telephone enquiries@scswis.com Independent Living Services - ILS Clyde Valley & Lanarkshire, page 2 of 31

3 Inspection report continued 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 3 Adequate Quality of Staffing 3 Adequate Quality of Management and Leadership 3 Adequate What the service does well The service is making progress in developing care plans for people. The service is making improvements to scheduling visits in order that a consistent reliable service is provided. The service had good ways of involving staff in how the service is run. There were good recruitment practices in place. What the service could do better The service needs to continue to closely monitor the revised staff rotas to ensure that schedules provide a reliable and consistent service and better continuity of care for people. The service should continue to make improvements to the assessments and care plans in place so that they can provide care and support in a way that suits peoples preferences and needs. The service need to continue to develop how they monitor and assure quality. They should involve people using services, relatives carers and others with an interest in the care service. Independent Living Services - ILS Clyde Valley & Lanarkshire, page 3 of 31

4 What the service has done since the last inspection This is the first inspection of this service since registration. Inspection report continued Conclusion There has been significant changes in the organisation in recent months. This has affected the geographical areas covered, the management and the day to day running of the service. The new management team are aware of the issues around the scheduling of visits in the service. They presented as being committed to sustaining improvements and continuing to develop the service. The service should continue to build on recent improvements in relation to recommendations and requirements we have made. Who did this inspection Kirsty Porter Mina Cassidy Independent Living Services - ILS Clyde Valley & Lanarkshire, page 4 of 31

5 Inspection report continued 1 About the service we inspected Independent Living Services (ILS) is an established organisation offering combined Housing Support and Care at Home services across Scotland. The service has undergone a recent restructure. The service can provide care to a range of people 24 hours a day, 7 days a week. Support packages and provided on an individual basis, according to their assessed needs. The service can be contracted privately or through Local Authorities. Before 1 April This service was registered with the Care Commission. On this date the new scrutiny body, Social Care and Social Work Improvement Scotland ( Care Inspectorate), took over the work of the Care Commission, including the registration of care services. This means that from 1 April 2011, this service continues its registration under the new body. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 3 - Adequate Quality of Staffing - Grade 3 - Adequate Quality of Management and Leadership - Grade 3 - Adequate 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. Independent Living Services - ILS Clyde Valley & Lanarkshire, page 5 of 31

6 Inspection report continued 2 How we inspected this service The level of inspection we carried out In this service we carried out a high intensity inspection. We carry out these inspections where we have assessed the service may need a more intense inspection. What we did during the inspection We wrote this report following an inspection that had both announced and unannounced elements. The inspection was carried out by inspectors, Kirsty Porter and MIna Cassidy. The inspection process took place between the dates of 17 October and 19 December During this period we: Spoke to 7 people using the service or their relatives/carers. Visited 3 people at their home on 25 October Made visits to the office on17 & 18 October 2011 to sample records, speak with management and staff. Spoke to 3 staff by telephone and 2 in the office. We sent out: Forty questionnaires via the provider to people who use the service, relatives and carers, 15 were returned Forty questionnaires via the provider to staff, 6 were returned. In this inspection we gathered evidence from various sources including: the services self assessment personal plans of people who use the service minutes of staff meetings staff training and recruitment records records of courtesy calls audit paperwork complaints records staff work rotas service user visit schedules Newsletter Independent Living Services - ILS Clyde Valley & Lanarkshire, page 6 of 31

7 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 report continued 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 Independent Living Services - ILS Clyde Valley & Lanarkshire, page 7 of 31

8 Inspection report continued What the service has done to meet any requirements we made at our last inspection The requirement The provider must provide services in a manner which respects the privacy and dignity of service users by telling service users about changes to staff providing care. This is in order to comply with: SSI 2011/210 Regulations 4(1)(b) - Welfare of users Timescale for implementation: within 24 hours of the issuing of this letter. What the service did to meet the requirement The service submitted an action plan indicating that fortnightly schedules are sent to service users telling them the names of the staff and times when there care will be delivered. The manager planned to monitor the effectiveness through monthly reviews and courtesy calls to service users. Changes had been made to the how the service is run and set rotas for the staff had been put into place. These changes are expected to improve continuity. Progress is such that this requirement is met. This issue will be monitored at the next inspection. The requirement is: Met The requirement The provider must manage the service appropriately. Suitable arrangements must be made to ensure that the service is provided consistently and that effective means are implemented for monitoring this. This is in order to comply with: SSI 2011/210 Regulation 4(1)(a)(b) - Welfare of users, 7(2)(c) - Fitness of managers. Timescale for implementation: within 24 hours of the issuing of this letter What the service did to meet the requirement The manager had given priority to resolving scheduling issues that have been the subject of a number of upheld complaints by us. Independent Living Services - ILS Clyde Valley & Lanarkshire, page 8 of 31

9 The manager submitted an action plan on 14 December 2011 detailing that all service users are now on a rota and staff are on a set shift pattern to assist in providing continuity and a more seamless home care service. An additional Customer Care Supervisor had also been added to the Motherwell team. The manager reported that this had led to an improved service. Progress is such that this requirement is met. This will be re-assessed at the next inspection of the service. The requirement is: Met Inspection report continued The requirement The provider must make arrangements to ensure the service keeps records that detail missed and late visits. The record should show an analysis of the information showing cause, effect and necessary action. This is in order to comply with: SSI 2011/210 Regulation 4(1) - Welfare of users What the service did to meet the requirement A recording system had been implemented where visits had been missed or shortened. Where visits were missed the regional manager told us that the staff member, service user and local authority had been spoken with. Staff were dealt with in accordance with the company policy. This is an area we will look at at the next inspection. The requirement is: Met The requirement The provider must manage the service appropriately. Suitable arrangements must be made to ensure that the service is provided to meet the service user's needs. This is in order to comply with: SSI 2011/210 Regulation 4(1)(a) - Welfare of users. Timescale for implementation: within 24 hours of the issuing of this letter. What the service did to meet the requirement See requirement 2. The requirement is: Met Independent Living Services - ILS Clyde Valley & Lanarkshire, page 9 of 31

10 The requirement The provider must ensure that any complaint made under the complaints procedure is fully investigated. This is in order to comply with: SSI 2011/210 Regulations 18(3) - Complaints Timescale for implementation: within 24 hours of the issuing of this letter. What the service did to meet the requirement We looked at complaints records and significant events and found that the service had responded to complaints made. The requirement is: Met Inspection report continued The requirement The provider must review written information about making a complaint to ensure this is unambiguous. This is in order to comply with: SSI 2002/114 Regulation 7(2)(c) - Fitness of managers Timescale for implementation: within 24 hours of the issuing of this letter. What the service did to meet the requirement We looked at written information about making a complaint. This information is put into a welcome pack for service users. This was satisfactory. Our quality survey showed that many respondents did not know about the complaint. We made a recommendation about this. The requirement is: Met What the service has done to meet any recommendations we made at our last inspection This is the first inspection since re registration. 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: Not Applicable Comments on Self Assessment Independent Living Services - ILS Clyde Valley & Lanarkshire, page 10 of 31

11 Inspection report continued 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. Every year all care services must complete a self assessment form telling is how their service is performing. We check to make sure this assessment is accurate. A fully completed self assessment was completed it identified areas of strengths and where improvements could be made. We did not concurs with the self awarded grades. We accept that there had been improvements made to how the service was run but did not think that the service was performing as well as the self assessment indicated. Taking the views of people using the care service into account Around 100 people use the service. We sent out 40 questionnaires to service users and their carers 15 of these were returned to us. We spoke to 7 of these people on the telephone. We visited 3 in their homes. We were told: The office staff do not return telephone calls the service was reliable enough and the staff always stay for the expected time. Staff were regularly late. This person was very happy with the girls who came in and enjoyed their company. There had been occasions when staff came to support this person and they were not fully aware of their needs. This person told us that the management had taken account of their wishes about what carers supported them. In terms of being happy with the overall quality of care respondents. strongly agreed 40% agreed 47% disagreed 13% One person told us about issues relating to scheduling of visits when their regular carers were on annual leave or when there were last minute call offs and about not always getting information about who would be supporting them on time. Also this person said that the the office regularly do not return calls. Taking carers' views into account "very happy, going well, [relative] gets on well with named carer. Carer is flexible. Use hard backed diary to communicate. No issues with the office. Independent Living Services - ILS Clyde Valley & Lanarkshire, page 11 of 31

12 Inspection report continued This person told us they were unhappy with the service. The issues were around carers not attending and the service changing the carers and the times of their visits. Th office staff do not return calls. Staff do not stay for full visit. The carers themselves were described as"wonderful, kind and considerate", they complete a book which contains "good information". This person had no issue with the carers and felt that the problem lay with the office. "no concerns or issues with ILS", "limited group of carers", "has confidence in them", "reliable, may be a little late not an issue". Carers complete a book when they are in. This person knew the staff in the office and thought that the new manager was doing OK. "happy with the service", have a designated carer as they wished. Service is reliable and they get a call if the carer is delayed. The office is a bit "iffy", "helpful enough". " more than satisfied" this person confirmed they had regular carers and they asked to keep one particular staff member an this was agreed. No complaints. "overall very happy with ILS staff and management", " very helpful", Terrific have the greatest admiration for staff, couldn't be better, obvious training. This person told us that they service was reliable and that they had telephone numbers to contact if there were any issues. The staff were described as "friends" and were "respectful". Independent Living Services - ILS Clyde Valley & Lanarkshire, page 12 of 31

13 Inspection report continued 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: 3 - Adequate 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 This is the first inspection of the service since registration in March The service had yet to fully implement the company participation strategy. However, there were basic methods in place to allow service users and carers to participate in assessing the quality of care and support provided by the service. These included: Courtesy Calls Complaints Procedure On call help line Allocated Customer Care Supervisor The service manager told us that at the time of registration ( March 2011) priority was given to ensuring that all of the service users were reassessed and a personal plan prepared. There was evidence that service users and their carers were involved in the care planning process. Due to the time frame involved very few reviews of these had taken place. The manager had a schedule of planned reviews. Service users and their relatives were invited to speak with the Manager or staff at any time to discuss any concerns they had and an established complaints procedure was in place. Service users confirmed that they could make a complaint. We looked at records and found that the manager had investigated and responded to most complaints made. There had been some changes to how the office based staff worked. There were 2 Customer Care Supervisors who had been assigned to a geographical area. This meant that service users had a contact in the office to direct their enquiries to. Independent Living Services - ILS Clyde Valley & Lanarkshire, page 13 of 31

14 We were shown an information pack to be given to new service users. This contained relevant information including how to make a complaint The organisation had a service user quality survey. We were told that this is to be given out to service users in January Areas for improvement Inspection report continued We found that the service was in the early stages of implementing the company participation strategy. In our returned questionnaires 69% of people told us that the service did not ask for their opinions about how it could improve. The service is aware of the need to ensure that 6 monthly reviews are completed. This will be examined at the next inspection. Some of the service users commented that the staff in the office did not return their calls. We found evidence of courtesy calls that had been made. Some were made when arranging appointments to arrange care plan meetings or reviews, others were in response to when staff been early or late for a visit or when one staff member instead of two attended. There did not appear to be any structured scheduling of courtesy calls or an identified number that should be made over a designated period. See recommendation 1. In our returned questionnaires 34% of people were unsure about the services complaints procedure and 53% of people were unaware that they could make a complaint to us about the quality of the service. See recommendation 2. The manager discussed a proposal to introduce an on line feedback form in the future. The services self evaluation identified the following areas of improvement: Implement service user forums to include service users and their families introduce monthly newsletter review paperwork to ensure that it is "user friendly" for all service users on line feedback forms planned Grade awarded for this statement: 3 - Adequate Number of requirements: 0 Number of recommendations: 2 Independent Living Services - ILS Clyde Valley & Lanarkshire, page 14 of 31

15 Inspection report continued Recommendations 1. The service should develop the ways in which service users and carers are encouraged to express their views on any aspect of the service. National Care Standards, Care at Home, Standard 11: Expressing Your Views. 2. The service should ensure that service users and their carers are aware of how to make a complaint to the company and to Care Inspectorate. National Care Standards, Care at Home, Standard 11: Expressing Your Views. Statement 3 We ensure that service user's health and wellbeing needs are met. Service strengths Most people who are supported by the service indicated that they were happy. In our returned questionnaires 87% of respondents said overall they were happy with the quality of care from the service. We looked at service user records. We found that a risk assessment had been completed, this covered a wide range of issues including moving and handling, the home environment and home appliances. Some contained good detail of the risks identified and the control measures in place. There was a signed Support Agreement and a support plan. Again, some contained good detail and provided sufficient direction about the care required and how it should be provided. The service had appointed Senior Support Workers whose role was to support direct care staff. To do this they hey had completed training in Risk Assessment, Manual Handling Risk Assessment and Personalised Support Plan Development. We observed communication books that staff completed when they had supported a service user. We found that where a service users needs had changed and additional support was required this had been passed on to the service users care manager for the care package to be reviewed. There was an out of hours on call service. There were records about accidents and significant events. The staff we spoke to were aware of how to report any concerns within the organisation and to us. Independent Living Services - ILS Clyde Valley & Lanarkshire, page 15 of 31

16 Areas for improvement Inspection report continued The services self evaluation identified a number of areas where they felt that they could improve: continue to implement personalised support plans develop a cook book where staff and service users can share recipes and handy hints roll out medication training to all staff Complaints made to us found that service users are not always told when there are changes made to the person supporting them. This could be due to staff sickness, holidays or unexpected delay. This should be improved. We made a requirement about this. The provider must develop and implement acceptable strategies to ensure support to service users is provided seamlessly and consistently. This is in order to comply with: SSI 2011/210 Regulations 4(1)(a) - Welfare of users. We think that the service management had made improvements and shown a commitment to resolving this issue. The service had previously given out weekly visit schedules to service users. This has been changed. Service users are posted a copy of their visit schedule fortnightly. Any changes to this are passed on by telephone. The service manager had made changes to staff work patterns in order that staff and service users had a planned rota. Progress is such that this requirement is met. This will be monitored at the next inspection. Complaints made to us have also identified that on occasions the support delivered is not always as planned. For example staff failing to attend for a planned home visit or not staying as long as they were expected too. We made a requirement. The provider must manage the service appropriately. Suitable arrangements must be made to ensure that the service is provided consistently and that effective means are implemented for monitoring this. This is in order to comply with: SSI 2011/210 Regulation 4(1)(a)(b) - Welfare of users, 7(2)(c) - Fitness of managers. The service management recognised the need to improve reliability and continuity for Independent Living Services - ILS Clyde Valley & Lanarkshire, page 16 of 31

17 service users and to ensure that staff had a regular rota that allowed for adequate time between service users visits to ensure that service users receive the agreed duration of support at the agreed time. The manager had met with the staff and changes had been made to their work patterns and to how annual leave was agreed. The people we spoke to confirmed these changes. We acknowledge that the management are trying to overcome scheduling issues and accommodate service users preferences. The management are aware of the need to closely monitor this matter to ensure these improvements are sustained and outcomes for service users are good. We acknowledge that this is a work in progress but consider that the action taken by the company is satisfactory to comply with this requirement. This will be re examined at the next inspection. We are also aware that the service are in the process of introducing a new computerised management system. When this is in place it is expected that it will help in matching service users choices and preferences to staff skills and experience. We wish to acknowledge recent achievements that had been made in relation to implementing personal plans. However,we found that the quality of these and of assessments of peoples needs varied. We found an occasion where the information in an assessment of a persons needs in managing their medications was different from the information in the care plan. In general we found care plans to be basic with limited information. The detail recorded could be more person centred. See requirement 1 All assessments and reviews should be signed and dated. Quality monitoring processes should be improved to ensure that this is addressed and that personal plans contain enough detail to direct staff in the support required and how the person liked it to be delivered. These should be signed to confirm that the service user or representative, where appropriate, agrees with the content. Grade awarded for this statement: 3 - Adequate Number of requirements: 1 Number of recommendations: 0 Requirements Inspection report continued 1. Care Plans must provide sufficient detail to enable staff to provide individualised care. The care plans should be reviewed and audited on a regular basis. This is to comply with SSI 2011 Regulation 5 (1) - provider must, after consultation with each service user and where it appears to the provider to be appropriate, any Independent Living Services - ILS Clyde Valley & Lanarkshire, page 17 of 31

18 representative of the service user, within 28 days o of the date on which the service e user first received the service prepare a written plan ( "the personal plan" which sets out how the service users health and welfare needs are to be met. Timescale - by 31 January Statement 5 We respond to service users' care and support needs using person centered values. Service strengths We received positive comments about the staff members who supported service users in their homes. In our returned questionnaires everyone thought that staff treated them with respect. 71 % of our returned questionnaires confirmed that their needs and preferences were detailed in a personal plan. Almost all people knew the names of the staff who provided their care and 64% thought that staff had enough time to carry out the agreed support and care. We recognise that the care service do not determine how long a visit should last. The manager told us about challenges they faced in trying to establish set rotas and schedules for staff whilst trying to accommodate individual service users wishes and preferences about times of visits and what staff member would be supporting them. The manager recognised the need to establish a reliable and consistent service and felt that she had made progress in achieving this. The management believed that re-structuring within the office staff which included another Customer Care Supervisor post would facilitate a more person centred approach. Some of the people we spoke to told us that the management had taken account of their wishes about what home care worker would be providing them with their care and support. All of the staff who returned our questionnaires indicated that they thought that the service provided good support to service users. Areas for improvement Inspection report continued We found that there were areas where the service could improve upon in order to be more person centred. We have upheld five complaints about service users not being told which home care worker would be visiting them and about the home care service not being provided as agreed. We feel that the service needs to continue to make improvements in this area to ensure that a consistent and reliable service is provided. Independent Living Services - ILS Clyde Valley & Lanarkshire, page 18 of 31

19 We were also told about office staff not returning telephone calls and raise this with the management. We have also identified that we found that care plans were not particularly person centred. A requirement has been made about this also in Statement 3 of this quality theme. In their self assessment the service identified the following areas for improvement: "To continue implementing a personalised care plan for all service users. Develop an action plan that will ensure reviews are undertaken at least 6 monthly. To continue to seek service user feedback from our current of participation opportunities To develop further opportunities for service users to consult, comment and otherwise engage with our managers and staff toward ensuring the service develops and continues to meet individual needs, choices and preferences. " Grade awarded for this statement: 3 - Adequate Number of requirements: 0 Number of recommendations: 0 Inspection report continued Independent Living Services - ILS Clyde Valley & Lanarkshire, page 19 of 31

20 Inspection report continued Quality Theme 3: Quality of Staffing Grade awarded for this theme: 3 - Adequate Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths The ways of involving people and asking them for their views are included under strengths in Quality Theme 1, Statement 1. We heard from service users that the service management had taken account of their requests for particular staff members to support them. The service had a service user evaluation form which asked for peoples views on their care workers performance and their satisfaction with the service. The four we seen had positive comments. Areas for improvement The service should develop opportunities for people using the service to comment on the quality of staffing. This may include involving people in the recruitment and selection of staff and in staff training and development processes. See areas of improvement in Quality Theme 1, Quality Statement 1. In their self assessment, the service identified the following areas of improvement. "Continue to offer opportunities for service users to engage in the recruitment process. Continue to seek feedback from service users about the quality of staffing. Review the documents and methods used to gather feedback to ensure they are user friendly to all of the service users" Grade awarded for this statement: 3 - Adequate Number of requirements: 0 Number of recommendations: 1 Independent Living Services - ILS Clyde Valley & Lanarkshire, page 20 of 31

21 Inspection report continued Recommendations 1. The service should develop the ways in which service users and carers are encouraged to express their views on the quality of staffing. National Care Standards, Care at Home, Standard 11: Expressing Your Views. 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 is the first inspection of the care service since it was registered in March We looked at 7 staff files in order to assess how effectively the provider implemented safer recruitment procedures. Applicants were asked to complete an application form. The records sampled showed that two references, one of which was from the candidate's immediate employer. Criminal history checks had been carried out. There was a system in place to ensure that candidates were physically and mentally fit for the post for which they were being interviewed.. There was evidence that new staff attended induction training. This took account of moving an handling, health and safety, personal care delivery and incontinence care. One staff member we spoke to told us that they were happy with their induction time. This person requested an additional day shadowing an more experienced worker. This request was granted/ Overall recruitment files were well organised. We were told about an updated induction work book that was being piloted. The new induction process is designed to evidence when new staff achieve levels of competency. The service had just started to implement a new staff retention policy to offer continued support to new staff. Areas for improvement At the present time only service managers are eligible to register with the SSSC ( Scottish Social Services Council). The external manager contacted the organisations headquarters about checking the SSSC register as part of the companies pre employement checks. We understand that the recruitment policy had been recently updated to show this change and that the register will be checked for all future applicants. Independent Living Services - ILS Clyde Valley & Lanarkshire, page 21 of 31

22 In their self assessment the service identified the following areas of improvement: "To continue with our Safer Recruitment practices and link these to professional registers such as SSSC and NMC to authenticate the identity and competence to practice. To continue developing links with specialist recruitment agencies to support our recruitment and induction processes. To complete the review of the Induction Training towards developing and implementing a progressive induction process that is competency based and linked to the Continuous Learning Framework". 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 The staff we spoke to said they has one to one supervisions. There was a staff supervision schedule that showed supervision dates. We looked at training records and found that staff had attended training in customer care, core values, person centred care planning, protection of vulnerable adults, challenging behaviour, medication and moving and handling at their induction. There was evidence that staff meetings had taken place. Inspection report continued The company had introduced a "LOV" recognition and award scheme to reward and promote and show that they valued staff who performed to a high standard. The organisation had a staff handbook, this contained information about their core values and a summery of key polices such as whistle blowing and training and development. Staff had also been given a copy of the organisations dignity at work policy to try to create a working environment where staff are treated fairly. We were given a copy of a staff development workbook this took account of the National Care Standards. Independent Living Services - ILS Clyde Valley & Lanarkshire, page 22 of 31

23 The staff we spoke to confirmed that they have a set rota and schedule of service users to visit. They told us that there were care plans in peoples houses and that the management was approachable. There was a feeling that things were improving. In our questionnaires the staff indicated that they did not have any training needs that the organisation were not being met, that they had access to regular supervision and that they felt the organisation provided good support to service users. Most (88%) of the service users who completed our questionnaires told us that they thought that the staff had the skills to support them Areas for improvement We found training records were difficult to follow and did not accurately reflect the training that staff had attended. We were told that this was due to the number of people who input information about training and the fact that there was more than one system in use. Training records should be improved. See recommendation 1 Some of the staff had not attended Adult Support and Protection training however, we could see from the Newsletter that this was planned. Other planned training included medication, child protection and a programme of SVQ training. The provider should undertake a training needs analysis an use this to form a training plan that takes account of health and safety matters and the needs of individual service users. See requirement 1. The management should ask staff to evaluate training attended. Inspection report continued The service planned to implement an electronic management system that would help match staff skills and training to individual needs of service users. One staff member told us that communication in the office could be better to ensure that messages were passed on and telephone calls returned. We found no supervision records in the files of some recently employed staff. We would have expected people to have had one to one time with the manager during their initial period of employment. See recommendation 2. In their self assessment, the service identified the following areas for improvement. "To liaise with Compliance Team re. implementing agreed SVQ programmes. To continue with the Training Programmes that are linked to individual needs as well as Team and anticipated care and support needs." Independent Living Services - ILS Clyde Valley & Lanarkshire, page 23 of 31

24 Grade awarded for this statement: 3 - Adequate Number of requirements: 1 Number of recommendations: 2 Requirements 1. The provider should ensure that staff receive training appropriate to their role. Training records should be maintained in such a way as to evidence the training that staff have attended. This is in order to comply with SSI/210 Regulation 15 (b) (i) Staffing. Timescale for implementation: within two months of receipt of this report. Recommendations Inspection report continued 1. A training needs analysis should be completed for all staff to take account of mandatory staff training and training specific to the needs of the service users. This information should be used to form a staff training plan. National Care Standards, Care at Home, Management and Staffing. Standard All staff should have access to regular one to one supervision with their line manager. National Care Standards, Care at Home, Management and Staffing. Standard 4. Independent Living Services - ILS Clyde Valley & Lanarkshire, page 24 of 31

25 Inspection report continued Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 3 - Adequate 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 ways of involving people and asking them for their views are included under strengths in Quality Theme 1, Statement 1. We received many positive comments about the management and leadership in the service. Areas for improvement The service should develop how they gather the views of service users and carers about how the service is run. The service should consider involving an independent person to assist in obtaining feedback about the quality of management and leadership in the service. See areas of improvement in Quality Theme 1, Quality Statement 1. In their self assessment the service identified some areas of improvement as follows: "Continue to develop opportunities and methods through which service users can contribute to assessing and improving the quality of management and leadership. This includes more opportunities for face to face meetings with managers as well as more user friendly documentation." Grade awarded for this statement: 3 - Adequate 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 We found overall that the company had good ways of motivating and involving the staff to express their views and make suggestions about how the service was run. Independent Living Services - ILS Clyde Valley & Lanarkshire, page 25 of 31

26 The company had produced a detailed Newsletter in May and again in October. This gave staff very good information about business they were tendering for and about training programmes that were planned. The company had also introduced initiatives to encourage the staff to refer service users to the company, people for employment and to reduce travel time and cost. We could see that office and care staff meetings had taken place as had one to one and group supervision sessions. This gave the staff an opportunity to comment on how the service could be run. The organisation had introduced senior support staff into the staffing structure. This created additional opportunities for progression within the staff team. In general terms we found that the staff team considered that the change of management had been positive and that the service manager was approachable. The company had recently introduced the "ILS Care Academy" this initiative was aimed at training managers about managing people and communication. The staff we spoke to were clear about the on call support available and the management structure within the company. Areas for improvement In other areas of the company we could see that senior managers had met with various staff over lunch to discuss their views and thoughts about the companies performance and how it could improve. This is considered to be good practice and are aware that a date was planned in this region. The service should consider a staff survey as another method of gathering the views of the staff team. In their self assessment, the service identified areas for improvement as follows: "Continue to develop opportunities to engage with staff and encourage their contribution. This includes ensuring that staff can see the effective value of their contribution so feedback to them is as important as feedback from them". Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Independent Living Services - ILS Clyde Valley & Lanarkshire, page 26 of 31

27 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 company had ISO 9001:2000 accreditation. The company had a quality team to facilitate quality assurance and compliance. They had a range of comprehensive audit documents available within the company to assess how well each service was performing and where improvements were needed. This took account of service user care files and staff recruitment, training and development processes. These processes had not been fully implemented at the time of the inspection. We found that there were some methods in use to measure the quality of the support provided. Some people had received a courtesy call or had a service user evaluation completed. There was also a "significant events" process in place.the management staff were aware of the need to review formally the recently introduced personal support plans and risk assessments with service users. The company had a service user quality survey. This was to be given out in the new year. Areas for improvement Inspection report continued In our questionnaire we asked people if the service check with them regularly that they were meeting their needs 58% said that this was the case. We found that some spot checks and service user evaluations had been completed. However, these were not being followed up where service users had identified issues such as " not meeting need". The service management should ensure that issues are followed up to the satisfaction of all individuals. We found that the quality and detail of the personal support plans was inconsistent and these should be audited on a regular basis to ensure that the content is accurate and directs staff well in the care and support needs of each person. A previous requirement has been made about this in Theme 1, Statement 3. We think that quality assurance systems should be improved to ensure that visit schedules are closely monitored to ensure that performance in this area continues to improve. The service should consider involving external agencies including social workers and health professional in their quality survey. In their self assessment, the service identified areas for improvement as follows: Independent Living Services - ILS Clyde Valley & Lanarkshire, page 27 of 31

28 "To continue to seek feedback from our current processes but review these to ensure the opportunities and methods enable service users the best opportunity to participate. To ensure that we evidence to service users and staff where their feedback has contributed to improving the quality of services" Grade awarded for this statement: 3 - Adequate Number of requirements: 0 Number of recommendations: 0 Inspection report continued Independent Living Services - ILS Clyde Valley & Lanarkshire, page 28 of 31

29 Inspection report continued 4 Other information Complaints There have been 5 upheld or partially upheld complaints about this service. You can find out information about complaints that have been upheld or partially upheld on our web site 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). Independent Living Services - ILS Clyde Valley & Lanarkshire, page 29 of 31

30 Inspection report continued 5 Summary of grades Quality of Care and Support Adequate Statement 1 Statement 3 Statement Adequate 3 - Adequate 3 - Adequate Quality of Staffing Adequate Statement 1 Statement 2 Statement Adequate 4 - Good 3 - Adequate Quality of Management and Leadership Adequate Statement 1 Statement 2 Statement Adequate 4 - Good 3 - Adequate 6 Inspection and grading history All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Independent Living Services - ILS Clyde Valley & Lanarkshire, page 30 of 31

31 Inspection report continued 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 SCSWIS. 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@scswis.com Web: Independent Living Services - ILS Clyde Valley & Lanarkshire, page 31 of 31