Mull & Iona, Coll & Tiree and Colonsay Home Care Service/Housing Support Service Housing Support Service

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1 Mull & Iona, Coll & Tiree and Colonsay Home Care /Housing Support Housing Support Willowview Community Care Centre Lower Soroba Oban PA34 4SB Telephone: Tiree: Central No Type of inspection: Unannounced Inspection completed on: 22 March 2018 provided by: Argyll and Bute Council provider number: SP Care service number: CS

2 About the service The Mull, Iona, Colonsay, Tiree and Coll combined Home Care and Housing Support is run by Argyll and Bute Council and provided to people in their own homes on these five islands. To organise and deliver the care at home and housing support service the provider employs the following, Home Care Manager and Home Care Organisers as well as over seventy home support workers and an administrator, who work in full and part-time capacity with a menu of hours and shift patterns. At the time of the inspection the service was providing support to the following numbers of people in their own homes: Coll = 1 Colonsay = 1 Tiree = 5 Mull and Iona = 80 which was approximately 950 hours per week. There was also a team of home carers who work in Bowman Court a 'progressive care centre', where people are tenants of a Housing Association. The tenants have access to prepared and served lunch and dinner in the complex dining room. Bowman Court is adjacent to the hospital at Craignure, Isle of Mull. The home support workers have a shift pattern providing 24 hour cover, seven days per week rota for Bowman Court. The service operates 24 hours per day 365 days per year. The people who use the service are supported by an out of hours service 'CareFirst'. What people told us Fifteen completed care standards questionnaires were returned by people who use the service or their carers, relatives or friends. The overall feedback was positive regarding the care and support received but there was a theme in all the written responses from people who use the service about their concerns for support staff. "I visit my relative approximately once per month and always find a cheerful and supportive atmosphere. My relative seems to genuinely enjoy her interactions with the carers - and them with her" "Over all I am happy with the care given to my spouse. They show care and kindness to both of us. I am sometimes concerned about the long hours the cares work, which in turn leaves gaps in the daily programme; this is not the carers fault. Some work beyond their remit" "Carers need more time in mornings and lunchtimes. Our carers do a wonderful job working very difficult hours often under difficult work hours after 10pm. Nevertheless they remain faithful, discrete, honest and amazingly kind to their patients. They deserve a pay rise" "Perfectly happy with the service received, a number of daily visits. The staff are delightful people but they are in short supply" "My relative enjoys having the carers in. All the girls treat her with the greatest respect. We have no complaints. There is always a bit of good humour (laughter is the best medicine". Inspection report for Mull & Iona, Coll & Tiree and Colonsay Home Care /Housing Support

3 Self assessment Care services were not required to submit a self assessment document during the inspection period From this inspection we graded this service as: Quality of care and support Quality of staffing Quality of management and leadership not assessed 1 - Unsatisfactory Quality of care and support Findings from the inspection Since the last inspection the Health and Social Care Partnership (HASCP) has commenced and the people who use the service are assessed by either social work or health staff and if they meet the aims and objectives of the service these details will be referred to the home care service. The individual who makes use of the service, their family and or primary carer are invited to participate in the development of their own care plan and six monthly review meeting to ensure it continues to meet their requirements. People who completed the questionnaire told us that they did not in all cases have a copy of their individual care or support plan in their home. As the care plan is an aide memoire for staff to support the individual to meet their assessed needs failure to have a care plan in every home could have poor outcomes for the person using the service and compromise their health and wellbeing. Staff regularly receive a work schedule from the office with the details of the individuals' service frequency and tasks to be delivered during the time specific home visit. The care service provides a welcome pack for new service users and it includes important contact details and publications including the complaints procedures for the HASCP. People told us through the care standards questionnaires that they did not know about the provider's complaints procedure. Although the registered office for this service is on the mainland in Oban the operational office bases for the home care services are located on Mull and Tiree. The staff use an electronic recording system where personal details, care plans and personnel matters are retained and through the system the service delivery is organised. The one point of information retention should provide confidence for the persons who use the service in that when their support worker is unavailable the management will arrange for an alternate support worker to receive a schedule directing them to the individual's home address. The management and care support workers are recruited as per the provider's recruitment policy and procedure and the necessary checks are completed to protect the welfare of the people who use the service. There is access to training for the support staff to meet the assessed needs of the individuals they visit. Staff told us that a number of them had been participating in the Promoting Excellence - Dementia but due to unforeseen circumstances the facilitator was unable to continue. Staff said that to date they have not been advised when the provider will rearrange the dates for the continuation of this course. Staff receiving this training course would benefit the outcomes for people who use the service especially those who have cognitive impairment or dementia. Inspection report for Mull & Iona, Coll & Tiree and Colonsay Home Care /Housing Support

4 Please read in conjunction with the requirements recorded at Quality of Management and Leadership. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 3 - adequate Quality of staffing This quality theme was not assessed. Quality of management and leadership Findings from the inspection At the time of the inspection there was no registered manager for the service. Since the last inspection the provider had failed to e-notify the Care Inspectorate that due to staffing issues, such as vacancies and ill health absences, what interim management structures had been put in place for this service. (See requirement 1) People who use the service can be confident that the provider has a public liabilities insurance policy in place and it was visible in the social work office base at Craignure. The insurance policy was not accompanied by the registration certificate for the care service. During the inspection process all staff we met tried to assist but no one had previously been part of this scrutiny process. Due to the absence of experienced employees in management roles within care at home and housing support there was a lack of experienced personnel to facilitate the inspection process and this is reflected in the outcome grades. (See requirement 2) Staff told us that the provider's support mechanisms for their employees had been impacted upon by the absence of line management and therefore supervision and staff meetings were not planned or on a regular basis. When they did take place the agenda was very limited, poorly attended and personalised development issues were not progressed or outcome achieved. (See requirement 3) There was a lack of evidence available during the inspection regarding the collation and auditing of the provider's quality assurance processes including the consultation and participation of people who use the service and their carers through surveys or questionnaires to aid the continuous improvement of the service and outcomes for people. Inspection report for Mull & Iona, Coll & Tiree and Colonsay Home Care /Housing Support

5 We were advised by senior management that through the HASCP there was an improvement plan under development for the future view of care at home and housing support on the islands and mainland to improve outcomes for people who use the service. There was evidence that the service had failed to meet the legal requirement that every person using the service should have their personal care plan reviewed a minimum of six monthly. (See requirement 4) Requirements Number of requirements: 4 1. The provider must ensure that they apply to the Care Inspectorate to advise of the proposed responsible employee within care at home to be the registered manager and have the capacity to facilitate the inspection process. The provider must ensure that the responsible person ensures all reportable events are notified to the regulator in a timely manner as per the Care Inspectorate and the provider's service guidance for reportable incidents and events. This is in order to comply with: The Social Care and Social work Improvement Scotland (Requirements for Care s) Regulations 2011 (SSI2011/210) regulation 3 - Principles and regulation 4(1)(a) - Welfare of users Timescale: To start immediately and be completed by 25 June The provider must ensure a consistent and sustainable support to the registered manager and employees at Mull, Iona, Tiree, Coll and Colonsay care at home service to ensure that the aims and objectives of the care service are met and that staff are in sufficient numbers and have the necessary competency levels to facilitate the inspection process, arrange delivery of the care service and ensure positive outcomes for all persons and their advocates. This is in order to comply with: The Social Care and Social work Improvement Scotland (Requirements for Care s) Regulations 2011 (SSI2011/210) regulation 3 - Principles and regulation 4(1)(a) - Welfare of users and regulation 15(b)(i) -. Timescale: To start immediately and be completed by 30 July The provider must review the staff training and competency levels to implement best practice to protect the people who use the service. The provider must provide the Care Inspectorate with a copy of the training calendar developed and to be delivered, to meet the requirements of all employees identified through supervision and the assessed needs of residents to provide positive outcomes for people who use the service. * Promoting Excellence - Dementia Inspection report for Mull & Iona, Coll & Tiree and Colonsay Home Care /Housing Support

6 This is in order to comply with: SSI 2011/210 Regulation ensure that persons employed in the provision of the care service receive - * training appropriate to the work they are to perform; and (ii) suitable assistance, including time off work, for the purpose of obtaining further qualifications appropriate to such work Timescale for improvement: To be completed by 30 July The provider and management must review that the provider's policies and procedures are accessible and understood by all parties regardless of roles and responsibilities. The audit system is implemented to ensure positive outcomes for people who use the service and to protect the health and wellbeing of all stakeholders. For example ensure that each individual has a copy of their own care plan and records of care plan reviews a minimum of six monthly, minutes of meeting, action plan, outcomes and way forward. This is to comply with: SSI 2011/210 Regulation 4(1) (a) - Welfare of Users - a provider must make provision for the health, welfare and safety of service users To start immediately and be completed by 25 June Recommendations Number of recommendations: 0 Grade: 1 - unsatisfactory What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 The Medication Policy should be reviewed and staff should receive appropriate training in The Administration of Medication. Inspection report for Mull & Iona, Coll & Tiree and Colonsay Home Care /Housing Support

7 This is to comply with: SSI 114 Regulation 4 (1) Welfare of Users. (a) providers shall make proper provision for the health and welfare of service users. Timescale: 6 months from receipt of this report. This requirement was made on 15 March Action taken on previous requirement The provider has trained and designated duties as follows: Home Carers grade 5 = prompt medication Home Carers grade 8 = administer medication The provider has a p&p and this is provided to the home carers and to the Care Inspectorate during this inspection. Met - outwith timescales What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations There are no outstanding recommendations. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at Enforcement No enforcement action has been taken against this care service since the last inspection. Inspection report for Mull & Iona, Coll & Tiree and Colonsay Home Care /Housing Support

8 Inspection and grading history Date Type Gradings 4 Apr 2017 Announced (short notice) Care and support 5 - Very good 5 Feb 2016 Announced (short notice) Care and support 26 Mar 2015 Unannounced Care and support 27 Feb 2014 Announced (short notice) Care and support 11 Mar 2013 Announced (short notice) Care and support 13 Dec 2011 Unannounced Care and support 3 Jun 2009 Announced Care and support 30 May 2008 Announced Care and support Inspection report for Mull & Iona, Coll & Tiree and Colonsay Home Care /Housing Support

9 Date Type Gradings Inspection report for Mull & Iona, Coll & Tiree and Colonsay Home Care /Housing Support

10 To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com Find us on Facebook Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. Inspection report for Mull & Iona, Coll & Tiree and Colonsay Home Care /Housing Support