Shaw Community Services - Edinburgh Support Service Care at Home Unit 5 Newington Business Centre Dalkeith Road Mews Edinburgh EH16 5DU Telephone:

Transcription

1 Shaw Community Services - Edinburgh Support Service Care at Home Unit 5 Newington Business Centre Dalkeith Road Mews Edinburgh EH16 5DU Telephone: Inspected by: David Todd Type of inspection: Unannounced Inspection completed on: 9 January 2013

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 11 4 Other information 20 5 Summary of grades 21 6 Inspection and grading history 21 Service provided by: Shaw Community Services Ltd (DCA) Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: David Todd Telephone enquiries@careinspectorate.com Shaw Community Services - Edinburgh, page 2 of 22

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 People using the service had a copy of their care plan in their own home. Plans had good information that guided staff about how to provide the care needed. People we spoke with told us they thought the regular staff they had gave them good care and help. What the service could do better The service must ensure that information they record in care plans about moving and assisting people is accurate. The service should ensure staff record the times of their visits to people using the service. What the service has done since the last inspection This was the first inspection of this service. Conclusion The service could make improvements to how they record risks to ensure that care in consistent. People we spoke with thought the care was good and their regular staff knew them well. Shaw Community Services - Edinburgh, page 3 of 22

4 Who did this inspection David Todd Shaw Community Services - Edinburgh, page 4 of 22

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Before 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 Requirements and Recommendations. If we are concerned about some aspect of a service, or think it needs to do more to improve, we may make a recommendation or a 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 based on best practice and the National Care Standards. A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reform (Scotland) Act 2010 ('the Act') and secondary legislation made under the Act, or a condition of registration. Where there are breaches of Regulations, Orders or Conditions, a requirement may be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. Shaw Community Services was registered with the Care Inspectorate on 14 March 2012 to provide a care at home service to people living in their own homes. The service has an office base in the Prestonfield area of Edinburgh. Staff provide a care at home service to people in different parts of the City. The service says its aims and objectives include: * To support service users to continue to live valued and fulfilled lives in their community * To treat service users with dignity and respect and ensure their privacy at all times * To treat every service user as an individual and provide a person centred support package specifically tailored to meet their needs. At the time of inspection the service was providing care to approximately 45 people. 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 Shaw Community Services - Edinburgh, page 5 of 22

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. Shaw Community Services - Edinburgh, page 6 of 22

7 2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care. What we did during the inspection We wrote this report following an unannounced inspection. The inspection was carried out by Care Inspectorate Inspector David Todd. This took place on 19 December 2012, between 9.30am and 4.30pm and on 4 January 2013 between 9:15am and 3.40pm. We told the Manager what we found on 9 January As requested by us the care service had completed a self assessment form. In this inspection we gathered evidence from various sources including the relevant sections of policies, procedures and other documents including: Sampled support and care plans Reviews of support and care plans Risk assessments Support agreements Communication books and diaries Team meeting minutes Recruitment records Training records Support and supervision records Staff training records Incident and accidents Complaint records Quality assurance information Participation policy Complaints policy Infection Control policy Discussions with the Service Manager Discussions with six members of staff. We visited four people using the service and their relatives in their own homes. Shaw Community Services - Edinburgh, page 7 of 22

8 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 Shaw Community Services - Edinburgh, page 8 of 22

9 What the service has done to meet any recommendations we made at our last inspection This was the first inspection of this service 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: No Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. We received a fully completed self assessment document 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 planned. They graded the service and we agreed with some of these grades. Taking the views of people using the care service into account We sent out 20 Care Standards Questionnaires to people using the service and their relatives. Seven were returned by people using the service. Comments included: 'We are very happy with the care we get. The staff are very kind, efficient and friendly...our two main carers are like family to us'. 'There are a handful of Shaw carers who are very helpful, polite, well-mannered and always respect my privacy. Nothing that I ask of them is too much trouble'. Shaw Community Services - Edinburgh, page 9 of 22

10 Some people said they had not had the service very long and that their comments were based on a short time with the service. One person said they had not yet been given a personal plan but this was 'being rectified'. Five people 'strongly agreed' and two people 'agreed' that 'overall, I am happy with the quality of care and support this service gives me'. Other views are referred to in the relevant quality statements. Inspection report continued Taking carers' views into account We sent out 20 Care Standards Questionnaires to people using the service and their relatives. Four were returned by relatives. One person 'strongly agreed' and three people agreed that 'overall, I am happy with the quality of care and support this service gives me'. Other views are referred to in the relevant quality statements. Shaw Community Services - Edinburgh, page 10 of 22

11 3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths The evidence showed people using the service and their families were involved in discussions about the care they wanted and any changes to it. Care plans were reviewed at least every six months. We saw that the service encouraged relatives to take part in reviews. People said they were able to comment on their care and support and agree changes. Examples were given where the timing of the service or staff member was changed to meet peoples' needs. This meant people using the service could modify it to meet their wishes. The service had used questionnaires to ask people and their families what they thought about the service. This gave people using the service an opportunity to comment on the quality of the service they received. We saw copies of questionnaires in peoples' files. We saw how the service had dealt with any issues raised. A newsletter for people using the service had been issued in December This gave people information about the service and new staff. A feedback form had been attached asking what people thought of their care and the quality of staff. One aim of the service was to 'support service users to access advocacy when needed'. An advocate is a person independent of any aspect of the service who acts on behalf of, and in the interests of, the person using the service. Shaw provided people with a list of local advocacy services to use. Shaw had a (draft) Service User Involvement policy. This stated service users should be 'empowered to take a central role in designing, developing and delivering services'. It identified various methods to do this: Shaw Community Services - Edinburgh, page 11 of 22

12 * Feedback questionnaires * Observing staff * Newsletters * Service user and relative meetings or forums Areas for improvement The service should continue to develop the ways it gathers feedback from people using the service. During feedback we discussed how care plan reviews and spot checks on staff could be used to gather people's views about what improvements they would like. The service agreed to plan how to do this in ways that were meaningful for people using the service. The service told us it wanted to make use of Service User forums so that people using it and relatives could meet to discuss the service, how it was provided and changes to improve it. Meetings have not yet been planned but people and there families had been asked to take part. We will monitor progress at the next inspection. The service should develop ways to feedback information to service users about the improvements it has made. We discussed how this could be done, for example, in the newsletter. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths People using the service had detailed support, care plans and guidance for staff in how they wanted their care provided. Plans were of a good standard. These contained information about the health needs each person had and contact details for the GP and other health professionals involved. Each person had named staff (a key worker) who cared for them regularly. The care plans we sampled showed how staff helped people using the service to meet their health needs. These included carrying out the care described in the care plan. Some of the personal plans had detailed information about how the person wanted their care given. Important information was highlighted. The Manager told us they planned to ensure plans contained enough information for staff to ensure care was given in the ways people wanted. Shaw Community Services - Edinburgh, page 12 of 22

13 Staff wrote down what they had done in a daily log book. This meant there was a record of the tasks carried out. It also meant staff could pass information to each other. Each person using the service had a risk assessment in place. This identified any risks and ways to reduce these. The assessment helped staff work with people in safer ways. Staff we spoke to said they were familiar with the health needs of people using the service. Staff were able to discuss health problems that had affected people using the service, how they had dealt with these and how they had included the person (or their family) in the discussion. People using the service said they thought staff had a good understanding of their health and wellbeing needs and supported them to have these met. Overall people told us that the continuity of care staff was good. Staff told us they worked with the same people wherever possible. People using the service were helped with taking medication in different ways. Many people took it themselves. Sometimes staff helped by reminding people. The organisation supported staff to carry out their work in this area. It had a medication policy based on the City of Edinburgh procedures. This provided guidance to staff to manage medication with the person using the service, to meet their needs and when possible, to increase independence. The service provided training in medication and assessed how well staff carried out this task. Staff we spoke with told us they had completed this training. Areas for improvement Inspection report continued We saw that sometimes staff did not record when they started or finished a visit to a service user. The Manager agreed to remind staff of the need to do this (see recommendation 1). The Manager told us the service had experienced some difficulties employing staff but that this had improved in the last four months. One person told us that regular staff now came to them and this had improved the quality of care. The Manager said they were aware of the need to ensure people using the service had regular staff and would aim to do this. We will monitor progress at the next inspection. We saw one moving and assisting risk assessment that had not been brought up to date following changes in the person's abilities. This meant the information available to staff in the care plan in the person's home was not accurate. It is important that the information is correct and in enough detail to ensure the person's health and well being needs were met. The Manager agreed to follow this up and we have made a requirement (see requirement 1). Shaw Community Services - Edinburgh, page 13 of 22

14 Grade awarded for this statement: 4 - Good Number of requirements: 1 Number of recommendations: 1 Requirements 1. The provider must ensure that all risk assessments are reviewed at least once in every six month period, and where there is significant change in a service user's health, welfare or safety needs or when requested to do so by the service user or their representative. This is to comply with SSI 2011/210 5(2)(b) - Personal Plans. Account should also be taken of National Care Standards, Care at Home, Standard 3 - Your personal plan and Standard 4 - Management and staffing. Timescale: to start on receipt of this report and have outstanding reviews completed by 28 February Recommendations Inspection report continued 1. The service should ensure all staff record the times of visits to people using the service in the daily care notes. National Care Standards, Care at Home, Standard 4 - Management and staffing. Shaw Community Services - Edinburgh, page 14 of 22

15 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 Please see the strengths in Statement 1.1. People using the service said they were able to comment on their care and support and make changes. Examples were given where the timing of the service was changed to meet individual need. We also saw examples of where feedback had been used in staff support and supervision to improve practice. Areas for improvement At feedback we discussed further ways the service could involve people using the service and carers in improving the quality of staffing. The Manager said they hoped to use the group meetings to improve involvement. We suggested the service could consider how to involve people using the service and their families in the recruitment of staff and developing staff training plans. We will follow this up at the next inspection. 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 As this was a new service most staff had only attended induction training. The induction gives staff an introduction to the service, its aims and objectives, values, its policies and procedures. Staff said induction training was very good. This took place over three days. It included first aid, food hygiene, infection control, moving and handling and adult protection. Shaw Community Services - Edinburgh, page 15 of 22

16 Following induction staff shadowed other workers. This was especially helpful to staff who were carrying out care work for the first time. Staff told us they thought they could shadow other staff until they felt confident in their new role. Staff we spoke with said they had 1-1 meetings with the Manager. Support and supervision is where staff have a one to one meeting with their supervisor. They are able to talk about their work, problems and future training. Staff said they found the meetings helpful. They said the Manager and senior staff were always available. They could contact them by phone for support at any time and were able to drop in to the office if they had a problem or issue. We looked at three staff recruitment files. We saw that staff were recruited in line with safer recruitment guidelines. We saw that references had been obtained. We saw that a health check had been carried out. We saw that Protection of Vulnerable Groups (PVG) checks had been completed and that staff did not begin work until this had happened. The Manager told us staff could not be given work until all checks had been completed by Human Resources. Areas for improvement The service had identified the need to provide Scottish Vocational Qualification (SVQ) training and assessment for all staff. This would mean staff would meet the Scottish Social Services Council (SSSC) requirements for registration of care workers. The service should continue to give staff access to this training. The induction training gave new staff a useful introduction to the roles of a care worker and the different needs of people using the service. The Manager told us she was aware of the limits of the induction and that the organisation was to plan further training days to develop staff in, for example, understanding dementia. We agreed the service should develop a training programme to ensure staff had the training necessary to meet service users' needs (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 a training plan for staff to support them to meet the health, welfare and safety needs of people using the service. National Care Standards, Care at Home, Standard 4 - Management and staffing. Shaw Community Services - Edinburgh, page 16 of 22

17 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 Please also see Statement 1.1. People using the service told us they thought that the service they received worked well. They said that if there were any difficulties they would contact the office or Manager. They said that when this occurred staff were helpful and listened to the problem. They said the service tried to resolve issues quickly and usually let them know if staff were going to be late. Areas for improvement Please also see statement 1.1 The service could consider how to involve users and carers in helping it complete its self assessment. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide Service strengths Please also see statements 1.1, 3.1 and 4.1and references to quality assurance in other statements. We asked the Manager how they knew that the service they were providing was good enough. They said they worked closely with staff to ensure they had, for example, enough time to carry out the work. This was done by monitoring times and auditing daily care notes. Issues and concerns, such as the length of time of a visit, would be Shaw Community Services - Edinburgh, page 17 of 22

18 picked up. We were also told the Team Leader carried out spot checks to observe practice and audit care plans. Senior staff were responsible for ensuring that the quality of the service was checked and where necessary make improvements. They used a number of systems to help monitor the care and support given to people using the service. These included: * Spot checks on staff performance * Checks on new staff (with feedback from people using the service) * Complaints * Accident and incident recording * Support and supervision meetings. As part of the contract with City of Edinburgh Council, Shaw Community Services use an electronic monitoring system, CM2000. This meant the service can check when staff arrive and leave a person's home and the length of time they stay. The system would also alert the service if staff did not attend. We looked at the monitoring information provided by the Council. We saw the service was achieving reasonable results for staff being on time. We looked at one complaint the service had received. We saw that this had been investigated, actions taken and that it had been dealt with appropriately. The service had also told the Care Inspectorate about the complaint and outcome. This was because of the seriousness of the complaint. Services must inform the Care Inspectorate when some kinds of incidents and accidents occur. These are called notifications. Shaw Health Care had completed a Quality Assurance Review Report following a visit to the service in September The report was broadly positive and had identified a small number of issues and actions the service had to take. These were written into an action plan by the Manager. Areas for improvement Inspection report continued The service had good methods in place to encourage feedback from people using the service and their carers. The service was also monitored by City of Edinburgh Council. It could however develop ways to get feedback from other external stakeholders. We will follow this up at the next inspection. During the inspection we talked about how the service would maintain and develop its quality assurance as the service grew larger. The Manager told us they recognised the level of their own involvement in auditing and checking the work the service carried out at present and how that would become more difficult as the service expanded. They said they planned to increase the numbers of staff able to monitor and audit the service and staff to try to ensure quality was maintained. We will monitor how this has progressed at the next inspection. Shaw Community Services - Edinburgh, page 18 of 22

19 Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Shaw Community Services - Edinburgh, page 19 of 22

20 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 No 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). Shaw Community Services - Edinburgh, page 20 of 22

21 5 Summary of grades Quality of Care and Support Good Statement 1 Statement Good 4 - Good Quality of Staffing Good Statement 1 Statement Good 4 - Good Quality of Management and Leadership Good Statement 1 Statement Good 4 - Good 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. Shaw Community Services - Edinburgh, page 21 of 22

22 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: Shaw Community Services - Edinburgh, page 22 of 22