Glasgow SOLE Housing Support Service

Transcription

1 Glasgow SOLE Housing Support Service Quarriers Regional Office 252 Keppochhill Road Glasgow G21 1HG Telephone: Type of inspection: Announced (short notice) Inspection completed on: 19 September 2017 Service provided by: Quarriers Service provider number: SP Care service number: CS

2 About the service Glasgow SOLE is registered with the Care Inspectorate to provide housing support and care at home to people who have learning disabilities and/or physical disabilities. The provider is Quarriers. The service has been operating since 2004 and registered with the Care Inspectorate since the Care Inspectorate was formed in Support provided to people can range from a few hours a week to 24 hours a day. The service is provided to people living in the north-east and southside of Glasgow. At the time of this inspection, support was being provided to 35 people. The registered manager co-ordinates the overall running of the service. Team leaders locally manage the staff teams who provide direct support to people. At the time of the inspection, the service was made up of 10 staff teams. The aims of the service include to: "...challenge poverty and inequality of opportunity and choice, to bring about change in people's lives". What people told us We visited seven people at their homes and observed a social activity where 10 people were taking part. For those people who were not able to verbally communicate their views to us, we could see that they were relaxed in the presence of staff and that staff were very responsive and caring to their needs. In addition to the comments we received, we also looked at feedback that the service gathered from supported people and carers. Overall feedback was very positive and comments included: "Very happy...staff are good". "Staff help me do what I like to do". Self assessment Although the service was not asked to submit a self-assessment, we were impressed that the process of selfassessment had continued since the last inspection. This shows a commitment to working in a quality focused way. From this inspection we graded this service as: Quality of care and support Quality of staffing Quality of management and leadership 5 - Very Good 5 - Very Good 4 - Good Quality of care and support page 2 of 9

3 Findings from the inspection Involving people and putting them at the centre of their support was very much at the heart of the service. People felt that they had a say in decisions that affected them and that very good opportunities were provided to review support arrangements. We observed service users to be comfortable and relaxed in the presence of staff. Many staff had known people they supported for a number of years and this contributed to the trusting relationships that had been formed. It was clear from discussions that staff were committed to ensuring that service users' experiences led to positive outcomes. We found a number of excellent and very good examples of this. For instance, staff had been matched to service users who had similar interests, which had led to people being able to spend time on hobbies that they enjoyed. A service user had gained employment and another person had started gardening and developed a friendship at the same time. Across the service people were encouraged to have meaningful activity by developing social networks and making use of their local communities. Physical and mental well-being continued to be high on the agenda. People were supported to attend routine health checks when needed and specialist services were accessed pro-actively. We noted feedback from a health professional on the quality of end of life care provided to a person: "Recently I witnessed first-hand the exceptional care, dedication and support Quarriers provided to one of my clients...the service worked closely in partnership with health and social work to enable the clients' wish to die with dignity at home". Whilst the majority of outcomes for people were very positive, we found that outcomes for a person who had recently moved to the service needed attention. This highlighted the assessment process as an area for improvement, and when we raised this with the management team we were reassured by the action taken to ensure better outcomes for the person involved. We have made a recommendation about this in the 'management section' of this report. The vulnerabilities that people could have were considered by staff and it was good to hear that approaches to risk were part of on-going discussions. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 5 - very good Quality of staffing Findings from the inspection Since our last visit the service had reflected on ways to improve service user involvement in the recruitment of staff. We heard of a new process that had proved to be successful whereby service users had felt able to take on more responsibility when meeting with candidates. page 3 of 9

4 Staff that we met with presented as very passionate and caring about the work they did. It was clear that staff gained satisfaction in providing very good care to people that they supported. In keeping with good practice, some teams used volunteers as a means of adding different skills and qualities to enhance support to people. Most of the staff that we met with said that morale was good and that their motivation levels were high. However, one staff team told us that this could be better because of a specific situation regarding the recent admission of a service user that we have referred to earlier in this report. When we brought this feedback to the management team, we were advised that action to address the areas of improvement was taken. Staff development processes had been enhanced, which included the introduction of 360 degree appraisals and an improved focus on reflective practice and shared learning. We found very good examples of direct observations of staff practice that had been carried out by line management. A new staff supervision workbook was due to be implemented, and it was very good to see that this included on-going discussions about keeping people safe from harm. Whilst staff were generally positive about training and education opportunities that they were provided with, there is a need to support staff more in keeping up to date with current best practice. We would ask that this also includes a review of staff awareness of medication guidance. (See Recommendation 1). At the time of the inspection some teams were using agency staff to cover shifts as a result of staff vacancies. We could see that the provider had been active in trying to fill these vacancies. In order to improve upon staff contingency plans to deal with future vacancies, the provider had recently committed to being overstaffed by 10%. This is a very positive development, which ultimately should impact on strengthening the workforce. Requirements Number of requirements: 0 Recommendations Number of recommendations: 1 1. Performance processes such as supervision and team meetings need to focus more on directing staff to current best practice that informs and influences their work. For example, this should include regular access to the Care Inspectorate Hub and SSSC (Scottish Social Services) website. This process should include evaluating the knowledge that staff gain from accessing best practice and the impact on their work. In addition, this should include reviewing staff awareness against current 'best practice' medication guidance. National Care Standards, Housing Support Services, Standard 3: Management and Arrangements National Care Standards, Care at Home, Standard 4: Management and Arrangements Grade: 5 - very good Quality of management and leadership page 4 of 9

5 Findings from the inspection The management team were known to people and were able to demonstrate a very good knowledge of service users and family or friends who were important to them. We found vast improvement in the morale and motivation of team leaders and the manager since our last visit. It was clear that this staff group felt refreshed and that this had helped take forward improvements that we had previously highlighted. A key contributing factor had been a change in the line management of the service, which was described as being "very supportive". The management team had worked hard to make sure that staff and service users were involved in assessing the quality of service. Whilst it was early days, it was good to see that local team development plans were being worked on that would then contribute to the overarching service development plan. We received very good feedback from team leaders and the manager on new organisational approaches to quality, which had included 'quality clinics'. It was good to hear that the work from quality clinics was being shared with support staff. Systems and audits to check the quality of service were mostly effective. However, our comments in other sections of this report in relation to the assessment of a new service user highlight a significant gap in this area of quality checking and monitoring. Whilst action was taken to address required improvements, this was remedial in response to us raising the impact on outcomes for the person involved. Our findings demonstrate the need for management to pay closer attention to the assessment process for new people moving to the service. (See Recommendation 1). The provider acknowledged that asking external stakeholders for their views on service delivery was an important aspect of quality assurance, and work was being undertaken to improve how feedback in this area was gathered. Overall, our findings show that management of the service had strengthened since the last inspection and were committed to continual improvements for the benefit of service users. Requirements Number of requirements: 0 Recommendations Number of recommendations: 1 1. The provider should confirm the improvement made to policy and practice to ensure that the assessment process for new people moving to the service will be monitored effectively to take account of outcomes. National Care Standards, Housing Support Services, Standard 3: Management and Arrangements and Standard 4: Housing Support Planning National Care Standards, Care at Home, Standard 3: Your Personal Plan and Standard 4: Management and Arrangements Grade: 4 - good page 5 of 9

6 What the service has done to meet any requirements we made at or since the last inspection Previous requirements There are no outstanding requirements. What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 An evaluation of staff knowledge and understanding of nutritional care and ASP (Adult Support and Protection) should be carried out to determine that this reflects good practice. National Care Standards, Housing Support Services, Standard 3: Management and Arrangements and Standard 4: Housing Support Planning National Care Standards, Care at Home, Standard 3: Your Personal Plan, Standard 4: Management and Arrangements, Standard 7: Keeping Well-Healthcare This recommendation was made on 14 November Action taken on previous recommendation Work had taken place in these areas, however the testing of knowledge and impact on practice needs to be tested further - this will be referred to under Theme 3. Recommendation 2 The manager should ensure that any environmental restriction is clearly explained within personal plans and is in keeping with best practice, such as 'Rights, Risks and Limits to Freedom (Mental Welfare Commission for Scotland, March 2013). National Care Standards, Housing Support Services, Standard 3: Management and Arrangements and Standard 4: Housing Support Planning National Care Standards, Care at Home, Standard 3: Your Personal Plan, Standard 4: Management and Arrangements, Standard 7: Keeping Well-Healthcare This recommendation was made on 14 November page 6 of 9

7 Action taken on previous recommendation Protocols were in place, however the testing of staff knowledge on 'Rights, Risks and Limits to Freedom (Mental Welfare Commission for Scotland, March 2013) needs further work. Recommendation 3 The provider should explore further the comments made by staff in relation to low morale and seek remedies to address concerns as appropriate. National Care Standards, Housing Support Services, Standard 3: Management and Arrangements National Care Standards, Care at Home, Standard 4: Management and Arrangements This recommendation was made on 14 November Action taken on previous recommendation This recommendation has been met, and staff who we spoke to at the last inspection reported significant improvement in this area. However, one team of support workers reported new related issues due to the recent admission of a person that they did not believe was being managed well - see Theme 4 for further detail. 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 and grading history Date Type Gradings 14 Nov 2016 Announced (short notice) Care and support 4 - Good Management and leadership 3 - Adequate 18 Dec 2015 Announced (short notice) Care and support 4 - Good page 7 of 9

8 Date Type Gradings Management and leadership 4 - Good 4 - Good 21 Oct 2014 Unannounced Care and support 3 - Adequate 3 - Adequate Management and leadership 3 - Adequate 21 Oct 2013 Announced (short notice) Care and support 4 - Good 4 - Good Management and leadership 3 - Adequate 17 Aug 2012 Unannounced Care and support 5 - Very good 5 - Very good Management and leadership 5 - Very good 7 Jan 2011 Announced Care and support 5 - Very good Management and leadership 1 Dec 2009 Announced Care and support 5 - Very good 5 - Very good Management and leadership 20 Apr 2009 Announced Care and support 5 - Very good 5 - Very good Management and leadership 4 - Good page 8 of 9

9 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. page 9 of 9