West Lothian Council - Housing & Building Services Housing Support Service West Lothian Council West Lothian Civic Centre Howden South Road

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1 West Lothian Council - Housing & Building Services Housing Support Service West Lothian Council West Lothian Civic Centre Howden South Road Livingston EH54 6FF Telephone: Type of inspection: Announced (Short Notice) Inspection completed on: 6 June 2014

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 13 4 Other information 24 5 Summary of grades 25 6 Inspection and grading history 25 Service provided by: West Lothian Council Service provider number: SP Care service number: CS If you wish to contact the Care Inspectorate about this inspection report, please call us on or us at enquiries@careinspectorate.com West Lothian Council - Housing & Building Services, page 2 of 26

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 We saw that staff tried hard to put people at the heart of the services provided. Services are provided by trained and committed staff. We saw people using the service were encouraged to take part in the service users group and give their views about the service. People using the service we spoke with said positive things about the staff and their commitment to the work. What the service could do better The service and the people using it need to build upon the participation strategy to ensure that views and concerns are heard and acted on. The service should find ways to involve people using the service in interviewing new staff as part of recruitment and in assessing how they carry out their work. What the service has done since the last inspection Staff numbers have increased in the parts of the service where more were needed. This has given staff more time to carry out their work. Support and supervision meetings were now recorded consistently. More audits of the service were carried out to improve the quality of the service. West Lothian Council - Housing & Building Services, page 3 of 26

4 One of the hostels used by the service has closed. Conclusion The service has made some changes that have improved the ways it is provided. West Lothian Council - Housing & Building Services, page 4 of 26

5 1 About the service we inspected West Lothian Council - Housing, Construction and Building Services (the service) is operated by West Lothian Council (the provider or 'the council') and provides short term support to people living in their own homes and in temporary accommodation including hostel style accommodation. Where longer term support is required by people, the service helps them get help from other appropriate services. The service consists of a housing support team based at the Civic Centre in Livingston, providing support to people in temporary accommodation or their own tenancies and the Emergency Accommodation Team who work from three sites in Bathgate, Broxburn and Blackburn. A family unit is part of the service. One of the aims of the service says that 'Housing Support services are practical services that assist people to maintain independent living in the community'. 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 This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April 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. 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 This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April West Lothian Council - Housing & Building Services, page 5 of 26

6 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 Inspection report continued 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. West Lothian Council - Housing & Building Services, page 6 of 26

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 announced (short notice) inspection. The inspection was carried out by one Care Inspectorate Inspector. This took place on 4 June 2014 between 9.30am and 6pm, on 5 June 2014 between 9.30am and 5pm and on 6 June 2014 between 9.15am and 2.30pm. We told the Manager what we found at the inspection on 6 June As requested by us the care service sent us an annual return. The service also 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 Appraisal records Staff training records Incident and accidents Complaint records Quality assurance information Complaints policy Minutes of meetings for people using the services Discussions with: The Registered Manager A Team Manager West Lothian Council - Housing & Building Services, page 7 of 26

8 Three team leaders Seven staff We were able to speak with people using the service in some of the accommodation we visited and also visited one person in their own home. Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at West Lothian Council - Housing & Building Services, page 8 of 26

9 What the service has done to meet any recommendations we made at our last inspection We made nine recommendations at the last inspection. 1. The service should continue to develop the range of ways in which people using it are able to assess and improve the quality of support. National Care Standards, Housing Support Services, Standard 8 - Expressing your views. The Homeless Network Group had reformed and was being supported in its activities by the service. This should help the service engage more consistently with people who are or have used it, to help it improve. This recommendation had been met. 2. The service should ensure that people using the service are aware of their right to complain to the Care Inspectorate. National Care Standards, Housing Support Services, Standard 8 - Expressing your views. We found that people were reminded they could complain to the Care Inspectorate and the contact details were contained in the monthly review form. This recommendation had been met. 3. The service should ensure that all staff have adequate access to risk assessment information, including how they can work with each person using the service to reduce risks and other measures they need to take to keep the person, and themselves, safe. National Care Standards, Housing Support Services, Standard 3 - Management and staffing arrangements and Standard 4 - Housing support planning. The increase in staff meant there was less reliance on 'bank staff' to cover the work. Staff told us that there were handovers at each shift to ensure that information was passed on. Risk indicators were completed for each person and 'bank staff' provided a written record for any concerns they had. This recommendation had been met. 4. The service should ensure that risks which apply to the person using the service are West Lothian Council - Housing & Building Services, page 9 of 26

10 recorded in ways that help people understand the risks in their lives and promotes ways to help people manage these. People should be involved in determining the risks where ever possible. National Care Standards, Housing Support Services, Standard 3 - Management and staffing arrangements and Standard 4 - Housing support planning. Staff told us that they assessed the risks people were taking and discussed these with them. However we did not see that people were able to sign the form to show they were aware of what was being recorded. It may not always be appropriate to do this but where ever possible people should have this opportunity. We have made this recommendation again to allow the service to consider this further (see statement 1.3). 5. The service should ensure that adequate numbers of staff are available to meet the needs of the people using the service, as outlined in individual support plans. They should ensure that there is adequate continuity of staff. National Care Standards, Housing Support Services, Standard 3 - Management and staffing arrangements and Standard 4 - Housing support planning. We found that more staff were available in some of the hostels where this was needed. This recommendation had been met. 6. It is recommended that the Manager continues to develop service user involvement in assessing the quality of staffing at the service, particularly to recording involvement in staff induction to the service and staff training. National Care Standards, Housing Support Services, Standard Expressing your views. We found that agreements had been made to improve this kind of involvement for people using the service. We have made the recommendation again to give the service time to implement this. Please see statement It is recommended that the Manager should ensure staff supervision is delivered in accordance with the proposed plan. The Manager should monitor the supervision plan to ensure that the supervision target dates are met. Notes of meetings should be recorded and reflect content of what was discussed. National Care Standards, Housing Support Services, Standard 3 - Management and staffing arrangements. We found that support and supervision was taking place regularly and recorded. This recommendation had been met. West Lothian Council - Housing & Building Services, page 10 of 26

11 8. The service should continue to develop how it engages with service users to assess and improve the quality of management and leadership of the service. National Care Standards, Housing Support Services, Standard 8 - Expressing your views and Standard 3 - Management and staffing arrangements. The Homeless Network Group had reformed and was being supported in its activities by the service. This should help the service engage more consistently with people who are or have used it, to help it improve. This recommendation had been met. 9. The service should assess and review its quality assurance systems to ensure that service users, staff and stakeholders are active in improving the service and ensuring standards are maintained. All staff should be aware of the systems they need to use to achieve this and complete the actions necessary. Improvement plans should be developed as appropriate for each part of the service. National Care Standards, Housing Support Services, Standard 3 - Management and staffing arrangements and Standard 8 - Expressing your views.. We found that staff were aware of the systems in use and the managers were keeping some checks on the work carried out in each part of the service. Supervision was regular and recorded. This recommendation had been met. The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. 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. The service provider told us how the people who used the care service had taken part in the self assessment process. West Lothian Council - Housing & Building Services, page 11 of 26

12 The service graded itself against the statements we inspected. We agreed with those grades. Taking the views of people using the care service into account We sent out 100 Care Inspectorate Care Standard Questionnaires and 17 were returned to us before the start of the inspection. Thirteen people strongly agreed and two people agreed that 'overall, I am happy with the quality of care and support this service gives me'. One person disagreed and one person did not know. People made the following comments: 'It has been a great help and support for me being here and it has got me to where I needed to be'. 'Excellent' 'I am really happy with the support I get from this service'. 'I think it is a great service which helps people in a very good way. Staff are very helpful'. 'I can go through some rough times but the staff are always there to help me...i can go down and wake them if I need to which makes me feel safe'. Taking carers' views into account We did not meet any families or carers during this inspection. West Lothian Council - Housing & Building Services, page 12 of 26

13 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 provider had a participation strategy. This identified some of the ways in which service users could take part in developing the service. We also found that more thought had been given to how staff could encourage people to participate in different ways. This included promoting and helping people attend groups. The service used a number of methods to help service users express their views. These included: * Homeless Network Group meetings * Residents' meetings at different sites * Planning support * Reviewing support plans monthly * Newsletters * Satisfaction surveys * Exit surveys (when people moved on). At this inspection we saw that the Homeless Network Group was re-establishing itself and that two recent meetings had taken place between people who had used the service previously, and one Manager in the service. We found that the Group had a clear sense of what it wanted to achieve and how to go about this. There was recognition of the difficulties of engaging with people using a homeless service. The meeting looked at different ways to do this. It was agreed people who had used the service in the past could also help develop the service in the future. The service had a complaints procedure. This provided opportunities for people to West Lothian Council - Housing & Building Services, page 13 of 26

14 raise issues formally if they were unhappy with the service. Many complaints were resolved at a local level informally. Where formal complaints were made, these were recorded and acknowledged. Timescales were in place to ensure that complaints were investigated as quickly as possible. Each person using the service had a support plan. Plans were of a good standard. We found people were able to participate in planning their support and were asked to decide upon the goals that they wanted to achieve. These were reviewed monthly and changes were recorded. This meant people were actively involved in planning what they wanted to do in getting the right kind of help. The accommodation based services held residents meetings. This gave people the chance to give their views about the place they were living in and what changes they would like. Staff we spoke with said they were encouraging people to attend the group. Where necessary they would support them to help them settle into it. We thought that staff and existing group members were keen to promote the group and its benefits and get more people to come. We found there was a better understanding of the benefits of service user participation, for both the people using the service and the service itself. Areas for improvement At the last inspection we had referred to some of the achievements of the Service Users Group previously, including the tenant led inspection. We now found that, after a tentative beginning, the group had reformed as the Homeless Network Group (HNG). This had linked into each hostel and carried out a small survey. There were also clearer plans about how to link into people using the service regularly and encourage attendance. We also found staff had more of a role to play, both in supporting the group and in helping people to attend. We thought this gave the HNG more structure and support for its activities. The group was also being mentored by one community council chair, supporting its active participants. These measures should give the group a firmer foundation and we will see how this has progressed at the next inspection. The service and HNG should also consider how to increase the participation of the people living in temporary accommodation. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued West Lothian Council - Housing & Building Services, page 14 of 26

15 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued We looked at eight support plans during the inspection. These recorded people's assessed needs and also what they said they wanted from the support. All plans we looked at were signed by the person using the service. They were asked to agree that information could be shared with other services. This helped ensure people knew who had access to information about them. Staff we spoke with said they were familiar with the health needs of people using the service. A 'single shared assessment', which could be passed on to other services, was completed. This asked people about their health needs and helped to identify other services that might be required. Staff we spoke with told us about health problems that had affected people using the service, which health professionals were involved and how they had dealt with any concerns. File notes showed the range of health professionals people using the service had recent contact with. We saw that the service had very good relationships with many health agencies in West Lothian, including Moving into Health (MIH) and the Addictions services. MIH is a NHS mental health nursing team that works in partnership with West Lothian Council and provides specific services to homeless people. Staff used some of their meeting time to talk about how people could improve their health through better diet and taking exercise. Classes were held to learn cooking skills. People, often with little money, had access to food banks in their local area and would be supported to use them. Referred by staff, people were given healthy ingredients and instructions on how to use them. One service now had bicycles people could use. This helped people be safe on the roads and introduced them to the cycle path network locally. The Manager also told us the service was able to purchase additional emergency items such as children's nappies and clothes. Staff supported or encouraged people using the service to attend a range of activities to improve their well-being. These included social contact, food shopping and supporting people to attend specific events. People we spoke with said staff had been very supportive and helped them through 'some tough times'. We saw some very thoughtful work taking place. At the family unit for example, children were given a 'sleep tight' pack which contained a teddy bear, bedtime story book, toiletries and blanket. This helped make children feel welcome at stressful West Lothian Council - Housing & Building Services, page 15 of 26

16 times. Staff also had the time to help new mothers develop the skills they needed to look after their babies. Areas for improvement At the last inspection we had raised concerns about the numbers of staff that were employed in some of the accommodation based services and the effect this had on the quality of support provided. We were also concerned that the high use of 'bank staff' did not contribute to a quality service and the management of risks. We found that staff levels had increased. Staff told us this meant they had more time to follow-up on work with each person. They were more able, for example, to support people to appointments with other services. There is less reliance on 'bank staff' to cover core business hours, which means the continuity of support has improved. The service should continue to monitor the numbers of staff in each service to ensure that support meets people's needs. We will see how this has been maintained at the next inspection. At the last inspection we recommended that people using the service should be aware of the records of risk kept about them. In the records we looked at it was not possible to tell if people had been made aware of the records and understood their content. We have made the recommendation again (see recommendation 1). Reviews of the service were carried out every month and fed into the support plan. Many of the support plans were not signed by the person using the service and it was not clear what people's views were of the support received. This would be an opportunity to record their comments (see recommendation 2). Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 2 Recommendations Inspection report continued 1. The service should ensure that risks which apply to the person using the service are recorded in ways that help people understand the risks in their lives and promotes ways to help people manage these. People should be involved in determining the risks where ever possible. National Care Standards, Housing Support Services, Standard 3 - Management and staffing arrangements and Standard 4 - Housing support planning. 2. The service should ensure that support plans are signed and that the views of people using the service are recorded. National Care Standards, Housing Support Services, Standard 3 - Management and West Lothian Council - Housing & Building Services, page 16 of 26

17 staffing arrangements, Standard 4 - Housing support planning and Standard 8 - Expressing your view. West Lothian Council - Housing & Building Services, page 17 of 26

18 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths Please also see statement 1.1. The service had agreed ways to ensure that people using the service took part in recruiting and inducting new staff. In the Care Standard Questionnaires returned to us 16 people agreed or strongly agreed that staff had the skills to support them. One person disagreed. Fourteen people strongly agreed and three agreed that staff treated them with respect. Areas for improvement People using the service should be encouraged to help assess and improve the quality of staffing at every opportunity. We made a recommendation about this at the last inspection and have made it again, to give time to develop this work (see recommendation 1). Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. It is recommended that the Manager continues to develop service user involvement in assessing the quality of staffing at the service, particularly to recording involvement in staff induction to the service and staff training. National Care Standards, Housing Support Services, Standard Expressing your views. West Lothian Council - Housing & Building Services, page 18 of 26

19 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Inspection report continued West Lothian Council had a range of policies and procedures to support staff in their work. Twenty three staff questionnaires were returned to us. These showed that staff had access to policies and were aware of their content. We saw that changes to policies and procedures were discussed in team meetings. We also saw that staff had attended training to keep them up to date with specific issues such as welfare reforms and housing legislation. Some staff were undertaking longer courses for their professional development. Staff said that they were able to attend training. They could discuss their needs in support and supervision or at their annual review. We saw that the organisation had a list of training staff should have. This included refresher days for mandatory training such as child and adult protection, as well as training directly relevant to the work they were doing. A wide range of training was offered by other council departments and from external sources, including mental health awareness and working with victims of domestic abuse. Staff we spoke with said they had support and supervision with their team leader or manager. They said they found the meetings helpful. Support and supervision means staff have a one to one meeting with a more senior staff member. They can discuss their work, issues and concerns, training and development in these meetings. One meeting was used as an appraisal of performance. Staff said they could say what they had achieved over the past year, set new goals and plan their training for the year. At the last inspection we said that supervision notes had not been completed or were too repetitive. We found that all notes were now recorded and were of better quality. Staff also had meetings with their managers to discuss their key work with the people they were responsible for. This helped support staff evaluate and review their work. This also meant the manager was aware of workloads and areas for concern. All staff had a training record which showed what they had completed. Some of this training was specific to one service, such as postnatal mental ill health while others applied generally. These included mental health first aid and drug and alcohol brief interventions. The organisation had a good recruitment process. A police check (PVG) was carried out before people started work. They also had to complete a comprehensive induction to the organisation and service. West Lothian Council - Housing & Building Services, page 19 of 26

20 In the Care Standard Questionnaires returned to us most agreed or strongly agreed that staff treat me with respect, staff have the skills to support me, staff meet with me regularly and staff have enough time to carry out my support'. One person disagreed with some of these statements. One person said that 'my support worker is very caring and because of my support needs spends more time than is allocated, always with a very pleasant attitude. Hard to find any fault in the support'. Areas for improvement We found that some staff did not have a qualification that would allow them to register with the Scottish Social Services Council when required. At the last inspection we had agreed staff needed to be aware of development opportunities and be told when they would be supported to gain qualifications. This had not happened for some staff (see recommendation 1). The service should continue to ensure there are adequate numbers of staff available to meet the needs, support and care of people using the service. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. The service should ensure that it has identified an appropriate level of qualification for staff working in the service, to enable them to register with SSSC. It should inform staff when they are likely to be put forward for the qualification. National Care Standards, Housing Support Services, Standard 3 - Management and staffing arrangements. West Lothian Council - Housing & Building Services, page 20 of 26

21 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 The strengths identified in statements 1.1 and 3.1 may apply here. People using the service were given some information about changes that took place in the service and wider organisation. A newsletter for homeless people was issued every three months to keep people up to date and provide information about activities in the local area. We met with representatives of the Homeless Network Group and tenants' community group. They told us about their meetings with the manager of the Emergency Team and other staff within West Lothian Council. They outlined their plans for service user involvement in the service and discussed the work they had already completed. They said that the service was providing support to them to progress their work. This was positive and it is hoped an active group will be reestablished involving current users of the service as well as people who have used it in the past who want to support tenant participation. The Group told us that it had written an article for the Tenant's Newsletter. This is circulated to all tenants. This would raise the profile of the Group and their work in the wider community. Areas for improvement The service and HNG should continue to work together to support people who are using or have used the service to help assess and improve it. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 West Lothian Council - Housing & Building Services, page 21 of 26

22 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 strengths identified in statements 1.1, 3.1 and 4.1 may also apply here. We found the service had a number of systems in place to help it assess the work being done. These included: * Staff one to one or support and supervision meetings * Performance review and development meetings * Case management meetings * Quality checks * Staff development days * Performance management procedures. We spoke with team leaders and the Manager in each service we visited. We asked them how they knew that the service they were providing was good enough. Most referred to case management as the way to keep track of individual staff work and ensuring it was kept up to date. This also provided the opportunity to assess the amount of time staff needed to complete case work. The service kept records of: * ncidents and accidents * complaints * notes of meetings with people using the service * staffing issues, including training. We looked at a sample of these records. We saw the information was checked by the Manager and followed up as required. The service is monitored by West Lothian Council. In its self assessment the service told us it contributes to the West Lothian Assessment Model (WLAM) and to the Customer Service excellence (CSE) award. This means the service is able to get feedback about how well it is achieving outcomes. The Homeless Network Group had carried out an initial survey of people's' views about the service they received. Areas for improvement Inspection report continued At the last inspection we said that it was not clear that staff understood how quality assurance was used or their part in it. We have said elsewhere in this report that some systems such as supervision have improved. We thought that some progress West Lothian Council - Housing & Building Services, page 22 of 26

23 had been made to meet the recommendation made at the last inspection but that the service should continue to develop this. The service should continue to develop the ways that staff, stakeholders and people using the service are able to be involved in assessing and improving it. When something goes wrong in a service, for example, if a service user has a serious accident, the Manager has to tell the Care Inspectorate. This is called a notification. The Manager was aware of their responsibility to do this but had not told us about the adult and child protection referrals they had made. We discussed this at feedback and agreed they will do so in future. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued West Lothian Council - Housing & Building Services, page 23 of 26

24 4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in the Care Inspectorate re-grading a Quality Statement within the Quality of Management and Leadership Theme (or for childminders, Quality of Staffing Theme) as unsatisfactory (1). This will result in the Quality Theme being re-graded as unsatisfactory (1). West Lothian Council - Housing & Building Services, page 24 of 26

25 5 Summary of grades Quality of Care and Support Good Statement 1 Statement Good 5 - Very Good Quality of Staffing Good Statement 1 Statement Good 5 - Very Good Quality of Management and Leadership Good Statement 1 Statement Good 4 - Good 6 Inspection and grading history Date Type Gradings 1 Jul 2013 Announced (Short Notice) Care and support Staffing Management and Leadership 3 - Adequate 4 - Good 3 - Adequate 16 Sep 2011 Unannounced Care and support 6 - Excellent Staffing 5 - Very Good Management and Leadership Not Assessed 14 Oct 2008 Announced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. West Lothian Council - Housing & Building Services, page 25 of 26

26 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: West Lothian Council - Housing & Building Services, page 26 of 26

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