Enable Scotland (Leading the Way) - Oban, Lorn and Isles Housing Support Service Unit 3 McLeod Building Lochavullin Estate Oban PA34 4PL Telephone:

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1 Enable Scotland (Leading the Way) - Oban, Lorn and Isles Housing Support Service Unit 3 McLeod Building Lochavullin Estate Oban PA34 4PL Telephone: Inspected by: Elspeth Gibb Type of inspection: Unannounced Inspection completed on: 25 July 2013

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 10 4 Other information 17 5 Summary of grades 18 6 Inspection and grading history 18 Service provided by: Enable Scotland (Leading the Way) Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Elspeth Gibb Telephone enquiries@careinspectorate.com Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 2 of 20

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 6 Excellent Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well The inspection showed that the manager and the staff team are enthusiastic and committed to the people they support. The way people are supported to be involved in the service was excellent. There is an open supportive atmosphere throughout the service and people feel free to drop into the office. Personal planning systems in place are excellent and the people using the service were positive about the way staff support them in their daily lives. There was strong evidence that staff are keen to improve the service for each person and that they are well supported by the manager. What the service could do better The supervision arrangements for some staff have been infrequent but plans are in place to resolve this. Some staff would benefit from more in depth understanding of the regulatory process and the quality themes inspected. What the service has done since the last inspection Since the last inspection, new health care plans have been put in place for each person. Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 3 of 20

4 Conclusion Inspection report continued Enable Oban continues to provide a very high quality service which is valued by service users, staff and the local community. Who did this inspection Elspeth Gibb Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 4 of 20

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Prior to 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 The Care Inspectorate will award grades for services based on findings of inspections. Grades for this service may change after this inspection if we have to take enforcement action to make the service improve, or if we uphold or partially uphold a complaint that we investigate. The history of grades which services have been awarded is available on our website. You can find the most up-to-date grades for this service by visiting our website, by calling us on or visiting one of our offices. Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve its service, we may make a recommendation or 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 but where failure to do so will not directly result in enforcement. A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reforms (Scotland) Act 2010 and Regulations or Orders made under the Act, or a condition of registration. Where there are breaches of the Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Inspectorate. Enable Scotland Oban, Lorn & Isles is a branch of the national care provider Enable Scotland (Leading the Way). The service provides care and support to a range of vulnerable adults with learning disabilities, mental health problems, physical disabilities, dementia and drug and alcohol dependency. The service is also available to children with disabilities under the age of sixteen. Some individuals receive 24 hour support within their own homes while others receive visiting/floating support for varying amounts of time. Based on the findings of this inspection this service has been awarded the following grades: Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 5 of 20

6 Quality of Care and Support - Grade 6 - Excellent Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very 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. Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 6 of 20

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 which took place over three days - 7th May, 29th May and final feedback was given on 25th July The inspection was carried out by SCSWIS inspector, Elspeth Gibb. People were visited in their own homes and a meeting was held with the staff group. There was a delay in completing the inspection due to the inspector's absence from work. The report is a summary of the findings and detailed feedback was given at the end of the inspection visit. As requested by us, the care service sent us an annual report. The service also sent us a self assessment form. In this inspection, we gathered evidence from various sources including the relevant sections of policies, procedures and other documents, including: Personal plans of people who use the service Minutes of meetings Completed service user questionnaires Staff Training Records Discussions with the manager, team leaders and the staff team Visits to the homes of 3 service users Relatives of people who use the service Observing interactions between people who use the service and staff 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 Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 7 of 20

8 Inspection Focus Areas (IFAs) Inspection report continued 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 Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 8 of 20

9 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 that the people who used the care service had actively contributed to the self assessment process. Taking the views of people using the care service into account The people who use the service communicated in a range of ways what they felt about the service they receive. Some told us how helpful they found the staff in the office and that they could drop in any time. Very positive relationships were observed and there was a high level of satisfaction with the service. Taking carers' views into account Relatives of the people supported were very positive about the quality of the service. Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 9 of 20

10 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: 6 - Excellent 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 We found the performance of this service to be excellent in the areas covered by this statement. We concluded this after we consulted with service users in their own homes, engaged in discussion with all the staff available on the days of inspection and examination of a wide range of documentation relating to the service. Personal plans described how people wished to be supported in a person centred way and the recordings indicated that there was a high level of participation and involvement throughout the service. Within the personal plans we could see that people had regular review meetings to evaluate the service. The people who use the service chose whom they wanted to attend their review meetings. As at the previous inspection, all staff and service users were involved in a workshop day to contribute to the self assessment of the service. This was an innovative approach and the results in promoting awareness of the quality statements were excellent. Team meetings are planned for every six weeks to discuss issues about each person's care and a monthly summary of needs and actions taken was in place in each file. There was a local participation strategy that outlined how people would be involved in different aspects of the service. There are complaints and suggestions leaflets readily accessible to service users and relatives. Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 10 of 20

11 The people using the service are involved in the training plan and some have communication books which help them make their wishes and opinions known. All the people that we spoke with told us that they felt they were involved in making decisions about their own life. Areas for improvement Some staff were unsure about their contribution to the self assessment procedure and this has been followed up by the manager. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued We found this service's performance was excellent in the areas covered by this statement. We concluded this after we spoke to the manager and the staff team, reviewed personal plans, questionnaires and talked to people who use the service. Each person using the service had a detailed essential lifestyle plan which highlighted individual health needs and how staff could best meet those needs. There was strong evidence of person centred support planning and accountable practice. New health care plans are being put in place for each person as part of the new outcome based support planning system in use throughout the service. Health concerns were well documented and interventions were well recorded in order to ensure accountability. The organisation has implemented personalisation training for all staff to support them to use the new planning system. All the support plans we looked at identified regular contact with the GP, dentist and other involved health professionals. There were strong links with opticians, audiologists, speech and language therapists, chiropodists and other health professionals. There was also some very good examples of alternative health professionals supporting individuals. There was evidence of good joint working with the learning disability nurse who is based in Oban. The staff that we spoke with, were aware of the health needs of the people that they supported and how those needs should be met. Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 11 of 20

12 Areas for improvement The service should strive to maintain the excellent standards evident at this inspection. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Inspection report continued Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 12 of 20

13 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths The people using the service are involved in the interview process in a meaningful way. They are also involved in staff development and training days. Details of the general procedures and methods used to promote participation are included at Quality Theme 1.1. Areas for improvement The self assessment stated that further open days are planned to look at practice and development to be arranged. Grade awarded for this statement: 6 - Excellent 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 We found that this service was performing very well in the areas covered by this statement. We concluded this after we spoke to the manager and the staff team, reviewed personal plans, questionnaires and talked to people who use the service. Staff felt they could talk with the team leader and the service manager if they had any concerns. The inspection showed that there was an open and supportive approach to managing the service. The management team work very well together and showed by their actions and discussion that they were strongly committed to staff development, training and the development of a strong person centred approach to supporting people. Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 13 of 20

14 Regular team meetings take place to explore ways to improve services and to give the opportunity to raise concerns or issues. The organisation has very well established policies and procedures which underpin practice and all staff are aware of the SSSC codes of practice. All staff are supported to attend staff development days and they said that these were very enjoyable and beneficial. A high percentage of staff already have SVQ qualifications and others are currently working towards this qualification. All mandatory training in moving and handling and food hygiene is up to date and staff have access to a very good training programme covering a wide range of development areas. The team leaders have also had access to SVQ 4 training and a Personal Development Award to enhance their management and leadership skills. Areas for improvement A more regular planned supervision programme will improve the opportunities for improvement of practice. The possibility of introducing group supervision alongside individual planned supervision was discussed at the inspection. Some staff expressed concerns about their terms and conditions of employment but were still motivated to work for the organisation. Staff awareness of the regulatory process could be developed further and increased understanding of the purpose of the self assessment and grading of the service should be promoted. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 14 of 20

15 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very 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 We found this service's performance was excellent in the areas covered by this statement. We concluded this after we spoke to the manager and the staff team, reviewed personal plans, questionnaires and talked to people who use the service. The inspection showed that the management team were using innovative ways, including workshops to involve people in the self assessment process in order to raise awareness of the quality people can expect from the service. People are encouraged to communicate their views and suggestions for improvement and there is an open inclusive approach to the management of the service. There are regular staff meetings which promote effective communication and helps ensure that a high quality service is maintained. The organisation has a document entitled 'The way ENABLE Scotland is run' which outlines and reinforces the commitment to participation. Areas for improvement Some improvements to the management of supervision were discussed during the inspection. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 15 of 20

16 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 We found this service was performing very well in the areas covered by this statement. We concluded this after we spoke to the manager and the staff team, reviewed personal plans, questionnaires and talked to people who use the service. The manager follows the organisation's internal quality assurance system which provides thorough, accountable procedures to ensure that quality is maintained. The inspection showed that the management team were using innovative ways, including a workshop to involve people in the self assessment process, to raise awareness of the quality people can expect from the service. People are encouraged to communicate their views and suggestions for improvement and there is an open inclusive approach to the management of the service. There are regular staff meetings which promote effective communication and helps ensure that a high quality service is maintained. A supervision plan is in place which offers the opportunity to raise any concerns and all staff have an annual staff appraisal. Internal quality audits of the service take place and the organisation has started using EFQM model to evaluate performance. Upward appraisals are used to gain feedback about the performance of senior staff. Areas for improvement The self assessment notes the intention to develop the way questionnaires are used in the service. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 16 of 20

17 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). Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 17 of 20

18 5 Summary of grades Quality of Care and Support Excellent Statement 1 Statement Excellent 6 - Excellent Quality of Staffing Very Good Statement 1 Statement Excellent 5 - Very Good Quality of Management and Leadership Very Good Statement 1 Statement Excellent 5 - Very Good 6 Inspection and grading history Date Type Gradings 30 Oct 2012 Announced (Short Notice) Care and support Staffing Management and Leadership 5 - Very Good 5 - Very Good 5 - Very Good 12 Aug 2011 Unannounced Care and support 5 - Very Good Staffing Not Assessed Management and Leadership 5 - Very Good 8 Jun 2010 Announced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership Not Assessed 17 Jun 2009 Announced Care and support 5 - Very Good Staffing 4 - Good Management and Leadership 5 - Very Good 22 Dec 2008 Announced Care and support 4 - Good Staffing 4 - Good Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 18 of 20

19 Management and Leadership 4 - Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 19 of 20

20 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: Enable Scotland (Leading the Way) - Oban, Lorn and Isles, page 20 of 20