Turning Point Scotland - Perth & Kinross Housing Support Service 3 Grosvenor House Shore Road Perth PH2 8BD

Transcription

1 Turning Point Scotland - Perth & Kinross Housing Support Service 3 Grosvenor House Shore Road Perth PH2 8BD Inspected by: Averil Blair Neil Morrison Type of inspection: Unannounced Inspection completed on: 5 May 2014

2 Contents Page No Summary 3 1 About the service we inspected 4 2 How we inspected this service 6 3 The inspection 11 4 Other information 18 5 Summary of grades 19 6 Inspection and grading history 19 Service provided by: Turning Point Scotland Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Averil Blair Telephone enquiries@careinspectorate.com Turning Point Scotland - Perth & Kinross, page 2 of 21

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 6 Excellent Quality of Management and Leadership 6 Excellent What the service does well We saw that staff supported service users well with various risk issues, and encouraged them to make good community connections in the local area. What the service could do better The service planned to further develop outcome focussed support plans for service users. What the service has done since the last inspection The service had continued to build on excellent practice and was developing its garden project to allow service users to develop additional skills which may help them in seeking alternative activities. Conclusion During the inspection we spoke with service users and they told us that they felt staff supported them very well. They said that they felt they could speak with staff and that if they had any concerns staff would take action to support them. Who did this inspection Averil Blair Neil Morrison Turning Point Scotland - Perth & Kinross, page 3 of 21

4 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 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 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 Care Inspectorate. Turning Point Scotland is a nationwide, not for profit, care and support organisation which provides services to people with wide ranging needs across varied community settings and geographical areas. Turning Point's Perth Housing Support and Care at Home provides a support service to people with learning disability. Some people have a combination of support needs. At the time of the inspection the service had 4 service users being supported at Springlands House and 6 service users supported at Tulloch Road. In addition, the service supported additional service users living in their own tenancy within Perth. There is also a central office base close to all locations delivering care. The services are managed by a Service Manager. People who use the service have access to 24 hour staff support dependent on their needs. Based on the findings of this inspection this service has been awarded the following grades: Turning Point Scotland - Perth & Kinross, page 4 of 21

5 Quality of Care and Support - Grade 6 - Excellent Quality of Staffing - Grade 6 - Excellent Quality of Management and Leadership - Grade 6 - Excellent 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. Turning Point Scotland - Perth & Kinross, page 5 of 21

6 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 after an unannounced inspection which was carried out by two inspectors on a number of visits between 30 April 2014 and 5 May This included visits to the service's office as well as visits to meet service users in their own home. Prior to the inspection the service submitted an electronic self assessment and annual return as requested by the Care Inspectorate. During the inspection we gathered evidence from across the service, including the relevant sections of the provider's policies and procedures, records and other sources, including: - Completed Care Standard Questionnaires returned to the Care Inspectorate - Discussions with service users - Discussions with staff, in person and by telephone - A sample of personal plans - Risk assessments - Newsletters and bulletins - A sample of staff files - Records of staff training. Feedback was provided to the Service Manager and Assistant Service Manager on 5th May 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 Turning Point Scotland - Perth & Kinross, page 6 of 21

7 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 Turning Point Scotland - Perth & Kinross, page 7 of 21

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10 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. During the inspection, the Manager was informed on how to change the contact details on the eforms system to allow s to be sent from the Care Inspectorate directly to him. Taking the views of people using the care service into account During the inspection we spoke with service users both at their homes and at the service base while they took part in the garden project. They told us that they were very happy with the service they received, some were able to positively compare the service they received from Turning Point Scotland to services they had received in the past. They made comments such as "I can speak with my keyworker on a Sunday night, and we make sure everything is ok for the next week", and "I enjoy living where I do and the staff are very helpful and supportive". Taking carers' views into account We did not speak with any carers during this inspection. Turning Point Scotland - Perth & Kinross, page 10 of 21

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: 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 During the inspection we looked at a variety of documents which showed that service users were consulted and involved in their support. This included a sample of support plans, minutes of tenants meetings, minutes of reviews and quality assurance paperwork. We could see that there was clear involvement of service users in their support plans, and people who used the service told us that they felt they were fully involved in making sure that their support plans continued to meet their needs. They told us that they thought the service was excellent and we were able to confirm this. Service users told us that they had weekly meetings with their keyworker to discuss whether their support plans still met their needs. This also gave service users the opportunity to discuss any issues that concerned them. Service users had close contacts with associated services such as the Forensic Learning Disability service and, regular Risk Management review meetings where the support provided could be reviewed. Service users were fully involved in this process and this meant that if they wanted to take part in different activities risk issues could be discussed and strategies put in place to minimise risk. People who used the service were fully aware of this process and knew who to speak to if they had any concerns. They also said that they were confident that action would be taken if they raised concerns. All service users we spoke to during the inspection told us that they knew who to complain to and that they were aware of the Care Inspectorate and how to get in touch with them. During the inspection we visited service users in two units within Perth. At both these units service users had regular meetings where they discussed issues which affected Turning Point Scotland - Perth & Kinross, page 11 of 21

12 them all. We saw minutes of these meetings and, both staff and service users told us that this was a useful opportunity to discuss issues which arose as a result of shared living. We saw where minutes clarified what the service was going to do to solve problems, such as making sure staff were available to support service users on social events, and also what service users agreed to do, such as ensuring that they are considerate to other service users. We could see that there had been involvement of service users in the recruitment and selection of staff. Service users submitted a range of questions for prospective staff at interview, and they could then comment on the answers given. Service users were also involved in the internal self assessment process, known as IMPAQT, and this is discussed in more detail in Quality Theme 4 Statement 4. The service also uses questionnaires to staff, service users, carers and stakeholders to seek comment on the service. Areas for improvement The service is currently working on the development of outcome focused plans, having developed some outcome questions and associated processes on computer they are now looking to take this forward, to better identify whether service users get positive outcomes from the support they receive. 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 During the inspection we spoke with service users and staff, and looked at a sample of service users' support plans. We were able to confirm the service's own self assessment that they were providing an excellent service. We looked at a sample of service users' support plans, and could see that these were comprehensive, with detailed information on the support that service users should receive. This included clear and detailed information for staff on how to support or manage service users behaviours. Staff had developed detailed evidence of the identification of risk and how to manage it. These had been created with the involvement of service users and members of the wider care team, such as Forensic Community Learning Disability Nurse, and Psychiatric services. Generally we could see that there was good involvement of the multidisciplinary team, and service users were supported to make good use of health services, such as local GPs, dental and forensic services. Service users told us that they felt staff had Turning Point Scotland - Perth & Kinross, page 12 of 21

13 good knowledge of the support they needed, and that they listened to what service users said about their support. This meant that they felt supported and felt that staff would support them to be involved in a range of activities in the local community. Service users were supported by staff to make good use of community services such as sports facilities, community groups, volunteering opportunities and Turning Points' own Garden Project which was based at the provider's offices in Shore Road Perth. The service was currently involved in developing a Risk of Injury and Risk of Falls Injury Assessment process along with Glasgow Caledonian University. We saw that the service audited service users' medication and finances, both staff and service users told us that this meant they felt confident the service was ensuring that they were well looked after. Areas for improvement Risk management plans are comprehensive and give good detail. However, due to the fact that they were so comprehensive it was not always easy to see whether staff had signed them to ensure they were the most up-to-date versions of the document. The service is developing a system for recording service users' outcomes, this is to evidence that service users have the opportunity to make appropriate choices and that taking part in activities results in positive lifestyle choices for service users. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Inspection report continued Turning Point Scotland - Perth & Kinross, page 13 of 21

14 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 6 - Excellent Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths Evidence in support of this statement can be found in Quality Theme 1 Quality Statement 1. Areas for improvement See Quality Theme 1 Quality Statement 1. 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 The service was able to provide evidence in support of their self assessment grading of excellent. As part of the inspection we sent out Care Standard Questionnaires to service users and their families to seek their comments on the service. They told us that they felt staff supported their relatives well and, they felt that they could speak with staff about any issues and be confident that action would be taken. New staff underwent an induction and probationary period, and during this time they had the opportunity to take part in a range of training and shadowed more experienced staff to gain useful practical skills. Staff received regular supervision, and this allowed them the opportunity to discuss a variety of issues in relation to the support needs of service users, as well as more general issues. Turning Point Scotland - Perth & Kinross, page 14 of 21

15 Records were kept of supervision sessions, and we could see that issues identified for action were followed up. This could have included additional training or arranging for staff to have alternative experiences within the service. Staff told us that they appreciated this opportunity and that they felt comfortable discussing some difficult issues with senior staff. As a result of this they felt they were more confident in dealing with some of the more difficult support needs of service users. We also sent Care Standards Questionnaires to staff and they told us that, they felt they would be able to access training on a wide range of issues, and this included training on the protection of vulnerable adults, health issues such as, epilepsy and diabetes, practical issues such as first aid or food hygiene. When we looked at staff training records we saw that records had been kept of training attended and, the service had a system in place to identify when refresher training was required. Training was also evaluated to ensure it continued to meet the needs of the staff. The Manager confirmed that the provider was developing an E-Learning resource to compliment the practical training available to staff. Staff confirmed that staff meetings were held regularly and all staff were encouraged to go if they were available. Senior staff told us that they tried to ensure that staff had the opportunity to attend staff meetings regularly while on duty. We saw from the minutes of staff meetings that issues discussed at previous meetings were followed up, for example in one case, the Manager arranged team building development work for one team which helped them deal with various issues, and which staff told us had been successful and enjoyable. Areas for improvement The Manager is currently applying for registration with the Scottish Social Services Council and, is aware of the need for staff to register as soon as the appropriate register is open and available to them. In some Care Standards Questionnaires we received from staff it was apparent that not all staff had a common understanding of restraint and whether the service had a restraint policy in place. This may be down to interpretation of the question asked by the service should ensure that all staff are aware of the range of strategies which could potentially be regarded as restraint. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Inspection report continued Turning Point Scotland - Perth & Kinross, page 15 of 21

16 Quality Theme 4: Quality of Management and Leadership 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 management and leadership of the service. Service strengths Evidence in support of this statement can be found in Quality Theme 1 Quality Statement 1. Areas for improvement See Quality Theme 1 Quality Statement 1. Grade awarded for this statement: 6 - Excellent 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 The service was able to provide excellent information on the systems they used to ensure they provided a good quality service. We saw that they had a variety of systems in place to allow people who used the service and their families to be involved in assessing the quality of service they provided. Service users had regular weekly meetings with staff to ensure that support plans continued to meet their needs. Staff could take forward any identified issues to management. Personal support plans were audited by senior staff and we could see that where some actions were identified these were attended to. The service had produced a leaflet called "Have your Say!" which set out what the people using the service could expect from their support team. Service users had a minimum of six monthly reviews, frequently more often as a result of the Risk Management System and, they were encouraged to take part in these. They could also take part in regular service users' meetings to discuss common Turning Point Scotland - Perth & Kinross, page 16 of 21

17 issues. We could see that service users had been encouraged to take part in the Care Inspectorate inspection and, were happy to talk with Inspectors and comment on the service they received. The service had an audit calendar in place which identified internal audits due to be carried out in any given month, such as medication audits, support plan audits and audits of financial records of service users. The service administrator was able to identify at any time when training was carried out and when refreshers were due. At the time of the last inspection the service had applied for the Recognised for Excellence programme (R4E) which is part of the EFQM Levels of Excellence certification programme. The provider has since been awarded the Bronze award, and were working towards a higher certification. The service used a self assessment process which was called IMPAQT. This looked at a variety of issues such as values, person-centred planning and service user involvement. The service was able to identify how they met with the organisations strategic aims as well as other identified actions such as from Care Inspectorate inspections or local authority monitoring processes. This process had been streamlined since the last inspection and it now identified actions and, how they met with internal and external quality indicators as well as strategic aims. The service was now required to complete a quarterly monitoring form for the local authority contracts monitoring team which provided a number of statistics such as, the number of reviews carried out, any staffing issues, accidents and incidents along with any outcomes from these, any complaints and compliments. Areas for improvement As mentioned in previous statements, the service was developing outcome focused support plans and these will allow the service to monitor positive outcomes for service users. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Inspection report continued Turning Point Scotland - Perth & Kinross, page 17 of 21

18 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). Turning Point Scotland - Perth & Kinross, page 18 of 21

19 5 Summary of grades Quality of Care and Support Excellent Statement 1 Statement Excellent 6 - Excellent Quality of Staffing Excellent Statement 1 Statement Excellent 6 - Excellent Quality of Management and Leadership Excellent Statement 1 Statement Excellent 6 - Excellent 6 Inspection and grading history Date Type Gradings 14 May 2013 Unannounced Care and support 6 - Excellent Staffing 6 - Excellent Management and Leadership 6 - Excellent 22 Jun 2012 Announced (Short Notice) Care and support Staffing Management and Leadership 6 - Excellent 6 - Excellent 5 - Very Good 1 Feb 2012 Re-grade Care and support 2 - Weak Staffing Not Assessed Management and Leadership Not Assessed 17 Nov 2010 Announced Care and support 6 - Excellent Staffing Not Assessed Management and Leadership Not Assessed 28 Oct 2009 Announced Care and support 5 - Very Good Staffing 4 - Good Turning Point Scotland - Perth & Kinross, page 19 of 21

20 Management and Leadership Not Assessed 1 Jul 2008 Announced Care and support 4 - Good Staffing 4 - Good 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. Turning Point Scotland - Perth & Kinross, page 20 of 21

21 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: Turning Point Scotland - Perth & Kinross, page 21 of 21