Paisley Project Housing Support Service Bruce Court 43/45 Dundonald Road Paisley PA3 4NB Telephone: 0141 887 7524 Inspected by: Janie Fraser Type of inspection: Unannounced Inspection completed on: 8 May 2013
Contents Page No Summary 3 1 About the service we inspected 4 2 How we inspected this service 6 3 The inspection 10 4 Other information 20 5 Summary of grades 21 6 Inspection and grading history 21 Service provided by: Blue Triangle (Glasgow) Housing Association Ltd Service provider number: SP2003000162 Care service number: CS2004079114 Contact details for the inspector who inspected this service: Janie Fraser Telephone 01698 897800 Email enquiries@careinspectorate.com Paisley Project, page 2 of 22
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 5 Very Good Quality of Staffing 5 Very Good Quality of Management and Leadership 4 Good What the service does well The Paisley Project worked in partnership with the young people using the service to support them to learn how to mange their own tenancies in a safe, secure environment. The staff were committed and their good relationships with the young people allowed them to work toward positive outcomes for the young people. What the service could do better The project needed to look at standardising the way information is stored and recorded and how, through regular supervision, they could support staff to do this. What the service has done since the last inspection Young people who use the service had become more involved in the recruitment of staff and also had an input into the training needs of staff. Conclusion The project offered support and advice to vulnerable young people when they are in crisis and were committed to achieving positive outcomes for them. Who did this inspection Janie Fraser Paisley Project, page 3 of 22
1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Information about the care services is available on our website at www.careinspectorate.com This service was previously registered with the care inspectorate with the Care Commission and transferred its registration to the Care Inspectorate on 1 April 2011. Requirements and recommendations If we are concerned about some aspects of a service, or think it could do more to improve, we may make a recommendation or a requirement. A recommendation is a statement that sets out the 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. Recommendations are based on the National Care Standards, relevant codes of practice and recognised good practice. A requirement is a statement that sets out what is required of the care service to comply with Public Service Reform (Scotland) Act 2010 and Regulations or Orders made under the Act or a condition of registration. Where there are breaches of regulation, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. Blue Triangle (Glasgow) Housing Association Limited is a registered charity set up in 1975 and now delivers housing support services to males and females of all ages and all degrees of social exclusion. The Paisley project provides accommodation and support for up to 23 people aged 16 or over located at two sites in Bruce Court, Dundonald Road Paisley and Argyle Street Paisley. Bruce Court has 12 individual fully furnished flats, each containing living room, bedroom, fitted kitchen and bathroom. Argyle Street is a further supported accommodation maximum of 11 persons, seven within the core project and four scatter flats. There is also a staff office on both sites where the Support Workers and Housing Assistants who staff the building 24 hours each day. The service can also offer support to up to 23 young people following discharge who have; secured their own permanent tenancy secured a SSST tenancy secured accommodation in the private rented sector require some inputs after returning to live with extended family The Project enables excluded homeless people to develop their self confidence and the skills required to live independently. Paisley Project, page 4 of 22
Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 5 - Very Good Quality of Staffing - Grade 5 - Very 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 www.careinspectorate.com or by calling us on 0845 600 9527 or visiting one of our offices. Paisley Project, page 5 of 22
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. This was carried out by inspector, Janie Fraser, Inspector. The inspection took place over two days on Wednesday 29 May 2013 between 9.30am and 15.00pm, Monday 22 April between 09:30am and 12:30pm. We gave feedback to the manager of the service and the external line manager on 8 May 2013. As part of this inspection we took account of the completed annual return and the self-assessment forms that we asked the service to complete and submit to us. We sent care standard questionnaires to the manager to distribute to the young people who were using the service. We also asked the manager to give out the questionnaires to staff. During the inspection process, we gathered evidence from various sources. We spoke with: three young people who use the service four staff the manager of the service the external line manager We looked at: the participation strategy, this is the service plan for how they will involve service users. accident and incident audits of personal plans minutes of residents meetings evidence of meetings with outside professionals young people who use the service questionnaires news letters Paisley Project, page 6 of 22
policies and procedures staff training risk assessments 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 www.firelawscotland.org Paisley Project, page 7 of 22
What the service has done to meet any recommendations we made at our last inspection Recommendation 1: The written agreement should be reviewed to provide both parties with a clearer understanding of the amount of support which an individual can expect to receive on a weekly basis. National Care Standards, Housing Support Services, Standard 2:Your Legal Rights. Progress: It was noted at the inspection that written agreements had been reviewed and were now appropriate for the service that is being provided. 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. The Care Inspectorate received a fully completed self-assessment document from the provider. We were satisfied with the way the provider completed this and with the relevant information included for each heading that we grade services under. The provider identified what they thought the service did well, some areas for development and any changes it had planned. The provider told us how the people who used the service had taken part in the self assessment process. Paisley Project, page 8 of 22
Taking the views of people using the care service into account We spoke to three young people who use the service during the inspection who told us they were very happy with the care they received. They told us: "I am fine with the amount of support I get" "I am not interested in the group participation or the magazine but I am aware of them and know I could join them if I wanted. "my key worker does the best to give be the confidence to do things for myself" "my key worker helps me make appointments for things like the job centre and the doctors" "my key worker is amazing I do not know what I would have done without her she's easy to talk to and build a relationship with." "I had a very good experience from the staff when I arrived they made me feel welcomed" Taking carers' views into account We did not speak with any carers during this inspection. Paisley Project, page 9 of 22
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: 5 - Very 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 Paisley Project had provided very good opportunities for the young people who were using the service to give feedback and make suggestions for improving the service. We gathered evidence from discussions with the young people who use the service, personal plans, discussions with staff and minutes of meetings. We sampled four personal plans and found that young people were involved in planning and reviewing their care on a regular basis. This was supported by the three young people we spoke to who confirmed that they were included in all decisions and were asked regularly how the project could improve the care they received. The young people told us because their views were valued they built trusting relationships with staff and had confidence in them. There was good evidence that the young people also had the opportunity to discuss improvements to the service through quarterly questionnaires and monthly meetings. Blue Triangle also had a user's forum every three months and young people at the project are encouraged to attend. This was also confirmed by staff and the young people we spoke with. We found evidence of young people using the service being involved in improving the quality of the staff. There was a comprehensive complaints procedure that all young people are told about when they are first admitted. The young people we spoke to were all confident about who they could complain to if the had issues about the staff. They also told us there was a suggestion box where they can raise issues if they felt there were inconsistencies in staff practice. Monthly meetings provided another avenue for them to raise issues. Paisley Project, page 10 of 22
There was good evidence from the records we sampled that young people were also involved in improving the quality of the management and leadership. Young people had been invited to comment on the projects self assessment. There was evidence that they were part of a working party to look at how they can be more involved in the selection and recruitment of all staff. Young people also informed us about the magazine 'blueprint' which was made up from contributions from the young people currently using the service, and, people who had moved on. The magazine includes a variety of articles about improvements to the quality of the service across different areas. Involving the young people in these activities not only gave them a voice in the quality of their care but also gave them skills to assist them in building relationships and confidence to deal with other issues in their lives. Areas for improvement The service should continue to develop creative ways to include the participation of the people using the service and their families. They should ensure they are rigorous in identifying any areas for improvement and implementing action plans to address these. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Paisley Project, page 11 of 22
Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued We found the service was delivering good quality care resulting in very good outcomes for the young people who are using the service. At this inspection, we looked at personal care files, support plans and spoke with the young people using the service and with staff. The young people had very good support plans that identified a range of needs. Plans allowed the young people to focus on what they needed, and made sure agencies and staff were clear about the help that was required. There was evidence of arrangements for how the young people and staff would manage risk, health needs, employment or education opportunities. Young people and staff we spoke to also confirmed that plans were individual to the young person's needs and, where appropriate, other agencies were used to support specific areas of their plans. When we spoke with staff it was clear that training was given in relation to the health and well being needs of the young people they were caring for which allowed them to facilitate the support plans. One young person told us: "I like having my independence but always know that support is there if I need it" Young people told us that the project also encouraged them to have healthy life styles which included healthy eating, and opportunities to be involved in activities that would improve their health and well being. One young person was going to attend the 'Fairbridge programme' which had been organised by their key worker. It was a residential programme aimed at outdoor activities that assisted with life skills, relationships and confidence building. We found records that plans were reviewed on a regular basis and young people confirmed they were involved in this process. Records indicated that "met" and "unmet" outcomes were clearly recorded and any further action required in relation to these was clear. The quality of the support provided assists the young people to build better relationships, be more confident and more able to sustain their own tenancy when they move on to independence. Paisley Project, page 12 of 22
Areas for improvement Although the content of the care plans were very good we found that there was duplication on how information was being recorded in the files. The Project should examine their recording procedures and ensure that all staff are aware of the appropriate forms to record in to avoid duplication. This will be followed up at the next inspection. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Paisley Project, page 13 of 22
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 evidence in Statement 1.1 in relation to consultation and participation is relevant to this Statement. Areas for improvement The evidence in Statement 1.1 in relation to consultation and participation is relevant to this Statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Paisley Project, page 14 of 22
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 very good at responding to the training needs of the staff to ensure they were highly skilled and trained to meet young people's identified needs. At this inspection, we focused on training plans and records, minutes of team meetings, direct discussion with the young people who use the service, staff, and the manager. We looked at the staff training folder which was up to date and evidenced the regular training events that staff had attended. There was a comprehensive induction programme in place for new staff that included mandatory training. Mandatory training was also on going for staff as and when required. Staff told us that there was a training plan they were made aware of for the year. Opportunities for training was fair and they had access to training specific to the needs of the young people they were key working with. The staff we spoke to said the team had a diverse set of skills that complemented each other and allowed them to offer very focused work with the young people they worked with. Regular team meetings were used to discuss/share concerns about young people and to pull together skills and knowledge that would help support the young people. The staff also informed us it was an opportunity to discuss their daily practice. This was also when they could get up to date information on legislation,policies and procedures and review their work in line with National Care Standards to ensure they were taking a consistent approach with the young people. They felt this allowed them to build strong trusting relationships with the young people, which in turn helped the young people to move on to their own tenancies. This was reflected in the minutes of their team meetings and also individual care plans. The young people we spoke to told us that the staff were very knowledgeable and knew how to access resources to support them. One young person told us "all the staff are supportive I had a lot of things going on they were able to give me good advice." Areas for improvement Inspection report continued The service should continue with developmental away days, as identified in the self assessment. The staff would have the opportunity to meet with external line managers to provide a "whole team" approach. This would allow the service to take a holistic view of the service at all levels. Consideration should be made about how the young people who use the service could be involved. It would ensure there was a more rigorous approach to identifying areas for improvement, planning and implementing action plans. Paisley Project, page 15 of 22
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Paisley Project, page 16 of 22
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 evidence in Statement 1.1 in relation to consultation and participation is relevant to this Statement Areas for improvement The evidence in Statement 1.1 in relation to consultation and participation is relevant to this Statement Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Paisley Project, page 17 of 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 At this inspection, we found that the performance of the service was good for this statement. The project had clear evidence as discussed in statement 1.1 of how young people participated in assessing the quality of the service provided. We found feedback from stakeholder questionnaires. We looked at the internal quality assurance audit, supervision records and spoke with staff, the manager and an external manager. We examined the welcome pack given to all young people that clearly explained the mission statement of the service, policies and procedures, including complaints, reporting of accidents and incidents and service user participation. The young people informed us that their key worker goes through this with them to ensure they understand all the information in it. Areas for improvement Inspection report continued We examined five staff supervision records and found that four out of the five staff had not had supervision in over a year. There were no supervision agreements in the files to indicate how often supervision should occur, what would be in the agenda, and who would be responsible for which tasks. We also looked for annual appraisal but were unable to find these. We spoke to four staff who confirmed that when they they very rarely received supervision from the previous manager. They informed us that since the new manager had come into post at the end of March they had either had supervision, or, had a date in their diary for this to happen in the near future. The staff had confirmed that the lack of supervision and contact with the external management had resulted in low staff morale. However, they felt strongly that they had not allowed this to impact in the direct work with the young people using the service. Examination of care plans and direct conversations with the young people supported this. The new manager and external manager confirmed that they were now aware of staff feelings and also recognised that improving supervision and communication was a priority in improving the quality of the service. The provider should have a clear supervision agenda that both the supervisor and supervisee can contribute to. The service provider should also ensure staff have annual appraisals to look at how practice is supported through the continuous professional development of their staff. (See requirement 1). Paisley Project, page 18 of 22
The service provider needed to ensure that staff have access to external line managers, other than through the manager of the project, to discuss any concerns they have about the service that may impact on the quality of the care. Grade awarded for this statement: 4 - Good Number of requirements: 1 Number of recommendations: 0 Requirements 1. The provider should ensure that all staff working in the service have regular supervision which addresses their individual needs. Supervision should address training needs, competency and allow for reflection on practice. Annual appraisals should also be part of the supervision process. This is in order to comply with The Social Care and Social work Improvement Scotland (Requirement for Care Services) Regulations 2011( SSI 2011/210) regulations 15 (a) and (b) Staffing. Timescale: Within two weeks from the issue of this report. Paisley Project, page 19 of 22
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 Due to internal technical difficulties, we could not determine if an action plan had been submitted following the previous inspection. Upon submission of the draft report, the manager contacted the inspector regarding the action plan, explaining that a paper copy had been submitted to the Care Inspectorate. A copy of the original was subsequently emailed to us. This showed that it had been completed satisfactorily and submitted within the required timescale. Unfortunately due to Care Inspectorate ICT technical difficulty, this section has not pulled through into the actual report. The service gave us an appropriate action plan on 12/10/2010 and we re-graded to the appropriate level. 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). Paisley Project, page 20 of 22
5 Summary of grades Quality of Care and Support - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Staffing - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Management and Leadership - 4 - Good Statement 1 Statement 4 5 - Very Good 4 - Good 6 Inspection and grading history Date Type Gradings 7 Jun 2010 Announced Care and support 5 - Very Good Staffing 4 - 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. Paisley Project, page 21 of 22
To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on 0845 600 9527. 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: www.careinspectorate.com or by telephoning 0845 600 9527. Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: 0845 600 9527 Email: enquiries@careinspectorate.com Web: www.careinspectorate.com Paisley Project, page 22 of 22