Gowrie Care Limited - Supported Accommodation Project Housing Support Service 1 St John's Hill The Pleasance Edinburgh EH8 9TS Telephone:

Gowrie Care Limited - Supported Accommodation Project Housing Support Service 1 St John's Hill The Pleasance Edinburgh EH8 9TS Telephone: 0131 557 5502 Inspected by: Lynne Thow Type of inspection: Unannounced Inspection completed on: 20 February 2014

Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 11 4 Other information 23 5 Summary of grades 24 6 Inspection and grading history 24 Service provided by: Gowrie Care Ltd Service provider number: SP2003000083 Care service number: CS2004061961 Contact details for the inspector who inspected this service: Lynne Thow Telephone Email enquiries@careinspectorate.com Gowrie Care Limited - Supported Accommodation Project, page 2 of 25

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 Gowrie Care Ltd Supported - Accommodation project is a very valuable service which is well run and highly regarded by the people who use the service, staff and other professionals who work alongside it. Staff work alongside service users to devise support plans and risk assessments which are right for their individual circumstances and which show value for each and every service user. What the service could do better We discussed with the Manager the need to ensure the Care Inspectorate is made aware of all notifiable incidents and provided the guidance document in this area. We were confident this would happen. Although staff training was very good on the whole, the service is growing and developing and staff training should be kept in regular review to keep up with this changing need. We were confident that the provider was in the process of responding to this. What the service has done since the last inspection The service has continued to build on the very positive outcomes of the last inspection, including fully implementing the 'Outcome Star' process of assessment and intervention with clear review processes. There had been significant improvements in the support of service users who do not Gowrie Care Limited - Supported Accommodation Project, page 3 of 25

engage sufficiently with the help the service is offering and also improvements in supporting people to move on. Conclusion Gowrie Care Ltd - Supported Accommodation Project is a growing and developing service which is working hard to be flexible in the way it offers Housing Support. This is an excellent quality service delivered by a motivated and well engaged staff group. The staff and management team work well together. People who use the service felt well supported and described staff as building genuinely helpful relationships with them, which were helping them make progress in their lives. Who did this inspection Lynne Thow Gowrie Care Limited - Supported Accommodation Project, page 4 of 25

1 About the service we inspected Social Care and Social Work Improvement Scotland (SCSWIS) regulates care services in Scotland. It awards grades for services based on findings of inspections. These grades, including any that services were previously awarded by the Care Commission, are available on www.scswis.com Before 1 April 2011 this service was registered with the Care Commission as a housing support service. On this date the new scrutiny body, SCSWIS, took over the work of the Care Commission, including registration of care services. This means that from 1 April 2011 this service continued its registration under the new body, SCSWIS. 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 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 or 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." Gowrie Care Ltd - Supported Accommodation Project provides support to adults who have been homeless or are at risk of becoming homeless. Support is provided by staff teams at two premises in Edinburgh. People using the service have a range of needs, many having experienced addiction issues and/or mental health difficulties. The level and type of support provided is based on individual's needs. At the time of inspection 32 people were using the service. The service aims to provide the necessary individual support to enable people to move on to live in more permanent accommodation. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 6 - Excellent Quality of Staffing - Grade 6 - Excellent Quality of Management and Leadership - Grade 6 - Excellent Gowrie Care Limited - Supported Accommodation Project, page 5 of 25

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. Gowrie Care Limited - Supported Accommodation Project, page 6 of 25

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 that took place on 19 February. The inspection was carried out by Lynne Thow, Inspector. During this inspection we asked the service to show us evidence to support their selfassessment. We had discussions with the Manager, staff and people using the service. We looked at records including: * The service's internet website * Gowrie Care's service user survey results * Notifications of reportable incidents to the Care Inspectorate * Evidence of the service's most recent Self-assessment * Evidence of the service's most recent Annual Return * Certificate of Registration * Personal Plans * Business Planning consultation 2013 and Service Development Plan * Locality Plan - key Objectives * Risk assessments and work with other agencies * Accident records * Incident recording * Staff records including training records * Complaints records * Insurance Certificate * Minutes of staff and service users meetings * Relevant policies and procedures We took all of the above evidence into consideration when writing this report. We also took into account the Public Services Reform (Scotland) Act 2010 and associated Statutory Instruments, the National Care Standards - Housing Support Services and the Scottish Social Services Council (SSSC) Codes of Practice for Social Service Workers and Employers. Gowrie Care Limited - Supported Accommodation Project, page 7 of 25

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 report continued 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 Gowrie Care Limited - Supported Accommodation Project, page 8 of 25

What the service has done to meet any requirements we made at our last inspection The requirement There were no requirements or recommendations outstanding. What the service did to meet the requirement The requirement is: 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. 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 area that we grade service. The provider identified what it thought the service did well, some areas for development and any changes taking place. The self-assessment was completed to a high standard. Taking the views of people using the care service into account Before the inspection we sent the service Care Standard Questionnaires to be given to the people who use the service so that they could give us their views. We received 9 completed questionnaires and 6 staff questionnaires. We have included comments from people who use the service throughout the report. During the inspection we spoke individually with three service users, and 5 in a service user's meeting. The service users we spoke with were very happy with the Gowrie Care Limited - Supported Accommodation Project, page 9 of 25

service provided by Gowrie Care Supported Accommodation service, their feedback is throughout the report. Taking carers' views into account This is an adult housing support service. We did not find it necessary or appropriate to contact carers / relatives as part of the inspection process. Gowrie Care Limited - Supported Accommodation Project, page 10 of 25

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 that the service continued to operate to an excellent standard in relation to this Quality Theme. The service used a range of methods to hear people's views of the service and to involve them including: * Developing honest relationships which helped people to communicate openly. * People we spoke to told us they felt listened to and, if it was possible, staff made the things they suggested happen or explained if something wasn't possible. * Regular meetings with people using the service. * The service was continually striving to make information more accessible to people using the service. * Exit questionnaires and Gowrie Care Newsletters. * Regular reviews of support which fully involved service users. * Being clear about people's rights and responsibilities to help support them with managing their own permanent tenancy. There was very good use of pictures and symbols in support plans and information notices for people using the service. * We found evidence of changes happening as a result of ideas and suggestions from people using the service. * Service users were fully involved in staff recruitment and induction in a very meaningful way. * In this service, the manager and staff expressed a strong commitment to people using the service having an influence on how the service was provided. This meant people felt valued and able to speak up. Gowrie Care Limited - Supported Accommodation Project, page 11 of 25

People who use the service told us: "I am happy with the help... that I get from the staff and I feel that I can get on with the staff." "I respect and appreciate everything the support workers do for me. They are wonderful people who do their very best to support your needs, I thank God for their support..." "It's brilliant support, even staff that aren't my workers are really helpful, you can come and ask whenever you need it." We asked for some feedback from professionals who were involved with the service, their responses were very positive and included: "...it is evident to me when I visit the project, on a regular basis, that there is a high level of care and support given to all our service users... I often have to meet with service users to discuss payment of service charges, and the underlying theme is 'I don't want to lose my place'. There is close liaison between housing and the management/staff team." "The monitoring return includes summaries of the extensive service user involvement. The examples cover a wide variety of formal and informal mechanisms for engaging with clients. This has allowed them to successfully engage with people, some of whom have very challenging and complex support needs." "...Gowrie Care has a great reputation and is very good at service user involvement..." Areas for improvement The service should continue to work closely with service users and other partners to hear their views on how the service can continually improve and develop. Women's Aid, page 10 of 23 Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Gowrie Care Limited - Supported Accommodation Project, page 12 of 25

Statement 2 We enable service users to make individual choices and ensure that every service user can be supported to achieve their potential. Service strengths At this inspection, we found that the performance of the service was excellent for this statement. The service met the health and welfare needs of service users very effectively. We talked with service users, staff and other professionals working with the service and looked at support plans, policies, procedures, and the returned care standards questionnaires. Some of the strengths we found were: * Regular review and re- assessment with service users of their support needs and effective support planning which was encouraging service users to reach their potential. * Staff were very knowledgeable about the factors that affect how able people are to engage with services and were skilled at working with this. They were working very well with people to help them manage their choices and were advocating capably on their behalf with other services when appropriate. * Staff were assessing risks well and had developed a good balance of encouraging independence and addressing risk. * Staff were working hard to find ways of helping service users mix socially with one another. There had been a successful camping trip which was enjoyed by service users. * Service users were being encouraged to be involved in a variety of activities to enhance their health and well-being, including support to attend appointments and to make contact with the services they needed, including in sexual and mental health. * Regular assessments of the safety of the property were taking place with service users. * The resident's committee was another way that people could be involved in making decisions that helped them reach their potential. * Active involvement of service users in making decisions about the service that impact on them. People who use the service told us: "They stop and make space for you, it feels safe." "I like my wee flat, it's quality." Inspection report continued "I'm looking after myself better, family life is a lot better, they've helped me with my benefits, getting my birth certificate and visits with my daughter. The staff are really helpful and polite, any problems they are really helpful. It's been brilliant getting help Gowrie Care Limited - Supported Accommodation Project, page 13 of 25

to see my daughter." We spoke with professionals who work with the service and asked them about their experience of the quality of the service. Comments included: "We work very closely with the service, they will come into the prison and interview prisoners and often there is a smooth transition of being released from prison and moved straight into a supported accommodation. This is the best outcome for our client group." Areas for improvement The service should continue to work closely with service users and other partners to hear their views on how the service can continually improve and develop. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Gowrie Care Limited - Supported Accommodation Project, page 14 of 25

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 found in Quality of Care and Support, Statement 1, also applies to this statement. Areas for improvement Evidence in Quality of Care and Support, Statement 1 also applies to this statement. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Gowrie Care Limited - Supported Accommodation Project, page 15 of 25

Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths At this inspection we found that the service achieved an excellent standard in relation to this quality statement. We found strengths in many areas including the following: * The service development plan fully recognised the importance of a well trained and well motivated staff group and there were many actions in place to make this possible, including supervision and appraisal. * When we spoke with staff they described receiving very good training opportunities and were getting very good support from their team and from the management team. * They were an open and welcoming group who value good communication. * Staff were being given a variety of opportunities to increase their skills and knowledge including some being trained in the supervising of relief staff. * Staff were very capably supporting service users with access to employment including the "Women into Work" programme. * Staff we met with had a clear understanding of their role and best practice in Housing Support. They were clear with service users about their rights and their responsibilities and were advocating for them exceptionally well where appropriate. * Where there were service users who were not engaging with the service, staff were sure of their role and both supportive and effective in the work they did. * We saw evidence of staff being very clear about what their responsibilities were in helping service users achieve their goals. This work was well recorded and had regular review activity. * Staff had received training in substance misuse and in suicide prevention. We saw good work with service users in helping them identify and reduce their risks. Again this was also very well recorded to help make accessing by staff and review easy. * Staff training was including Welfare Reform which was helping make sure service users were getting the most up to date advice and help. People who use the service told us: Inspection report continued "The staff are there for me and when I'm feeling down they try their best to help me. I like that they treat me with respect and listen to me. I feel the staff care and are professional. I can't ask for better workers or management in this project, they all do an amazing job." "I came from (an institution). For the first time in a very long time I feel safe, I have started to enjoy life again. I could stay here for the rest of my life if they would let me, I know I have to get my own place." Gowrie Care Limited - Supported Accommodation Project, page 16 of 25

"Staff are very good, they are fantastic and I love being in the city centre." "I don't have anxiety or panic attacks anymore. Staff listened (private matter); Gowrie listened, for the first time someone listened." We asked for some feedback from professionals who were involved with the service, their responses included: "The staff are very approachable, are keen to discuss service users, to work with us and to have multi agency meetings. The management structure is very good and Gowrie Care is the only agency (of this kind) who does go into prisons and interview prisoners to see if they would be suitable for their project." "I work closely with staff if there are housing management issues surrounding service users, and the discussions and support from staff is at the highest level. Staff often have difficult cases to manage, but will call me for advice if there are housing management issues arising and these will be discussed fully with staff to ensure the best outcome. Staff are consistently looking at different ways to involve service users, with cooking, social skills, day trips out, gardening, all of which are giving people the opportunity to develop." "I cannot but admire the high level and quality of staff... I work closely with staff if there are housing management issues surrounding service users, and the discussions and support from staff is at the highest level. Staff often have difficult cases to manage, but will call for advice if there are housing management issues arising and these will be discussed fully with staff to ensure the best outcome. Staff are consistently looking at different ways to involve service users, with cooking, social skills, day trips out, gardening, all of which are giving people the opportunity to develop." "... with the joint working done with housing management and staff, people who are looking to move on to permanent accommodation can be identified and put forward for a tenancy...the Management at the project display real leadership. The procedures they have in place and the processes they adhere to, all culminate in an extremely successful relationship (between agencies)." Areas for improvement The service should continue to work closely with service users and other partners to hear their views on how the service can continually improve and develop. In particular staff training needs should be kept in review as the service continues to develop and change. Gowrie Care Limited - Supported Accommodation Project, page 17 of 25

Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Inspection report continued Gowrie Care Limited - Supported Accommodation Project, page 18 of 25

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 found in Quality of Care and Support, Statement 1, also applies to this statement. Areas for improvement Evidence in Quality of Care and Support, Statement 1 also applies to this statement. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Gowrie Care Limited - Supported Accommodation Project, page 19 of 25

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 and graded this aspect as excellent. We saw much strength in this service including: Inspection report continued * The Manager is now fully registered with the Scottish Social Services Council and 2 Senior staff have achieved SVQ 4 in Health & Social Care and are due to commence SVQ 4 in Management and Leadership this year. * We found the occasional incidence where refresher training was not always up to date. We were satisfied that the service was responding to this need. * Management/senior staff knew their team well and were both monitoring them and helping them develop their strengths. * Actions required as a result of inspections were included in the service delivery plan. * The staff team were having daily handover meetings where they were sharing important information to help reduce risk and to help people reach their potential. * Processes and support for service users not engaging with the service had been clarified further and was very clear for people using the service. * There were clear systems of quality assurance which allowed for the views of others and fully involved people who use the service. * Relief staff were now being provided with more formal support and supervision and this was helping with consistency for service users. * Systems were in place to make sure staff were providing support in line with the support plan. Support plans were relevant and up to date. * Staff were easily able to describe the support they were providing. * Effective communication systems were in place to ensure the support was effective. * Managers/seniors were reviewing the support arrangements with service users and taking any action needed. * There were well used mechanisms for staff support/supervision, such as group/ team/individual supervision. * The service was very good at seeking out feedback from external agencies. * Decision making was done in a very open and transparent way, this was a real strength of this service which was helping people who use the service and staff to feel valued. We asked professionals working with the service for their views on the quality of the service. Their feedback included: "...staff are going that extra mile on a daily basis with individuals including signposting them to other agencies." Gowrie Care Limited - Supported Accommodation Project, page 20 of 25

"(The service) had developed a cover sheet for the monitoring outcomes that are in the contract. This had been a simple and effective tool that has improved reporting and I have since encouraged other services to use it." "The reporting of performance is consistently of a high quality and is accurate. The service is required to submit information about occupancy rates on a four weekly basis and report on the outcomes that customers achieve on a quarterly basis. The returns are submitted on time and are presented in a clear and succinct style. The targets are generally met or exceeded; where this has not happened there has been very good reasons and good explanations given. There have been spot checks of the outcome returns and this has confirmed that the performance information is accurate." "The Manager and Assistant Manager at the service are always professional and they consistently work with the Council in an open and cooperative manner..." "...the leadership displayed, the procedures they have in place and the processes they adhere to, all culminate in an extremely successful relationship (between agencies)." People who use the service told us: "The Manager and Assistant Manager are fantastic people, my Support Workers are brilliant. My life seems so much better with these people's help, onward and upward for me!" "They support me in every way they can, they've helped me through all my housing stuff and they've helped me with courses to make things better. I can talk to the Manager, always talk to her. We have night staff and I can come and talk to them if I can't sleep." "My worker comes to the GP with and the dentist because I want support; they're one of the best. I've had the support I need and I'm ready to move on." Areas for improvement We discussed with the Manager the need to ensure the Care Inspectorate is made aware of all serious and notifiable incidents and have provided her with a current copy of the guidance. We had some feedback on the service regarding more clarity needed in the criteria for referral and re-referral to the service. We saw evidence that in line with its commitment to continually improve, the service was currently addressing this area to both respond to partner organisations while making sure there was effective 'gate keeping' of the service. Gowrie Care Limited - Supported Accommodation Project, page 21 of 25

Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Inspection report continued Gowrie Care Limited - Supported Accommodation Project, page 22 of 25

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). Gowrie Care Limited - Supported Accommodation Project, page 23 of 25

5 Summary of grades Quality of Care and Support - 6 - Excellent Statement 1 Statement 2 6 - Excellent 6 - Excellent Quality of Staffing - 6 - Excellent Statement 1 Statement 3 6 - Excellent 6 - Excellent Quality of Management and Leadership - 6 - Excellent Statement 1 Statement 4 6 - Excellent 6 - Excellent 6 Inspection and grading history Date Type Gradings 7 Dec 2011 Unannounced Care and support 5 - Very Good Staffing Not Assessed Management and Leadership 5 - Very Good 22 Jan 2009 Announced Care and support 5 - Very Good Staffing 5 - Very 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. Gowrie Care Limited - Supported Accommodation Project, page 24 of 25

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 Gowrie Care Limited - Supported Accommodation Project, page 25 of 25