Ark Housing Association Ltd - Forfar Support Service Housing Support Service 10A Windmill Brae Victoria Street Forfar DD8 3HF Inspected by: Timothy Taylor Type of inspection: Announced (Short Notice) Inspection completed on: 28 February 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 18 5 Summary of grades 19 6 Inspection and grading history 19 Service provided by: Ark Housing Association Ltd Service provider number: SP2003002578 Care service number: CS2010272702 Contact details for the inspector who inspected this service: Timothy Taylor Telephone 01382 207200 Email enquiries@careinspectorate.com Ark Housing Association Ltd - Forfar Support Service, page 2 of 20
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 5 Very Good What the service does well This is a service which is responsive to the needs of its service users. A service which adapts what it delivers in order to enable people to maximise their potential within a community setting. What the service could do better The service should consider making their support plans even more available to service users. What the service has done since the last inspection The service has been developing new accommodation that they have been allowed to use for supporting people in the community. Conclusion This is a well run: high quality service. Who did this inspection Timothy Taylor Ark Housing Association Ltd - Forfar Support Service, page 3 of 20
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 www.scswis.com. 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. 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." Ark Housing Forfar Support Service is operated by Ark Housing Association Ltd. The service operates a combined housing support and care at home service to people living in their own tenancy within Forfar, Arbroath and Blairgowrie. As part of the overall aims and objectives of the service they say they aim to "continually improve the provision of housing support and other related services for people with a learning disability and other needs." 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 5 - Very Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Ark Housing Association Ltd - Forfar Support Service, page 4 of 20
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. Ark Housing Association Ltd - Forfar Support Service, page 5 of 20
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 announced inspection which took place on 28 February 2013. As requested by us, the service sent us an annual return. The Care Inspectorate wrote to the service to request completion of the self evaluation form. Thirty questionnaires were sent to the service to distribute to service users. In this inspection we gathered evidence from the following sources:- Interviews with staff. Interviews with service users. Interviews with managers. Inspection of personal plans. Inspection of records. Inspection of policies and procedures 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 Ark Housing Association Ltd - Forfar Support Service, page 6 of 20
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 Ark Housing Association Ltd - Forfar Support Service, page 7 of 20
What the service has done to meet any requirements we made at our last inspection The requirement Where a legal order is in place for a service user that requires support staff to participate in their care and treatment a copy of the order or another way of ensuring that staff are fully aware of what is expected of them should be made available. This is in order to comply with: SSI 2011/210 - Regulation 4 (1) (a) - a requirement for providers to meet the health and welfare needs of service users. What the service did to meet the requirement There are now copies of this documentation in support plan files and any required actions to be taken by staff are in the relevant risk assessment. The requirement is: Met What the service has done to meet any recommendations we made at our last inspection The service now ensures that support plans are agreed and signed by service users. Supervision for staff now takes place in all localities within this service. Where necessary support plans are cross referenced to other plans where appropriate. The service now has a new set of guidelines on dealing with challenging behaviour. Where this is an issue a risk assessment is placed in support plans. 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: No Ark Housing Association Ltd - Forfar Support Service, page 8 of 20
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. A comprehensive self assessment was received for this service. Taking the views of people using the care service into account 4 service users were interviewed on the days of inspection and 12 care service questionnaires were returned to the Inspectorate. Here are some quotes that reflect the overwhelmingly positive views expressed:- I think the staff are excellent. They help me to budget my money, get insurance for my things and help me run my home. Yes I have a keyworker who is very helpful. They take me to my appointments. Staff are very friendly and helpful. Last year they helped me to go on holiday. Staff help me go to concerts. They involve me in my support plan. Taking carers' views into account No carers were interviewed during this inspection. Ark Housing Association Ltd - Forfar Support Service, page 9 of 20
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 This service provides a very good level of participation for service users who were routinely involved in assessing and improving care and support within the setting. Here are some of the services strengths in this area:- Service users support plans are audited each month with them and they are asked about the service they receive. This is done with key-workers who are a named person that each service users can claim as their own. Support plans are regularly reviewed including (at least) annually by the social work department. The service holds speak out meetings for service users where they can have their say about how the service is run. Ark have a designated participation officer who works within the guidance of the service's participation policy. They speak with service users and staff to gather their views. The complaints procedure was well publicised - all users get a copy of it with their information pack, they are reminded about the complaints procedure at monthly support plan audits and leaflets are up on the walls in the services. An annual quality assurance survey is sent out to service users and any feedback is audited and changes made. In interviews service users felt they were listened to and any problems were sorted out. Staff felt that when they had any ideas for improving the service these were listened to as well. Ark Housing Association Ltd - Forfar Support Service, page 10 of 20
Areas for improvement The service should continue to seek ways to improve their participation practice. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths The service provided a very good level of care and support for service users. Here are some of its strengths:- Each service user has their own individualised support plan where needs relating to physical and mental wellbeing is documented. These were found to be comprehensive, risk aware and individual to that person's needs. Every planned interaction with each service user is based on their individual assessments, their support plan is updated as necessary and each interaction is documented via individual contact sheets. Monthly auditing of the plan allows an opportunity for the key-worker and service user to identify if current interactions are useful and/or identify needs which are not being met. The service provides people with a range of supports including:- social supports such as accompanying people out into the community to access services, independent living supports such as help with cooking, cleaning and social events to help people be together. Service users confirmed this in their interviews with inspectors. Staff are trained in Ark's medication policy to ensure service users take the medication they have been prescribed. A service users medication records were inspected and found to be completed correctly. Service users confirmed that they get assistance to attend for any health appointments. Service users are assisted and accompanied on holidays. All health concerns are referred to the relevant health professional. In interviews service users felt the service was good at assisting them to live well in the community. Areas for improvement It was noted that the service could further develop support plans by giving a copy to each service user which is written in a form they can understand. See recommendation 1. Ark Housing Association Ltd - Forfar Support Service, page 11 of 20
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. Service users should be fully aware of their support plan and be given a copy they understand. NCS 3 Care at Home - Your Personal Plan. 2 You have a copy of your plan in a format that you can understand. Ark Housing Association Ltd - Forfar Support Service, page 12 of 20
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 This service provides a very good level of participation for service users who were routinely involved in assessing and improving care and support within the setting. Here are some of the services strengths in this area:- Service users support plans are audited each month with them and they are asked about the service they receive. This is done with key-workers who are a named person that each service users can claim as their own. Support plans are regularly reviewed including (at least) annually by the social work department. The service holds speak out meetings for service users where they can have their say about how the service is run. Ark have a designated participation officer who works within the guidance of the service's participation policy. They speak with service users and staff to gather their views. The complaints procedure was well publicised - all users get a copy of it with their information pack, they are reminded about the complaints procedure at monthly support plan audits and leaflets are up on the walls in the services. An annual quality assurance survey is sent out to service users and any feedback is audited and changes made. In interviews service users felt they were listened to and any problems were sorted out. Staff felt that when they had any ideas for improving the service these were listened to as well. Areas for improvement The service should continue to seek ways to improve their participation practice. Ark Housing Association Ltd - Forfar Support Service, page 13 of 20
Grade awarded for this statement: 5 - Very Good 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 found to have a highly motivated and well trained workforce. Here are some of its strengths:- The service ensures the continued quality of their staff through six weekly supervision to monitor performance and development. There are also regular regular team meetings. It was noted that supervision was used as a dynamic tool to explore performance and support in relation to staff. They confirmed it was a supportive experience. Staff reported there were effective systems to hand over information when they come on shift. A handover meeting was observed on the day of inspection and found to be effective. New staff get a robust and detailed induction programme which means they are fully familiar with their role prior to working on their own. This was confirmed by new staff who were interviewed and were able to show their induction folder. The service has a comprehensive set of policies and procedures which lay out expectations of good practice for staff. The service has all the expected policies and procedures to support good practice. Staff interviewed all had copies of the SSSC codes of practice and were able to speak about the National Care Standards in a way that showed they understood them. Levels of training were high staff interviewed reported they had received the following training:- person centred planning, medication, health and safety, food hygiene, mental health, moving and handling. Staff interviewed felt that the service would listen to their ideas and they felt part of a supportive team. Areas for improvement It was noted that not all staff received annual appraisal. This is seen as an important part of support and development for staff. See recommendation 1. Ark Housing Association Ltd - Forfar Support Service, page 14 of 20
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. Staff should all receive annual appraisal to ensure they can fully develop their performance and role. See NCS 4 Care at Home - Management and Staffing. You experience good quality care at home. This is provided by management and the care staff who have the skills and competence to carry out the tasks you require. The service operates in line with all applicable legal requirements and best-practice guidelines. Ark Housing Association Ltd - Forfar Support Service, page 15 of 20
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 This service provides a very good level of participation for service users who were routinely involved in assessing and improving care and support within the setting. Here are some of the services strengths in this area:- Service users support plans are audited each month with them and they are asked about the service they receive. This is done with key-workers who are a named person that each service users can claim as their own. Support plans are regularly reviewed including (at least) annually by the social work department. The service holds speak out meetings for service users where they can have their say about how the service is run. Ark have a designated participation officer who works within the guidance of the service's participation policy. They speak with service users and staff to gather their views. The complaints procedure was well publicised - all users get a copy of it with their information pack, they are reminded about the complaints procedure at monthly support plan audits and leaflets are up on the walls in the services. An annual quality assurance survey is sent out to service users and any feedback is audited and changes made. In interviews service users felt they were listened to and any problems were sorted out. Staff felt that when they had any ideas for improving the service these were listened to as well. Areas for improvement The service should continue to seek ways to improve their participation practice. Ark Housing Association Ltd - Forfar Support Service, page 16 of 20
Grade awarded for this statement: 5 - Very Good 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 has a very good quality assurance system. Here are some of the strengths:- It is clear that the health and wellbeing of service user is at the core of what this service does. The service has a high level of participation whereby service users, staff and other stakeholders can have an input into what the service delivers. (see 1.1). The service has systems in place to support staff, to develop their skills via training and supervision - they also involve staff in developing the service. (see 3.3) The service has a comprehensive set of policies and procedures. The service carries out regular case file audits to ensure that each service user's support plan is up-to-date. The service has used an external quality assessor (Investors In People) to accredited them and they have a Gold Award. The manager of the service has a good system for networking with other managers and local commissioners to ensure that quality is maintained in relation to other services. The service provider keeps management and staff up-to-date with changes in legislation and best practice. The service has an overall business plan which outlines how the service will develop and improve and it identifies who is responsible for any actions. Areas for improvement The service should continue to assure the quality of what it provides. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Ark Housing Association Ltd - Forfar Support Service, page 17 of 20
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 None noted 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 SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1). Ark Housing Association Ltd - Forfar Support Service, page 18 of 20
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 - 5 - Very Good Statement 1 Statement 4 5 - Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 7 Oct 2011 Announced (Short Notice) Care and support Staffing Management and Leadership 5 - Very Good 5 - Very Good 5 - Very Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Ark Housing Association Ltd - Forfar Support Service, page 19 of 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 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 Ark Housing Association Ltd - Forfar Support Service, page 20 of 20