L'Arche Inverness Housing Support Housing Support Service 13 Drummond Crescent Inverness IV2 4QR

L'Arche Inverness Housing Support Housing Support Service 13 Drummond Crescent Inverness IV2 4QR Inspected by: Dan MacKay Type of inspection: Announced (Short Notice) Inspection completed on: 27 March 2014

Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 10 4 Other information 17 5 Summary of grades 18 6 Inspection and grading history 18 Service provided by: L'Arche Service provider number: SP2003002642 Care service number: CS2010274868 Contact details for the inspector who inspected this service: Dan MacKay Telephone 01463 227630 Email enquiries@careinspectorate.com L'Arche Inverness Housing Support, page 2 of 19

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 L'Arche housing support service provides individualised care to support people to live in their own homes. Support is tailored to meet the needs of each service user. Support staff encourage people living in their own tenancies to be as independent as possible and to be involved in the L'Arche and wider community. The service's ethos enshrined fundamental human rights and this ensured a very person-centred approach to care and support arrangements. What the service could do better The provider needed to devise and implement a service-specific improvement plan for L'Arche housing support service. The service's policies and procedures needed to be updated to reflect current best practice guidance. What the service has done since the last inspection The service had developed detailed person-centred care plans which reflected the individual needs of each service user. L'Arche provided a wide range of opportunities for service users to participate and contribute their views and suggestions about the running of the service. L'Arche Inverness Housing Support, page 3 of 19

Conclusion The housing support service is a relatively new care provision. The manager and members of staff are attentive and eager to look at ways to further develop the service. This is a small housing support service. Staff are knowledgeable about service users needs and address these in a sensitive and respectful manner. Who did this inspection Dan MacKay L'Arche Inverness Housing Support, page 4 of 19

1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at www.careinspectorate.com This service registered with the Care Inspectorate on 24 November 2011. Requirements and recommendations If we are concerned about some aspect of a service, or think it could 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, 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 which sets out what is required of a care service to comply with the Public Services Reform (Scotland) Act 2010 and Regulations or Orders made under the Act or a condition of registration. Where there are breaches of Regulations, Orders or Conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. L'Arche Inverness Housing Support service is registered to provide a care service to people with learning disabilities. L'Arche Inverness Care at Home service is registered to provide a care at home service to people in their own home. The service is provided by L'Arche UK and is part of the Inverness L'Arche community. L'Arche UK also operates other Care Homes and Support Services nationally. In Inverness, L'Arche UK operates three care homes (Braerannoch, Saorsa and Mactalla) and a support service (L'Arche Workshops Resource Centre). The aims and objectives of the Housing Support and Care at Home services include to support people with a learning disability to achieve the highest possible level of independence in living arrangements in order to live in their own home/ accommodation instead of residential care; to have as much choice as possible, through support to understand all the options that may be available within an environment of positive risk taking and appreciation of safeguarding responsibilities; and to be seen by everyone as unique and having sacred value. L'Arche Inverness Housing Support, page 5 of 19

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 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. L'Arche Inverness Housing Support, page 6 of 19

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 L'Arche housing support service provides individualised care to support people live in their own homes. Support is tailored to meet the individual needs of each service user. Support staff encourage people living in their own tenancies to be as independent as possible and to be involved in the L'Arche and wider community. We wrote this report following a short notice announced inspection that took place on 27 March 2014. Feedback was given at the end of the inspection visit. The inspection was carried out by Dan MacKay, Care Inspector. As requested by us, the care service sent us an annual return. The service also sent us a self assessment form. We gathered evidence from various sources, including the relevant sections of policies, procedures, records and other documents including: * Personal plans and care reviews * Risk assessments * Care standards questionnaires (CSQs) that had been returned to us from people who use the service and their relatives/or advocates * Quality assurance arrangements * Staff files, including training records * Accident and incident records * Discussions with people who use the service, the manager and members of staff Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. L'Arche Inverness Housing Support, page 7 of 19

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 L'Arche Inverness Housing Support, page 8 of 19

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 Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. We received a completed self assessment document from the service provider. The self assessment provided good information and identified what the service thought they did well, some areas for development and any changes they had planned. Taking the views of people using the care service into account We met and spoke privately with two service users. Both expressed high levels of satisfaction with the service provided. It was clear from their comments that they appreciated the support provided to them by L'Arche staff members. Taking carers' views into account No carers were present at the time of the inspection visit. L'Arche Inverness Housing Support, page 9 of 19

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 We found that the quality of service user participation was Very Good. We concluded this after we examined a sample of support plans and associated review and support documents; reviewed the responses and comments in completed questionnaires and spoke to the manager and her assistant. People using the service gave their views informally on a day-to-day basis to members of support staff. If they needed changes to the way they were supported they had opportunities to express this and staff took their views into account. Each person using the housing support service had an individual support plan and was supported by a key worker. Staff supported people using the service to be involved with developing and reviewing their support plan as much as possible. L'Arche, as a national agency, had put in place a wide range of measures to include and involve service users in the running of the organisation. These included a 'national speaking group' which meets bi-annualy and includes a good practice forum. L'Arche communities, nationwide, were represented and suggestions about how things could be used were used to inform future organisational goals. L'Arche, a worldwide network of Christian communities across thirty countries, encourages service user involvement through its 'faith life group' based both on faith and community inclusion. L'Arche Inverness Housing Support, page 10 of 19

The Inverness L'Arche project convened daily meetings each morning for all of its participants. The Housing Support service users held weekly meetings. The service was continually striving to find new ways of communicating effectively with those who used the service, including IT software and non-verbal pictorial formats. A 'listening group' had been set up locally. Nominees are selected to represent the Inverness projects at national level. We were told how all of the various participative arrangements provided feedback into the one organisational umbrella to ensure each person could express their views and have their say. Within each personal plan evaluation sheets usefully evidenced feedback from service users. Where appropriate actions had been identified and were being worked through. One of the service users told how he had an independent advocate, who he had known for a long time, and who "does a good job" providing support. Areas for improvement The provider to survey the views of its various stakeholders about ways in which the quality of care and support could be further improved. The collated feedback should be used to inform an improvement plan for the service which should evidence an outcome focussed approach. (See Recommendation 1) Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The provider to survey the views of its various stakeholders about ways in which the quality of care and support could be further improved. The collated feedback should be used to inform an improvement plan for the service which should evidence an outcome focussed approach. National Care Standards, Housing Support Services, Standard 8 - Expressing Your Views. Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths We found that the service was performing to a very good standard in relation to this quality statement. L'Arche Inverness Housing Support, page 11 of 19

We concluded this after we examined a sample of support plans and associated care review documentation and daily recordings. At the time of the inspection three people were receiving support from the housing support service. Each person using the service had a personal support plan which set out the level of support that they required. The level of support provided varied according to individual need. There was good evidence that each service user's needs were reviewed regularly. The service had a strong person-centred ethos. We spoke privately with one of the service users who told us he was "quite happy in his own place". Another service user told us how he rated L'Arche highly. "Everyone's very good" we were told. "I have no problems". Each personal plan identified particular goals for service users of the L'Arche housing support service. Detailed risk assessments formed part of the personal plans and measures were identified to minimise risk and the likelihood of any serious occurences. In one instance we saw a very detailed risk assessment and summary which informed an action plan to support the individual. There was good evidence that the provider worked closely with allied professionals to manage any complex situations. In these instances the care programme was subject to regular, close review. Areas for improvement It would be good practice to consider if any anticipatory care support needed to be identified within each service user's personal plans. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 L'Arche Inverness Housing Support, page 12 of 19

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 findings in this statement are similar to those reported on in Quality Statement 1.1. We found that the quality of service user participation was Very Good. We concluded this after we examined a sample of support plans and associated review and support documents; reviewed the responses and comments in completed questionnaires and spoke to the manager and her assistant. Areas for improvement A recommendation has been raised in Quality Statement 1.1 of this inspection report for the provider to survey the views of its various stakeholders about ways in which the quality of care and support could be further improved. The collated feedback should be used to inform an improvement plan for the service which should evidence an outcome focussed approach. The survey should also invite views about ways in which the quality of the service's staffing could be further improved. To help achieve this the service should also survey the views of its own staff group. 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 We found that the service was performing to a very good standard in relation to this quality statement. We concluded this after we met with various members of staff and examined a range of documentation in relation to staff training, supervision etc. L'Arche Inverness Housing Support, page 13 of 19

The manager and her depute are registered with the Scottish Social Services Council (SSSC). Copies of the SSSC code of practice were given to new employees to ensure they were familiar with their roles and responsibilities. Staff received statutory and non-statutory training relevant to the post they were employed in. Four members of staff were shortly to commence SVQ Level 3 training We met with the assistant co-ordinator for the L'Arche Inverness services who described how she arranged relevant training for members of staff across the service. In addition to individual supervision arrangements, staff meetings took place every four to six weeks. We met with three members of staff during the inspection, in addition to the service manager. They all described their work positively. It was clear that they were very focussed individuals who took pride in their work. We could see that they had detailed knowledge of their service users support needs and had been active in either developing systems to support service users find ways to engage more actively or support staff to develop the skills necessary to perform their work. One of the evaluation sheets noted: "Always found the staff easy to approach if any concerns or questions. Staff think very highly of service users". Areas for improvement The provider should survey the views of its own staff group about ways in which the quality of the staffing could be further improved. The provider needed to ensure that staff supervision and appraisal arrangements are fully embedded practices within the service. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 L'Arche Inverness Housing Support, page 14 of 19

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 findings in this statement are similar to those reported on in Quality Statement 1.1. We found that the quality of service user participation was Very Good. We concluded this after we examined a sample of support plans and associated review and support documents; reviewed the responses and comments in completed questionnaires and spoke to the manager and her assistant. Areas for improvement A recommendation has been raised in Quality Statement 1.1 of this inspection report for the provider to survey the views of its various stakeholders about ways in which the quality of care and support could be further improved. The collated feedback should be used to inform an improvement plan for the service which should evidence an outcome focussed approach. The survey should also invite views about ways in which the quality of the service's management and leadership could be further improved. 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 We found that the service was performing to a good standard in relation to this quality statement. L'Arche Inverness Housing Support, page 15 of 19

We concluded this after we met with the manager and examined a range of related documentation including policies, procedures and associated materials to do with the running of the service. The provider used a range of methods which contributed to the way they assessed the quality of the service they provided. Amongst these included care reviews, the use of feedback questionnaires and various meetings involving people who used the service and other members of L'Arche communities. A complaints procedure was in place for people to use if they wished to make a complaint about any aspect of the service. However people using the service and their carers/representatives were encouraged to raise any issue or concerns with their support worker, or one of the community leaders in the first instance. There were arrangements in place for induction, appraisal and supervision of staff. Regular team meetings afforded opportunities for staff to raise any issue or query. We examined minutes of some of these meetings and found they had a business-like focus. The manager and supporting staff were aware of their notification obligations to the Care Inspectorate and the SSSC. Throughout the inspection visit the manager demonstrated a commitment to continuous evaluation, improvement and the further development the service. Areas for improvement The provider needed to update the service's policies and procedures to ensure they reflected current legislation and best practice guidance. It would be good practice to carry out a review of the service in line with the key messages of the national Winterbourne View learning disability investigation. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 L'Arche Inverness Housing Support, page 16 of 19

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). L'Arche Inverness Housing Support, page 17 of 19

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 11 Mar 2013 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. L'Arche Inverness Housing Support, page 18 of 19

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 L'Arche Inverness Housing Support, page 19 of 19