Brothers of Charity Services (Scotland) - Care Home Service Care Home Service Adults Garden Villa Gattonside TD6 9NW

Brothers of Charity Services (Scotland) - Care Home Service Care Home Service Adults Garden Villa Gattonside TD6 9NW Inspected by: Mandy Falconer Type of inspection: Unannounced Inspection completed on: 22 March 2012

Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 10 4 Other information 19 5 Summary of grades 20 6 Inspection and grading history 20 Service provided by: The Brothers of Charity Services (Scotland) Service provider number: SP2008010095 Care service number: CS2008186665 Contact details for the inspector who inspected this service: Mandy Falconer Telephone 01896 664400 Email enquiries@scswis.com Brothers of Charity Services (Scotland) - Care Home Service, 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 Environment N/A Quality of Staffing 5 Very Good Quality of Management and Leadership N/A What the service does well Brothers of Charity Care Home provides care to people with complex needs in a person centred manner taking account of the individual's wishes. Information about residents was easy to read and provided very good information on how their support was to be delivered. Staff working in the care home were enthusiastic about their roles and were observed to go about their work in a relaxed and calm manner. Support plans continue to improve and staff were very positive about the support they received. What the service could do better The service should continue to involve staff, carers and residents through meetings and visits to ensure they are aware of what the future plans are for the care home. What the service has done since the last inspection Two recommendations were made at the previous inspection about ongoing participation and the use of communication passports. Both recommendations had been met by the service. Brothers of Charity Services (Scotland) - Care Home Service, page 3 of 22

The manager and staff had continued to improve the support plans and they were much more person centred and contained good information about how each of the residents liked to spend their days. Conclusion Overall Brothers of Charity Care Home provides support to people in a well maintained and comfortable home, suitable to their needs. During the inspection staff were observed to be attentive and supportive in their care to residents. Activities were ongoing throughout the day and and participation in daily living skills, for example, cooking and laundry were promoted. One resident was supported to do the shopping and banking. The care home had very good audit systems in place for reviewing support plans, medication, health and safety and supervision for staff. Who did this inspection Mandy Falconer Brothers of Charity Services (Scotland) - Care Home Service, page 4 of 22

1 About the service we inspected Before 1 April 2011, Brothers of Charity Care Home Service was registered by the Care Commission. On this date the new scrutiny body, Social Care and Social Work Improvement Scotland (known as the Care Inspectorate), took over the work of the Care Commission, including the registration of care services. This means that from 1 April 2011 this service continued its registration under the new body, the Care Inspectorate. This care home, located in Gattonside in the Scottish Borders, is registered to provide care for a maximum of 7 adults with learning disabilities some of whom have sensory and physical impairments. Up to 2 residents may be receiving respite care. There were 6 residents living in the home at the time of the inspection and 1 vacancy. Staffing is provided over 24hours. Registered Nurse cover is provided during the day and there are on call arrangements whereby senior staff can be contacted in the event of an emergency. Allocated activity staff are also available each day and this is recorded on the duty rota. The main aim of the service is "to provide opportunities for individuals to experience a safe and fulfilling lifestyle, which maximises their health and wellbeing through skilled support". 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 Environment - N/A Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - N/A 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.scswis.com or by calling us on 0845 600 9527 or visiting one of our offices. Brothers of Charity Services (Scotland) - Care Home Service, 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 This report was written following an unannounced inspection which took place over one day on 22nd March 2012. The inspection was carried out by Mandy Falconer, Inspector, Care Inspectorate. As requested by us the service completed the annual return and self assessment documents online prior to the inspection visit. Six Care Inspectorate questionnaires were sent out to the residents and six were completed and returned. As part of the inspection we gathered evidence from various sources, including the relevant sections of policies, procedures, records and other documents, including: residents personal plans (care plans) including risk assessments residents life history information, activity records and activity planners minutes of residents, relatives and staff meetings the self assessment and annual return completed by the home's manager accident and incident records training records complaints records policies relating to the Quality Standards being inspected staffing schedule, certificate of registration and public liability insurance. newsletters Discussion with various people, including: the registered manager three staff members four residents Brothers of Charity Services (Scotland) - Care Home Service, page 6 of 22

Observation of staff while they carried out their work with residents throughout the inspection. 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 Brothers of Charity Services (Scotland) - Care Home Service, page 7 of 22

What the service has done to meet any recommendations we made at our last inspection Recommendations made at the last inspection. Recommendation 1 The service should continue to develop and evidence residents and relatives/carers participation in assessing and improving all aspects of the service provided, including the quality of care and support and the quality of staffing. Progress: The support plans evidenced discussion with residents and their families about the ongoing participation within the home. Questionnaires were used for gaining the views of relatives. This recommendation had been met. Recommendation 2 The Manager should ensure that the Communication Passports to inform staff practice in their work with each resident are developed and implemented taking into account information and recommendations of other health care professionals, for example, Speech and Language Therapists. Progress: Residents who had been given communication passports by the speech and language department used them on a daily basis and all staff were aware of who was using them. This recommendation was 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 self assessment was completed on line prior to the inspection as requested by us. The manager had involved the staff group in putting together the information contained in the self assessment. The information provided gave good information about how the service was meeting the quality themes. Brothers of Charity Services (Scotland) - Care Home Service, page 8 of 22

Taking the views of people using the care service into account We sent out six Care Inspectorate questionnaires before the inspection and all six were returned. Staff and relatives had assisted the residents to completed the forms due to their disabilities. All questionnaires returned were very positive and everyone was very happy with the support they received. The inspector spent time with one resident who was in for respite care and hoping that this would become a permanent placement. They were very happy with the care they received and enjoyed getting out and about with the staff. The inspector spent time observing the relationships between the staff and residents who had very limited communication. These were seen to be responsive and supportive to individual's needs. Taking carers' views into account No carers were present during the inspection. However, the inspector was able to read the comments received from questionnaires sent out by the service. These were found to be very positive about the service. Brothers of Charity Services (Scotland) - Care Home Service, 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 care home achieved a grade 5-Very good at the previous inspection and this had been maintained by the service. The care home continues to provided very good information about the service for prospective residents and their families. This included an information booklet about what the service had to offer. The manager visited prospective residents to carry out a pre assessment of their needs, visits were arranged for residents and their families to view the care home and meet staff and other residents. Formal review processes were carried out six monthly and relatives and residents were invited to attend the meetings to discuss the care and support provided by the care home. Information on local advocacy services was available and four residents had used this service. One resident had recently involved advocacy during the review process and felt that they were very good at putting their point of view forward. The service has introduced group advocacy for the residents and staff had recently received training in this area. Staff meetings continued to be held monthly and, from minutes reviewed by the inspector, a wide range of topics were discussed including changes to care plans, updated policies, training and general issues and updates regarding the home. Staff spoken with during the inspection confirmed that meetings took place regularly and that it was their responsibility to keep themselves up to date. Daily communication records showed that regular updates were made to care plans and messages were left for all staff to read and sign. Brothers of Charity Services (Scotland) - Care Home Service, page 10 of 22

Support plans were found to be updated and were person centred to the needs of each individual. Feedback in individual support plans showed that there was regular communication with families and carers and their views were sought during visits or at reviews. The Organisation had a 'Checking it out' group. Although none of the residents attended, decisions and information from the group were forwarded to the Service and throughout the wider Organisation. An up to date involvement policy was in place and this was linked to the corporate plan for the organisation. Questionnaires were used by the care home for respite residents to ask how their visit had been. As a result of these questionnaires the manager was able to make changes for any future stays in the home. Areas for improvement The service should continue to involve residents, staff and carers in all aspects of the service. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Brothers of Charity Services (Scotland) - Care Home Service, page 11 of 22

Statement 3 We ensure that service user's health and wellbeing needs are met. Service strengths Brothers of Charity Care Home provided very good evidence that each resident's health and well being needs were being met. This was evidenced through reviewing personal plans, speaking with residents and staff. Each resident had their own person centred support plan, as well as individual care plans and risk assessments, to ensure staff supporting residents had enough information about individuals needs and how they liked their support to be provided. Support plans covered the following areas: Personal health history Medical history and medications- including pictorial guidelines for service users Nutrition Personal hygiene Mobility Communication Finances Day activities including social and leisure As well as the support plan, each resident had a communication log for important information relevant to them. Each resident was registered with a local health centre and they were able to access doctors, dentists, chiropody, physiotherapy, opticians, dietician and other health professionals as needed. The service had built up a good working relationship with the learning disability team (LDT) who had an input into health related issues with some residents. The LDT were involved in reviews of resident's care and offered training and advice if needed. Staff working in the care home received training appropriate to the needs of the service users to enable them to work confidently and provide good support to individuals. The residents met weekly to plan their menus and staff had devised picture menu cards to enable residents to make their own choices. Staff were aware of the importance of healthy eating and had a very good understanding of the nutritional needs of all the residents. Brothers of Charity Services (Scotland) - Care Home Service, page 12 of 22

Residents weights were recorded and advice was sought from the dietician for several residents. This was evidenced in care plans for specific food and drink requirements and how they should be assisted. The medication system was reviewed by the inspector and found to be satisfactory. Records were kept of all medications entering the home. Medication administration records were up to date and completed correctly for all residents. Medications were reviewed by the doctor on a regular basis and this was recorded in the professional contacts record in the support plans. Areas for improvement The service should continue to maintain their good standards in this area. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Brothers of Charity Services (Scotland) - Care Home Service, page 13 of 22

Quality Theme 2: Quality of Environment - NOT ASSESSED Brothers of Charity Services (Scotland) - Care Home Service, page 14 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 Comments made under quality statement 1.1 also apply to this statement. Staff working in the service were positive about the support they received through the manager and seniors. Regular supervision takes place and training needs are recorded during this time. The organisation has a training programme in place for all staff and this was recorded on individual personnel records. The organisation had a very good recruitment policy in place and all recruitment checks were carried out as per the policy. Residents who were able were encouraged to take part in staff recruitment and this was mainly organised around informal visits to the home to meet prospective staff. Relatives and carers were asked about the qualities they would like to see in staff when recruitment was being undertaken. Staffing levels were checked and continued to meet the needs of the current residents and activity staff were also around during the day. Areas for improvement The service should continue to maintain their current very good standards in this area. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Brothers of Charity Services (Scotland) - Care Home Service, page 15 of 22

Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Brothers of Charity Care Home had a very committed staff group who were all motivated and positive about the roles that they perform. Training records and discussion with staff evidenced that they were happy in their jobs and felt well supported by the organisation. The manager had a keyworker system in place and staff spoken with were aware of their responsibilities in keeping support plans and residents care plans up to date. They were also responsible for keeping relatives/ carers informed of changes in their relatives care. All staff received regular supervision and this was organised on a six weekly basis. The manager had delegated some of the supervision to the registered nurses and senior staff. Staff commented that supervision was "good" and that it was a "positive experience". The organisation provided a yearly training plan and the managers received a quarterly update about the training available. Training records showed that training was up to date for all staff and this had included the following courses: First aid Moving and Handling Working Safely-covers infection control, fire and health and safety Medication training for non registered nurses PITN- physical intervention training and de-escalation techniques Adult support and protection Epilepsy Palliative care Deaf awareness Oral hygiene SVQ and HNC in social care. A high proportion of the staff were trained to SVQ 3 or above and all of the staff with the exception of the two newest staff had registered with the SSSC(Scottish Social Services Council). Brothers of Charity Services (Scotland) - Care Home Service, page 16 of 22

Areas for improvement The service should continue to maintain their good standards in this area. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Brothers of Charity Services (Scotland) - Care Home Service, page 17 of 22

Quality Theme 4: Quality of Management and Leadership - NOT ASSESSED Brothers of Charity Services (Scotland) - Care Home Service, page 18 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 The service gave us an appropriate action plan on 25th October 2010. 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). Brothers of Charity Services (Scotland) - Care Home Service, page 19 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 Environment - Not Assessed Quality of Staffing - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Management and Leadership - Not Assessed 6 Inspection and grading history Date Type Gradings 28 Sep 2010 Unannounced Care and support 4 - Good Environment Not Assessed Staffing 5 - Very Good Management and Leadership Not Assessed 27 Apr 2010 Announced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership Not Assessed 9 Dec 2009 Unannounced Care and support 5 - Very Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good 7 Jul 2009 Announced Care and support 5 - Very Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good Brothers of Charity Services (Scotland) - Care Home Service, page 20 of 22

All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Brothers of Charity Services (Scotland) - Care Home Service, 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 SCSWIS. You can get more copies of this report and others by downloading it from our website: www.scswis.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@scswis.com Web: www.scswis.com Brothers of Charity Services (Scotland) - Care Home Service, page 22 of 22