Home is Best Ltd Housing Support Service 20 Ballewan Crescent Blanefield Glasgow G63 9HW

Home is Best Ltd Housing Support Service 20 Ballewan Crescent Blanefield Glasgow G63 9HW Type of inspection: Unannounced Inspection completed on: 29 July 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 22 5 Summary of grades 23 6 Inspection and grading history 23 Service provided by: Home is Best Ltd Service provider number: SP2012011981 Care service number: CS2013315489 If you wish to contact the Care Inspectorate about this inspection report, please call us on 0845 600 9527 or email us at enquiries@careinspectorate.com Home is Best Ltd, page 2 of 24

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 The service was very good at involving their service users in assessing and improving the quality of care and support. They had gained weekly feedback from each service user. A sample of these records showed very positive feedback from service users and their families who were very happy with the service provided. We found that the service was very effective in meeting the health and welfare needs of their residents. The personal plans viewed, reflected person centred detail in risk assessments and care planning with any changes to care recorded. Staff rotas reflected the regular group of staff who provided the support for each service user. We found that the service provided very good support and relevant training opportunities for staff. Staff recruitment files viewed showed that a robust recruitment process had been followed. Completed induction and supervision meetings were also evident. The systems and processes, used by the service, provided a very good level of quality assurance. Home is Best Ltd, page 3 of 24

What the service could do better Some recording within personal plans could be improved further in relation to service user and relative involvement. Action taken on any requests or areas for improvement highlighted in the weekly feedback or questionnaires was not always clearly recorded. They should consider how to develop the involvement of service users and their relatives in staff recruitment, training and development. It was evident that management needed to review their policy and procedures in relation to supporting people with their medication including their record keeping and relevant staff training. Management were asked to formalise staff meetings. Inspection report continued They were also asked to review some of the content of their policies. What the service has done since the last inspection This was the first inspection since registration. There had been a change of manager since registration. Conclusion The service user numbers had been steadily increasing since the service's registration. There was evidence of the service being responsive to service users needs and any changes in care required. Very positive feedback was received from all service users and relatives about the level of care provided. Home is Best Ltd, page 4 of 24

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 in July 2013. Requirements and Recommendations If we are concerned about some aspect of a service, or think it 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 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 the Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. Home Is Best is registered to to provide support to older people living in their own homes. This was the first inspection since registration and the service were currently providing care and support to five people. The service's aims and objectives sets out their intention to enable individuals to remain in their own home and live in the community whilst enjoying a good quality of life, using a person centred approach with emphasis on listening to the needs, wishes and life choices of their service users. They endeavour to deliver the highest standards of care, where dignity and individuality are respected and independence encouraged. 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. Home is Best Ltd, page 5 of 24

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. Home is Best Ltd, page 6 of 24

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 was carried out by an inspector on the 29 July 2014 between 9.30am and 6.15pm. Feedback was provided to management at the end of the inspection visit. As requested by us, the care service submitted a self assessment and an annual return. We sent four questionnaires to the manager to distribute to service users. Four completed questionnaires were returned. We also sent two staff questionnaires for the manager to distribute.one completed questionnaires was returned. In this inspection we gathered evidence from various sources, including the relevant sections of policies, procedures, records and other documents, including: - Personal plans - Questionnaires - Staff training records - Policies - Discussions with management and 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. Details of what we found are in Section 3: The inspection Home is Best Ltd, page 7 of 24

Inspection Focus Areas (IFAs) Inspection report continued 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 Home is Best Ltd, page 8 of 24

The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The Care Inspectorate received a fully completed self-assessment document from the provider. We were satisfied by the way the provider completed this and with the relevant information included for each heading that we grade services under. The provider identified what it thought the service did well, some areas for development and any changes it had planned. The provider told us how the people who used the care service had taken part in the self-assessment process. Taking the views of people using the care service into account Two Care Inspectorate questionnaires were completed and returned from service users prior to the inspection visit. They were very happy with the quality of care received. Additional comments received were: 'I always look forward to X coming to help me on Wednesday' 'they are excellent that come to me. They are all kind and would go the extra mile for me'. Taking carers' views into account Two Care Inspectorate questionnaires were completed and returned from relatives prior to the inspection visit. They were very happy with the quality of care received. Additional comments received were: 'Home is Best is a very flexible service where all the staff are very kind and helpful. My relative is very happy with the support they give. They are a new company but have a very customer focused business model and they are a good example of Home is Best Ltd, page 9 of 24

what a small, local care service should look like. I know that they have taken the time to get to know my relative as they chat to them about many things which I have never told them about. I hope Home is Best continues to be this good'. Home is Best Ltd, page 10 of 24

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 service was very good at involving their service users in assessing and improving the quality of care and support. We focused on the information provided and how the service involved service users. The service's self assessment stated that they 'actively encouraged clients and their families to have a view on the service in which they receive, involving clients, family and others when planning care or as needs change'. In the personal plans viewed, we saw that the terms and conditions of the service to be provided were signed by the service users and/or their next of kin. A copy of the personal plan and daily records were kept in the service user's home. In the daily records, viewed, we saw regular entries of communication with the next of kin, keeping them up to date with the care being provided and any changes to the planned care. The personal plan also contained a copy of the brochure, closure strategy, the service's aims and objectives, complaint procedure and other useful phone numbers. One service user had been due a six monthly review and this had been carried out. Dates were being arranged with the other service users and their families who were now due a six monthly review. The service gained weekly feedback from each service user. A sample of these records showed very positive feedback from service users and their families who were very Home is Best Ltd, page 11 of 24

happy with the service provided. Questionnaires had also been completed by services users in relation their satisfaction with the service received, the times which staff attended, being kept up to date with any changes and knowing how to make a complaint. Space for additional comments and suggestions was also available. A sample of completed questionnaires, showed that service users were very happy with the care provided, that staff attended at the agreed times and that they were kept up to date with any changes. Some additional comments included: 'X and I get on very well, would not want to change her for anyone else' 'everyone is very good and excellent' 'the carers are very good and caring. I feel very much I trust them. They are professional and well-trained. They treat me with dignity and respect' 'I cannot find fault with the carers, they are caring and they look after me well' 'my daughter finds the service to be very flexible and always very helpful'. The service had a detailed brochure and website which gave good information about the services provided, the options available and what to do to enquire about the support they needed. All of the Care Inspectorate questionnaires returned from service users and relatives indicated that they had a support plan which detailed their support needs and that the service checked with them regularly that they were meeting their needs. Areas for improvement The service should review the following areas to improve the involvement of service users and their relatives in assessing the quality of care and support: In the personal plans viewed: - the moving and assisting assessments and support plans had not been signed by the service user or their nominated person. These should be signed and dated to reflect their agreement with the assessment and plan of care - the terms and conditions document indicated that an annual review of care would be carried out. Management were aware that this should be six monthly - we found that the terms and conditions date and the commencement date of service provision were different. These should be the same. The action taken on any requests or areas for improvement highlighted in the weekly feedback or questionnaires should be clearly recorded. Home is Best Ltd, page 12 of 24

Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Home is Best Ltd, page 13 of 24

Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths We found that the service was very effective in meeting the health and welfare needs of their residents. The personal plans viewed, reflected person centred detail in risk assessments and care planning with any changes to care recorded. Personal information and preferences were detailed and the aims of the package were clearly recorded. Time periods for each planned visit were indicated on the service plan. We saw that the minimum time period was half an hour. Input from health professionals such district nurse and occupational therapist was evident and recorded in the communication record. Any assistance required with prompting medication was recorded. Food preferences and menu planners were evident for those who required support with meal preparation. A sample of daily diary records reflected the time period of the visit and the care and support provided. We were told that none of the current service users required support with their finances or shopping. The service did have a policy and procedure if this service was required by any service user. The service had staff rotas which reflected the regular group of staff who provided the support for each service user. Each staff member was given a copy of their visits on a weekly basis. We were told that staff never provided care to a service user without first being introduced by a staff member that the service user knew. The service had a folder to record any accidents or incidents sustained by their service users while staff were providing care. None were recorded. Areas for improvement Inspection report continued Some areas were found not to be as effective in meeting the health and welfare needs of residents. We noted that staff were applying topical creams for some service users. We discussed this with management as this was administration of medication not prompting. They acknowledged this and agreed to review their policy and procedures in relation to administering medication including their record keeping and relevant staff training. We acknowledged that some of the current staff providing care were Home is Best Ltd, page 14 of 24

registered nurses who were trained to administer medication. We found that the relative communication record also contained communication with health professionals. We asked the management to review this to provide clearer records of communication with both. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Home is Best Ltd, page 15 of 24

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 service was very good at involving service users and their relatives in assessing and improving the quality of staff. We focused on the feedback from service users and their relatives. The methods of service user participation reported in Quality Theme 1 - Statement 1 remain relevant for this statement. The service's weekly feedback and questionnaire had relevant questions about the staff that provided their care. All responses were extremely positive. All of the Care Inspectorate questionnaires returned from service users and relatives indicated that: - staff treated them with respect - they were confident that the staff had the skills to support them - they were given enough time to carry out the agreed care - they knew the names of the staff who provide their support and care. Areas for improvement The areas for development reported in Quality Theme 1 - Statement 1 remain relevant for this statement. The service should consider how to develop the involvement of service users and their relatives in staff recruitment, training and development. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Home is Best Ltd, page 16 of 24

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 provided very good support and relevant training opportunities for staff. We looked at staff recruitment, supervision and training records. The recruitment files of two staff were viewed and found to show that a robust recruitment process had been followed. Completed induction and supervision meetings were evident. Staff induction was carried out over twelve weeks and included orientation to the company, policies and procedures, best practice and practical care such as personal hygiene, nutrition, infection control, communication, meal preparation, cleaning and care documentation. In addition to the induction, records showed that staff had received training in: - moving and assisting - first aid - food safety - medication awareness - Protection of Vulnerable Adults - dementia awareness. In the supervision meetings viewed, discussions about staff support, progress and identified training needs including SVQ were evident. The manager was the moving and assisting trainer and was also currently completing an SVQ level 4 qualification along with one of the directors. Areas for improvement The following areas were highlighted to provide further support for staff. Management were asked to clearly record: Inspection report continued - the relevant details of staff registration and Protection of Vulnerable Adults (PVG) checks in staff recruitment files - the more frequent supervision meetings carried out during the twelve week induction/probationary period - the action taken to address areas highlighted in supervision meetings - staff meetings. Home is Best Ltd, page 17 of 24

We were told that as there was currently a small staff team, they regularly met for informal meetings. Management were aware of the 2020 timescale for care staff to register with the Scottish Social Services Council (SSSC) and were planning to support staff to achieve the relevant qualifications. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Home is Best Ltd, page 18 of 24

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 The service was very good at involving service users and their relatives in assessing and improving the quality of management and leadership. We focused on how the service involved service users and their relatives at the organisation level of the service. The methods of service user participation reported in Quality Theme 1 - Statement 1 remain relevant for this statement. Service users had regular contact with the owners as they also provided care and support to service users. All of the Care Inspectorate questionnaires returned from service users and relatives indicated that the service asked for their opinions and they knew about the complaint procedures. Areas for improvement The areas for development reported in Quality Theme 1 - Statement 1 remain relevant for this statement. The service should consider involvement of service users and their relatives in the self assessment process. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Home is Best Ltd, page 19 of 24

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 systems and processes used provided a very good level of quality assurance. We looked at the service's policies and procedures, management meetings and service user feedback. As previously stated, feedback from the service's weekly feedback, questionnaires and the Care Inspectorate's questionnaires was very positive. Management were able to regularly assess the service provided to service users as they had regular contact through providing care and support to service users. Management were aware of the requirement to keep records of any missed or late visits. None were recorded. The complaints procedure information and contact details for the service and Care Inspectorate were provided in the terms and conditions document. We were told that they had not received any complaints. A sample of policies and procedures were viewed and found to reflect relevant legislation, best practice and sufficient detail for staff guidance. We saw monthly management meetings which reflected: - progress with staff training and any additional training required - promotion of the service through advertising and development of the company's website - staff and manager recruitment - photo identity for staff - commencement of staff supervision - care plan documentation development - service user feedback. Areas for improvement The organisation's quality assurance systems could be further improved. Management were asked to: Inspection report continued - add the Care Inspectorate's postal and email contact information to their Complaint's procedure - link the Whistleblowing policy with the Adult Support and Protection procedure Home is Best Ltd, page 20 of 24

where concerns relate to service users - reflect the planned frequency of supervision meetings in the Supervision policy - detail the procedure for the use of bedrails, door alarms, tagging etc in relation to the Restraint and limits to freedom policy - review the Medication policy in relation to self-medicating and staff administration of medication. Feedback from any health professionals which were involved with their service users should also be considered. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Home is Best Ltd, page 21 of 24

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 No additional information recorded. 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). Home is Best Ltd, page 22 of 24

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 All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Home is Best Ltd, page 23 of 24

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 Home is Best Ltd, page 24 of 24