Oran Street Day Centre Support Service Without Care at Home 45 Oran Street Maryhill Glasgow G20 8LY Telephone:

Oran Street Day Centre Support Service Without Care at Home 45 Oran Street Maryhill Glasgow G20 8LY Telephone: 0141 946 5659 Inspected by: Marjorie Bain Type of inspection: Unannounced Inspection completed on: 3 October 2011

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 21 5 Summary of grades 22 6 Inspection and grading history 22 Service provided by: Glasgow City Council Service provider number: SP2003003390 Care service number: CS2003000989 Contact details for the inspector who inspected this service: Marjorie Bain Telephone 01698 208150 Email enquiries@scswis.com Oran Street Day Centre, page 2 of 23

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 4 Good Quality of Environment Quality of Staffing N/A N/A Quality of Management and Leadership 4 Good What the service does well This is a very person centred service that seeks to meet the individual needs of each person attending the service. What the service could do better Significant staff turnover has delayed the development of the service and personal plan documentation and related reviews are currently not up-to-date. What the service has done since the last inspection With the exception of the manager, none of the staff have been in post for more than a year. Despite the fact, that some staff had only been in temporary post for a few short months, the staff group have pulled together and have sought to continue to provide a full and varied day support programme. Conclusion This is a service, led by a manager, who is determined to offer the highest possible level of care and support for people who attend the centre. Staff are creative in their approaches to delivering person centred care and people who attend the service reported very high levels of satisfaction. Oran Street Day Centre, page 3 of 23

Who did this inspection Marjorie Bain Oran Street Day Centre, page 4 of 23

1 About the service we inspected Before 1 April 2011 this service was registered with the Care Commission. On this date new scrutiny body, Social Care and Social Work Improvement Scotland (SCSWIS), 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, SCSWIS. Oran Street Day Centre is managed by Glasgow City Council social work services. The service had been registered with the Care Commission since April 2002. Oran Street Day Centre is located within a housing estate in the Maryhill area of the city and is close to a range of local amenities. The Centre is registered to provide a day service for a maximum of 30 older people per day. On the day of the inspection there were 25 service users in attendance. The aims and objectives of the service is "to assist people to remain in their homes should they wish to do so." Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 4 - Good Quality of Environment - N/A Quality of Staffing - N/A 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.scswis.com or by calling us on 0845 600 9527 or visiting one of our offices. Oran Street Day Centre, page 5 of 23

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 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. We inspected the service on 1 September 2011 between the hours of 9:10 am and 4.30 pm. We issued 30 Care Commission Quality Standards Questionnaires to people using the service and 16 (53%) were returned prior to the inspection. In this inspection we gathered evidence from various sources, including the relevant sections of policies, procedures, records and other documents, including: Annual Return Registration Certificate Self Assessment Participation Policy SCSWIS Quality Standard Questionnaires (16) Personal support plans for people attending the service (4) Life Histories (3) Monthly Bulletins (4) Minutes of Service Users (4) Observation of activities Quality Assessment Questionnaire Met with people who use the service (8) Spoke to relatives of people who attend the service (2) Staff files (2) Observation of staff morning briefing Minutes of Staff Meetings (5) Met with the Manager; Care Assistants (4); Drivers (2); Apprentice Care Assistant; Finance Officer Oran Street Day Centre, page 6 of 23

Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection report continued Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org Oran Street Day Centre, page 7 of 23

What the service has done to meet any recommendations we made at our last inspection There were two recommendations made at the last inspection one in relation to staff supervision which has been met and one in relation to showering facilities which had not been met. We have made a requirement in Quality Statement 4.1 to ensure that the health and welfare needs of people attending the service are met at all times by having accessible toilets and changing facilities. 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 service provider identified what they thought they did well, some areas for development and any changes they planned. The service 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 Twelve people who attended the service completed and returned a Quality Standards Questionnaire prior to the inspection. Everyone agreed or strongly agreed that they were happy with the quality of care the service provided. Most people knew about the service and SCSWIS complaints procedures, but some did not. While most people knew they had a personal plan, 3 did not and 2 did not know. Some people were a little uncertain as to whether their needs and preferences were detailed in their plan. Oran Street Day Centre, page 8 of 23

Taking carers' views into account Four relatives completed and returned a Quality Standards Questionnaire prior to the inspection. Everyone was happy with the service being provided. One carer felt that the service had a limited number of outings and felt that more funds should be made available to enable people who do not normally get out much to be able to go on more outings. We spoke to two carers on the day of the inspection both of which praised the service for the support being provided to their relative. Oran Street Day Centre, page 9 of 23

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 Overall 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 care and support provided by the service. Service strengths When people are being introduced to the service staff discuss and plan how best to help the person settle into their new surroundings. Everyone is issued with a welcome pack to provide details of what facilities are on offer. There is close contact with relatives during the settling period and this continues throughout the time people attend the centre. Regular newsletters are issued which provide an overview of meetings which have been held with those attending the service. Financial updates are given to advise on fundraising efforts and how these have supported outings and other special events. Notice is given of upcoming events and people are encouraged to sign up for those in which they wish to participate. Notice is given of forthcoming Care Inspectorate visits and people are encouraged to participate in inspections. People are provided with details of how to contact advocacy services. Sixteen people returned their Care Standards Questionnaires prior to the inspection and all agreed that they are asked for their opinions about how the service can improve. We met with a number of people who use the service and all were highly complimentary about the staff and the services being provided. Some people told us about recent consultation around meal quality and choice, and suggestions sought for future outings. They told us they felt their opinions helped shape the centre's activities. A small group of people had provided input into the service's self assessment for this inspection. The service had recently issued a questionnaire to everyone using the service and their relatives. Any suggestions for improvement will be considered by the service and efforts made to address any concerns. Oran Street Day Centre, page 10 of 23

Comments made in response to our questionnaire included: 'This club is very good' 'I was very much a person who didn't and couldn't go out on my own without a family member, but since going to Oran Street Day Centre its great, I can do a lot more now as the staff are so nice and care about me and all the service users' 'Completely happy' One relative told us how the service was helping them cope with their loved one's deteriorating mental health. We observed staff and people using the service to have a warm, close and friendly relationship. Areas for improvement We felt the monthly bulletins and service user minutes could benefit from improved lay-out. (See Recommendation 1) Three people responding to our questionnaire said they were not aware of the service's complaints procedures, while four people said they were not aware of SCSWIS complaints procedure. The service said they would continue to make people aware of how to raise complaints. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The service should review the lay-out they use for their monthly bulletin and minutes of service user meetings to include the use of graphics and improve layout to aid understanding. National Care Standards - Support Services - Standard 1 -Informing and deciding Oran Street Day Centre, page 11 of 23

Statement 5 We respond to service users' care and support needs using person centered values. Service strengths We attended the morning staff briefing and were impressed by the level of staff participation and efforts being made to address the individual needs of people attending the service. In particular, detailed plans were made to welcome someone who was attending the centre for the first time and help them settle. We spoke to one family member whose relative had recently started attending they service. They told us how their relative had previously been very depressed but since attending the service they were more cheerful and outgoing. They said their relative looked forward to coming to the centre and meeting people of their own age. They advised that staff had been very helpful and their relative was constantly praising staff. We examined the support plans of four people attending the service. Some people (3) had extensive personal histories documented while others were still in the process of being developed. The personal histories had been developed to a high standard. Records indicated how staff had sought to identify people's particular interests and source events and activities which would be of interest to them. Each person had a risk assessment and documented how staff should work with individuals. There was evidence of good liaison with families and health professionals to address any issues which arose. Thirteen of the people responding to our Care Standards Questionnaire were aware that they had support plans, while three thought they did not have a plan and two were unsure. Everyone expressed a high level of satisfaction with all aspects of the service, although one person said they thought the service did not have equipment to meet their particular needs. Some of the comments received in questionnaires included: Inspection report continued 'we get trips and do lots of activity, games and quizzes, and you can choose what you want to do' 'I am 83 years old I go to Oran Street Day Centre where I am very well looked after' We joined some people for lunch and later observed a number of activities. Staff demonstrated a sound knowledge of individual's needs and people using the service spoke warmly of all staff and some particularly singled out the drivers for praise telling us how helpful they were and how they were always cheery. Oran Street Day Centre, page 12 of 23

We met with all staff working on that day and found them all to be knowledgeable and highly committed to providing high levels of support. They demonstrated effective team working despite most only having worked in the service for a short time. The manager was observed to have a good working relationship with all staff and all people using the service knew the manager by first name and praised the service. Areas for improvement As a result of the provider's reconfiguration of day support services for older people, a neighbouring facility had been closed and some people had been transferred to this service. This had resulted in changes to transport arrangements which had initially resulted in longer bus journeys. Staff, including drivers, had worked hard to minimise the impact on people attending the service. People told us how the drivers tried to minimise the time anyone was on the bus. At the last inspection we made one recommendation which we will deal with in this Quality Statement. Reviews and risk assessments should be up-to-date and reflective of the current needs of each service user. Measures which have been put in place to meet the needs should be recorded. National Care Standards - Support Services - Standard 2 - Management and staffing and Standard 4 - Support arrangements The provider had implemented a reconfiguration of the whole of day support services and this had had some impact on this service. There was a vacant depute manager post which had been unfilled for some time and there had been a large turnover of staff. The manager had no day to day administrative support. Consequently reviews were not up-to-date although the manager hoped that now the staffing situation was improving that they would be able to bring their review programme up-to-date. (See Repeat Recommendation 1) During our inspection one person who had just started with the service was found to be missing. They had gone outside for a cigarette and had not returned. The manager immediately sent staff to look for the person and the person's relative was immediately contacted and liaison was maintained until the person was located. The person was found to have returned home and was safe and well and it had not been necessary to notify the police. The service needs to revise their approach to risk assessment to consider whether people need to be accompanied when outdoors. (See Recommendation 2) Oran Street Day Centre, page 13 of 23

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 2 Recommendations 1. Reviews and risk assessments should be up-to-date and reflective of the current needs of each service user. Measures which have been put in place to meet the needs should be recorded. National Care Standards - Support Services - Standard 2 - Management and staffing and Standard 4 - Support arrangements 2. The service should review their risk assessment policy and procedures to ensure that they fully evaluate whether people attending the service require to be accompanied while smoking outdoors when attending the service. National Care Standards - Support Services - Standard 2 - Management and staffing and Standard 10 - Feeling safe and secure Oran Street Day Centre, page 14 of 23

Quality Theme 2: Quality of Environment - NOT ASSESSED Oran Street Day Centre, page 15 of 23

Quality Theme 3: Quality of Staffing - NOT ASSESSED Oran Street Day Centre, page 16 of 23

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 One relative of someone attending the service visited while we were inspecting and we spoke to another relative who had telephoned the service. Both had regular contact with the manager and key workers and described the service as very supportive and in regular contact with them. There was a small group of people who met with the manager to discuss service improvements and planned outings and activities. Minutes of these meetings were circulated to everyone attending the service. Meetings of people attending the service were held on different days to enable everyone to participate. Some of the people we met were able to tell us about the meetings which had been held and what was discussed. When some concerns about meal variety was raised, the manager arranged for the cook to attend a meeting and hear first hand people's ideas for improving meals. On the week we attended new menus had been devised and at the request of those attending the centre, a menu was placed on each table to help people choose their preferred meal. 'I feel so safe I love being there, its helped me very much, Manager does a lot of things and makes sure nobody is left out...' 'Service all Round Excellent' Areas for improvement Following review of the meal service, a system had been agreed that the service would rotate the order in which each table was served, to ensure that everyone had the opportunity to be served first. Mostly this seemed to be working well except on the day we visited, some people who were not first to be served were unable to obtain their first meal choice as they had run out of that particular dish. People with whom we were sharing a table told us that there should be more meal supplies to avoid this problem. The manager agreed to discuss this with the cook to see if meal supplies could be increased. At the last inspection we made one recommendation in relation to shower facilities which we will address under this Quality Statement. Oran Street Day Centre, page 17 of 23

The organisation should ensure there are appropriate facilities such as having a shower in place to meet Service User's personal needs. National Care Standards - Support Services - Standard 4 - Support arrangements and Standard 2 - Management and staffing arrangements The service had been in discussion with the provider to have this matter addressed. Plans had been drawn up to reduce toilets from three to two to enable a shower facility to be installed which would provide sufficient space for two staff to assist. One person we spoke to said they had told the service, the difficulty they experienced accessing the existing toilet facility with their Zimmer frame. The manager acknowledged that if someone required assistance with toileting this would be very difficult with the current facilities. The service advised that they were beginning to see an increase in personal care needs of people being referred to the service. We became aware of an incident recently whereby someone had to be sent home early as the service had no showering or changing facilities to meet their needs. The manager was unable to tell us when shower facilities may be installed or toilets widened to accommodate people with mobility difficulties. The recommendation has not been met and some people attending the service are not having their personal care needs met. (See Requirement 1) The slowness of the provider to remedy the lack of showering and changing facilities in this service has resulted in us reducing the grade from 5 Very Good, to 4 Good for this particular Quality Statement. Grade awarded for this statement: 4 - Good Number of requirements: 1 Number of recommendations: 0 Requirements 1. The service will ensure that it has showering and changing facilities in place to meet the individual needs of people attending the service, including those who require the use of mobility aids. The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/201), regulation 4 (1)(a) - make proper provision for the health, welfare and safety of service users Timescale: 12 weeks from receipt of this report Oran Street Day Centre, page 18 of 23

Statement 3 To encourage good quality care, we promote leadership values throughout the workforce. Service strengths We interviewed two members of staff and a person who was undertaking a modern apprenticeship who was on placement in the service. Only one person had been in the service for more than one year. All staff were very knowledgeable about the individual needs of people attending the service and told us they felt part of a strong and friendly team. They told us everyone was encouraged to put forward their opinions and ideas and that the manager was very supportive. We observed a staff daily briefing session where it was clear that staff who were Key Workers for particular people, went to considerable lengths to source activities and outings which would be of interest, fun and stimulating. The manager was observed to encourage staff to develop areas of knowledge and expertise and have this shared within the team. For example, staff took on responsibility to organise events, activities and outings. All staff, including bus drivers, were observed to actively participate in activities and it was clear people using the service held staff in high regard. Given the high staff turnover in the last year to eighteen months, it is a testimony to the manager's skills and expertise that they have managed to develop a strong effective team in which individual members of staff are encouraged to develop their leadership skills. In particular, the apprentice had been supported and encouraged to develop their experience and skills with a view hopefully, in time, to securing a permanent position within the organisation. Areas for improvement At the last inspection we made one recommendation in relation to staff supervision which we will address under this Quality Statement. There should be planned supervision for all staff. Inspection report continued National Care Standards - Support Services - Standard 2 - Management and staffing arrangements We examined two staff supervision files. Supervision records were completed to a good standard recording progress during induction; addressing identified training needs; and providing staff with opportunities to visit other stakeholders such as Occupational Therapy and other provider services to observe practice. Oran Street Day Centre, page 19 of 23

Encouragement was given for staff to develop and build confidence in particular areas such as working in large groups. Formal supervision sessions were held three monthly and staff advised that they had regular informal contact with the manager and felt able to approach them with any ideas or concerns. This recommendation has been met. Staff supervision is three monthly, but more frequent supervision should be organised for staff who have recently joined the service. (See Recommendation 1) Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The service should review the frequency of supervision sessions for staff new to the organisation. National Care Standards - Support Services - Standard 2 - Management and staffing arrangements Oran Street Day Centre, page 20 of 23

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 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). Oran Street Day Centre, page 21 of 23

5 Summary of grades Quality of Care and Support - 4 - Good Statement 1 Statement 5 5 - Very Good 4 - Good Quality of Environment - Not Assessed Quality of Staffing - Not Assessed Quality of Management and Leadership - 4 - Good Statement 1 Statement 3 4 - Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 31 Jan 2011 Announced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed 12 Jan 2010 Announced Care and support 5 - Very Good Environment Not Assessed Staffing 5 - Very Good Management and Leadership Not Assessed 27 Nov 2008 Care and support 5 - Very Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Oran Street Day Centre, page 22 of 23

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 Oran Street Day Centre, page 23 of 23