New Trinity Centre Support Service Care at Home 7a Loaning Road Edinburgh EH7 6JE Telephone:

New Trinity Centre Support Service Care at Home 7a Loaning Road Edinburgh EH7 6JE Telephone: 0131 661 1212 Inspected by: Stephen Ball Grant Dugdale Type of inspection: Unannounced Inspection completed on: 25 February 2013

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 23 5 Summary of grades 24 6 Inspection and grading history 24 Service provided by: Capability Scotland Service provider number: SP2003000203 Care service number: CS2003011114 Contact details for the inspector who inspected this service: Stephen Ball Telephone 0131 653 4100 Email enquiries@careinspectorate.com New Trinity Centre, page 2 of 26

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 4 Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well We found that the New Trinity Centre provides a stimulating day service, offering a variety of group activities for people with complex support needs Those who use the service are consulted on a regular basis at local and national levels about how the service can be further improved and developed. The service does well in providing in an easy to read format documents with images and photographs to support those who may have communication support needs. The service also works closely with other health professionals to continuously strive to ensure the very best of care and support is provided and the wellbeing needs of service users are fully met. What the service could do better We identified some health and safety concerns with regards to the environment of the premises used at the New Trinity Centre. We have highlighted this further within this report. What the service has done since the last inspection The New Trinity Centre has continued to provide good service to service users since our last inspection. The service users we met with told us that they were very happy New Trinity Centre, page 3 of 26

with the service provided and with the choice of activities they can take part in, for example art and music groups. Conclusion The New Trinity Centre continues to provide a good day service which is valued by the people who use the service. Who did this inspection Stephen Ball Grant Dugdale New Trinity Centre, page 4 of 26

1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Prior to 1 April 2011, this function was carried out by the Care Commission. Information in relation to all care services is available on our website at www.scswis.com. This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April 2011. Requirements and recommendations If we are concerned about some aspect of a service, or think it needs to 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 based on best practice or the National Care Standards. - 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 ("the Act") and secondary legislation made under the Act, or a condition of registration. Where there are breaches of Regulations, Orders or conditions, a requirement may be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. ABOUT THE SERVICE WE INSPECTED The New Trinity Centre is a day centre run by Capability Scotland to provide day care for adults over the age of 16 who have complex care needs. It has been registered with the Care Inspectorate since 1 April 2002. The centre can accommodate up to 49 service users a day. On the day of inspection there were 42 service users in attendance. The service operates from 8:30 am until 4 pm, Monday - Thursday and from 9:00 am until 3:30 pm on a Friday. There are opportunities to participate in a range of activities e.g. arts and crafts, music, cooking, social and leisure pursuits and personal, development. Support is provided in community based activities as well as supporting service users to access college courses. People who access the centre mainly come from Edinburgh. 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 - Grade 4 - Good New Trinity Centre, page 5 of 26

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. 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. New Trinity Centre, page 6 of 26

2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care. What we did during the inspection We wrote this report following an unannounced inspection. The inspection was carried out by Care Inspectorate Inspector, Stephen Ball. Grant Dugdale, who is another inspector with the Care Inspectorate, also assisted with the inspection process by observing some of the activities at the centre and reading some of the files. As requested by us, the care service sent us an annual return. The service also completed a self assessment form. In this inspection, we gathered evidence from various sources including the relevant sections of policies, procedures and other documents including: We spoke with: * The deputy manager (in the absence of the registered manager). * 7 support workers / assistants. * 5 service users. * The inspector observed two large group activities. We looked at: * Sampled 10 support plans and risk assessments. * Sampled 10 reviews of support plans. * Sampled 10 staff files. * Read a sample of staff team meeting minutes. * Reviewed a sample of Incident and complaint records and reporting systems. * Quality assurance information. * Training records. * Service user surveys and feedback. * Minutes of Keywork meetings between service users and support staff. * Collated the responses from questionnaires issued to service users, carers and relatives. New Trinity Centre, page 7 of 26

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 New Trinity Centre, page 8 of 26

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. We received a fully completed self assessment document from the service provider. We were satisfied with the way the service provider had completed this and with the relevant information they had given us for each of the headings that we grade them under. The service provider identified what they thought they did well, some areas for development and any changes they planned. Taking the views of people using the care service into account We sent out 40 CI Care Standard Questionnaires to people using the service, relatives and carers. 11 were returned to us. Positive comments received "The New Trinity Centre continues to be an excellent service provider." Some raised particular issues: "It is only a problem with shortage of staff when it comes to drivers. Calls to advise no driver to collect / bring home not really adequate." 2 service user did not know the procedure for making a complaint to the service. 2 service user did not know how to make a complaint to the Care Inspectorate. Taking carers' views into account The majority of the questionnaires we received were positive. New Trinity Centre, page 9 of 26

Taking account of staff members Staff questionnaires were issued, 4 were returned to us. The majority of the responses we received were positive. New Trinity Centre, page 10 of 26

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: 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 We found the service to be working well with consulting service users and their carers on a regular basis and at different stages of support delivery about how the service can be improved. Capability Scotland, the provider of this service had a good system in place to capture the feedback from service users and carers, with this information then going straight to the management board of directors for Capability Scotland. The system, called `Have your Say` were found to be an excellent tool to allow service users to have an influence in developing the service but also building good communication between those who use the service and senior management. We saw evidence of clear feedback being provided to service users and their families by the service following any suggestions for service improvements. Information was also provided on any restrictions which could occur in suggestions not being possible for legitimate reasons. There was clear evidence, however, of activities being designed by the support staff as a direct result of service users being consulted on how to further improve the service. Suggestion boxes were also provided within the centre, along with posters explaining to service users and visitors the complaints procedure and information on quality assurance tools. We looked at any complaints the service had received since our last inspection. Only 1 New Trinity Centre, page 11 of 26

complaint had been received and we found the service had addressed this complaint in line with their complaints procedure. When we read a sample of key policies and procedures, we found that the complaints document detailed the role of the Care Inspectorate and the relevant contact information was included. A seasonal newsletter was provided to service users and family members. The contents of the newsletter contain relevant information in relation to Capability Scotland as an organisation, service information updates and publicising forthcoming events including the national `Have your say` annual forum meetings. We found the service worked well in transferring relevant documents like the complaints procedure, newsletters and care and support plans into easy to read formats, with the use of images and photographs to support those who may have communication needs. We read the results of the bi-annual national service user satisfaction survey which is undertaken by Capability Scotland. The results of the latest survey held in 2011 were very positive. 323 service users responded. 90% of the service users who responded to the survey were satisfied with the service. 83% enjoyed the activities. 85% were involved in the planning and review of activities. 74% were satisfied with the quality of personal care. 80% had been informed of any changes to the service. We were told by the management of the service that they were looking to hold open days for family members and carers with presentations on the support provided at the centre. We will follow this up at our next inspection. Areas for improvement Inspection report continued When we assessed the opportunities for service users and carers to participate in assessing and improving the quality of care and support provided by the service, we identified the added benefits the service would bring with developing this area further. For example, Service user and carer meetings were held on a regular basis in recent years. However, these meetings stopped taking place due to a lack of attendance. Whilst previous attendance may be low, the service should explore holding these meetings again to provide further opportunities for service users and carers to meet with the management of the service to discuss service developments and improvements. We are therefore making this a recommendation. Please see recommendation 1. The service would also benefit from having annual local satisfaction surveys in addition to the national one. This would allow them to identify any potential of areas of improvement locally and feed these areas in at a national level. The written agreement did not advise people of the arrangements for ending the New Trinity Centre, page 12 of 26

service, either by them or the service provider. The agreement should detail this information. We are therefore making this a recommendation. Please see recommendation 2. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 2 Recommendations 1. The service provider should explore holding service user and carer meetings to provide further opportunities for them to meet with the management of the service to discuss service developments and improvements. National Care Standards, Support Services, Standard 12 - Expressing your views. 2. The service provider should update the written agreement to ensure it advises people of the arrangements for ending the service. National Care Standards, Support Services, Standard 3 - Your legal rights. Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued We saw evidence that service users meet with a support staff member who is their keyworker on a monthly basis. The purpose of which was to discuss the on-going activities the service user is attending within the centre and any other relevant ongoing support needs. These meetings are recorded and actions are agreed to take forward. There were a variety of support activities service users can attend at the centre. These include group sessions of photography, music, art, women and men's pampa sessions. We attended some of these activities on the day of our inspection, to assess the interaction between service users and support staff. It was clear to us that the staff had a good understanding of the individual needs of service users and the support staff showed a high level of respect and dignity. Our observation of these activities was that the service users really enjoyed attending the groups and mixing and communicating with others. Each service user has a communication dairy they carry on their person. The purpose was to provide a means of daily communication between service user, service management / staff and family members. Some service users offered us a view of these diaries and it was clear to us that this method of sharing information was a very accessible method of communicating with others and used well. New Trinity Centre, page 13 of 26

We sampled a total of 10 service user support files. These files contained relevant support focused documents including the care and support plan, risk assessments and various protocols that staff must follow in order to fully meet the needs of service users. The contents of the support documents were very comprehensive, detailing the assessment of support needs and how the service should deliver the agreed support. The support plans we viewed were outcome based, meaning they were goals agreed with the service user on what they would like to achieve whilst attending the New Trinity Centre. The outcomes focused on communication, personal care, health and medication, social involvement, mobility and finances. The care and support plans also included a `safer assistance and mealtime plans`. These documents detailed the procedures staff should use to support a service user with any mobility needs and support with eating at lunch times. Staff sign to confirm they have read and understood the contents of these plans, to promote consistency amongst how the staff deliver the support agreed. Further support plans included the use of restraint, for example, when perhaps using a safety belt on various equipment used within the centre and epilepsy management plans, providing guidance for staff to follow. We sampled the Medical Administration Record (MAR) sheets used by staff when supporting a service user with their medication. These records were maintained by the on-site nurse, who also provides daily input to the support needs of service users. The service worked very closely with other health professionals, including speech and language and occupational therapists to support any communication and mobility needs of service users. We assessed how often the care and support needs of service users are reviewed. We found these were being reviewed on a six month basis, meeting the legislation requirements for this statement. We saw evidence of review feedback questionnaires being provided to service users and their carers after each review had been held. This provided service users and their carers an opportunity to provide feedback on their experiences of the review process and whether the service was continuously meeting their needs. The questionnaire focused on the following areas: * Is a personal care planning meeting required? * Is the service user and family happy with the service provided? * Are the staff well trained to meet the needs of the service user? * Do staff include you in things which are important to you? Inspection report continued New Trinity Centre, page 14 of 26

* Do you feel safe and secure? * An update on the relevant on-going outcomes to achieve. We found that a large majority of the responses from service users and family members was very positive. We looked at the risk assessments in place for service users. These focused on: * Safer assistance (moving and handing) * Mealtime support (safe eating support needs) * Challenging behaviour assessments * Communication * Personal care needs * Support in and out of transport * Emergency evacuation assessments Each of these risk assessments also included assessment of the staff ratio required to meet the support needs of service users. The service provides healthy eating options within the canteen area service users access and the service provider had been awarded the Healthy living award for the past five years. Areas for improvement Inspection report continued Although a great deal of detail is contained with the support plans and other supportive documents, we experienced challenges at times to get a full understanding of the care package in place due to the high volume of information. The service would benefit from having an overarching and easy to ready support plan in place for staff to access on a day to day basis with key information to meet the needs of service users. Whilst we saw evidence of service users meeting with their keyworker on a monthly basis, these meetings were often taking place in a group environment. As a result, these meetings were not confidential to individual service users needs. The service should explore providing keywork meetings on an individual basis. We are therefore making this a recommendation. Please see recommendation 1. We observed from the support files that there was limited evidence of an assessment of needs being undertaken and recorded. Although it was clear to us an assessment of needs had been undertaken for service users, the service should further improve how this is recorded and evidenced. We discussed this with the registered manager at our feedback meeting following the inspection. We will follow this up at our next inspection of the service. We read the key policies and procedures in place which the staff we spoke to were New Trinity Centre, page 15 of 26

familiar with. With regards to the adult support and protection procedure, we identified the need for this document to be reviewed to include the contact information of external support agencies, including the police and social work departments. We also found that some additional policies and procedures should be reviewed on a more regular basis, to ensure they continue to meet current legislation and best practice. These procedures included the risk assessment procedure which was last reviewed in 2009. With regards to the review of risk assessments, we found that the majority of these assessments were being reviewed on an annual basis, rather than the required six months under current legislation. We are therefore making this a requirement. Please see requirement 1. Upon reading some of the incident reports recorded since our last inspection of the service, we identified two incidents which resulted in a service user being admitted to hospital following a trip or fall. Whilst the service had followed the correct procedures in providing the required support to those concerned, these incidents were not reported to the Care Inspectorate. We highlighted this need with the service manager. The service provider must notify the Care Inspectorate of all accidents and incidents involving injury to the service user. Please see requirement 2. Grade awarded for this statement: 4 - Good Number of requirements: 2 Number of recommendations: 1 Requirements 1. The service provider must ensure risk assessments are undertaken for all residents and reviewed on a 6-monthly basis or less as and when required. This is to comply with the Scottish Statutory Instruments (SSI) 2011 No 210, Welfare of users, (4.1a) make proper provision for the health, welfare and safety of service users. Timescale: Within a 28 day period on receipt of this inspection report. 2. The service provider must notify the Care Inspectorate of all accidents and incidents involving injury to the service user. This is to comply with the Public Services Reform (Scotland) Act 2010. Timescale: Immediately on receipt of this inspection report. Inspection report continued New Trinity Centre, page 16 of 26

Recommendations 1. The service provider should ensure keywork meetings between service users and support staff are undertaken on a 1-1 basis to maintain confidentiality. National Care Standards, Support Services, Standard 4 - Support arrangements. Quality Theme 2: Quality of Environment 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 environment within the service. Service strengths Statements 1.1, 3.1 and 4.2 have been taken into account for this statement. Areas for improvement Statements 1.1, 3.1 and 4.2 have been taken into account for this statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 2 We make sure that the environment is safe and service users are protected. Service strengths We sampled the maintenance records and found that regular maintenance and safety checks had been carried out on the premises used by the service, including that of the hoists and other support equipment. Areas for improvement On the day of our visit to the New Trinity Centre, we came across a number of concerning health and safety matters. For example, on entering one area of the building, we discovered unattended building equipment including power tools and ladders. Whilst we acknowledge service users and staff need to have access to this area to use the fire door for any emergency evacuation, the area containing the power tools and other equipment was not secure and we saw no safety measures to protect service users. We also discovered a cupboard door open in the reception area which also contained joinery tools, including a chisel, again this area was not secure. New Trinity Centre, page 17 of 26

During the afternoon of our inspection of the service, we observed a service user exiting the building without any of the support staff being aware. The service user was unsteady on his feet and did not have the appropriate clothing for the cold climate outside. We monitored the service user leaving the building and crossing the busy car park to the gates of the premises and walking towards the main road. At this point we provided the relevant support to ensure the service user concerned was safe in his well-being and supported him back to the service. We spoke with the service manager to raise our concerns with regards to the service user exiting the day centre and the support staff not being aware of this. We were not satisfied that appropriate risk assessments and staff observation of service user safety was in place. We are therefore making a requirement that the service provider reviews current risk assessments in place to ensure the safe wellbeing of service users and the environment are maintained. Please see requirement 1. When we met with the registered manager of the service to provide formal feedback following the inspection, prior to this report being written, we were advised that the management of the service had taken appropriate steps to address the health and safety concerns highlighted on the day of our inspection. Grade awarded for this statement: 3 - Adequate Number of requirements: 1 Number of recommendations: 0 Requirements 1. The service provider must review current risk assessments in place to ensure the safe wellbeing of service users and the environment are maintained. This is to comply with the Scottish Statutory Instruments (SSI) 2011 No 210, Welfare of users, (4.1a) make proper provision for the health, welfare and safety of service users. National Care Standards, Support Services, Standard 5 - Your environment. Timescale: Within 28 days on receipt of this inspection report. New Trinity Centre, page 18 of 26

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 We were told by the management of the service that service users were involved in the Scottish Vocational Qualifications (SVQ) training of staff. We saw this to be an excellent way to give opportunities for service users and carers to participate in assessing and improving the quality of staffing within the service. We also saw good evidence of service users being involved in the recruitment of staff. We were advised that all staff interviews involve service users and they are able to ask questions at the interviews. The service had also developed supportive tools for service users to communicate through the use of images and symbols for the recruitment process. Areas for improvement The service should continue to develop on the excellent methods in place to involve service users and carers in assessing and improving the quality of staffing. Grade awarded for this statement: 6 - Excellent 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 read a sample of staff meeting notes to assess how often support staff meet as a team and share their working practices with others, discuss the needs of service users and service development. The evidence available to us told us that the staff meetings were held on a monthly basis. These meetings were well attended and focused on the above areas. New Trinity Centre, page 19 of 26

The service had a staff suggestion scheme in place, allowing staff to make suggestions about improving the service. All suggestions that the staff make were forwarded on to the Board of management for Capability Scotland to discuss and agree possible actions. Feedback was also provided to staff on an individual basis. We saw this to be a good practice approach to involve the workforce in having a direct influence on the continued development of the service. All staff received an in-depth induction to Capability Scotland. The six month structured induction covered safer assistance, food and risk assessments. This period also includes learning the service's policy and procedures. Staff also shadow more experienced staff until their levels of competency are assessed by the management of the service. We read the staff support and supervision policy. This document detailed the aims and objectives of staff meeting with their line manager three times a year, with an annual appraisal concluding the year with new training and learning outcomes for the following 12 months. Capability Scotland had an annual training in place. This consisted of core refresher training on areas like moving and handing, infection control and adult support and protection to name just a few. Further comprehensive training is provided to staff, covering medication, epilepsy and other areas staff require training for to meet the needs of service users. Our assessment of the training provided by Capability Scotland was very good. The support staff we spoke with also commented on how well they were supported in this area of professional development. We also saw evidence of support staff completing learning outcome examinations. This was a useful tool for the service management to use to assess the learning outcomes for staff and to ensure they are fully competent in their roles. Areas for improvement When we looked at the staff support and supervision records, we identified gaps in the frequency of these meetings taking place. Seven out of the ten we sampled were not being held in line with the service's procedure. The service provider should ensure staff receive regular practice and development meetings with their line manager three times a year and in line with the service's policies and procedures. We are therefore making this a recommendation. Please see recommendation 1, Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1 Inspection report continued New Trinity Centre, page 20 of 26

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 Statements 1.1, 2.1and 3.1 have been taken into account for this statement. Areas for improvement Statements 1.1, 2.1and 3.1 have been taken into account for this statement. 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 Capability Scotland had a number of quality assurance methods and tools as detailed within their quality assurance policies and procedures. We saw this information on display in an easy to read format around the centre on notice boards in key areas. In addition to external methods, including the inspections undertaken by the Care Inspectorate, Capability Scotland had their own quality assurance and development department located within the head offices of the service provider. This department undertake regular quality checks of the service and we saw clear evidence of this being done, along with any recommendations for improvements following these checks being carried out. These recommendations were added to the overall continuous improvement action plan the service has in place. We saw this to be a very good approach to quality assessing the service. We were also aware of cross service audits being done during the course of the year. This involved managers from other Capability Scotland services visiting services and to New Trinity Centre, page 21 of 26

undertake a management perspective quality assurance check of the service. Again we saw this to be a very good strength for this statement. Areas for improvement We identified that the service provider would strengthen their quality assurance tools by implementing file audit systems on service user and staff support and supervision files. Having a system of this kind would provide the service management with clarity of when relevant documents need to be reviewed and updated. We are therefore making this a recommendation. Please see recommendation 1. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. The service provider should implement a file auditing system for service user and staff files, to clarify when relevant documents need to be reviewed and updated. National Care Standards, Support Services, Standard 2 - Management & Staffing. New Trinity Centre, page 22 of 26

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). New Trinity Centre, page 23 of 26

5 Summary of grades Quality of Care and Support - 4 - Good Statement 1 Statement 3 5 - Very Good 4 - Good Quality of Environment - 4 - Good Statement 1 Statement 2 5 - Very Good 3 - Adequate Quality of Staffing - 5 - Very Good Statement 1 Statement 3 6 - Excellent 4 - Good Quality of Management and Leadership - 5 - Very Good Statement 1 Statement 4 5 - Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 10 Jan 2014 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 21 Jul 2011 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing Not Assessed Management and Leadership Not Assessed 17 Nov 2010 Announced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed New Trinity Centre, page 24 of 26

27 Oct 2009 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing 4 - Good Management and Leadership 5 - Very Good 15 Jan 2009 Announced Care and support 4 - 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. New Trinity Centre, page 25 of 26

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 New Trinity Centre, page 26 of 26