GCC SWS Homelessness Emergency/ Assessment Centre (3) Housing Support Service Clyde Place Assessment Centre 38 Clyde Place Glasgow G5 8AQ Type of inspection: Unannounced Inspection completed on: 26 November 2014
Contents Page No Summary 3 1 About the service we inspected 4 2 How we inspected this service 6 3 The inspection 10 4 Other information 22 5 Summary of grades 23 6 Inspection and grading history 23 Service provided by: Glasgow City Council Service provider number: SP2003003390 Care service number: CS2013315621 If you wish to contact the Care Inspectorate about this inspection report, please call us on 0345 600 9527 or email us at enquiries@careinspectorate.com GCC SWS Homelessness Emergency/Assessment Centre (3), 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 provided an excellent standard of support to vulnerable men affected by homelessness which was person centred and outcome based. What the service could do better The service should consider how it may better evidence service user and other key peoples' involvement in its next self assessment exercise. The service should also continue to look at different ways of increasing service user involvement: the manager had recognised this as an area for improvement. What the service has done since the last inspection This is the first inspection of this service. Conclusion The service was highly valued by the men living at Clyde Place. Staff working in this service were committed to providing the best standard of care and support and were motivated to look for ways to improve the lives of the men using the service. GCC SWS Homelessness Emergency/Assessment Centre (3), page 3 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 www.careinspectorate.com The service registered with the Care Inspectorate on 22 October 2013. If we are concerned about some aspect of a service, or think it could do more to improve its service, 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. A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reforms (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 Inspectorate. Glasgow City Council Social Work Services Homelessness Emergency/Assessment Centre (3) is provided to men living at Clyde Place Assessment Centre. There are 54 places at the centre. The service provides accommodation and support options to meet the needs of vulnerable men affected by homelessness, many of whom have complex needs. The service works in partnership with a wide range of care and housing professionals to deliver a comprehensive holistic service in a safe environment. The main aim of the service as detailed in the service aims and objectives is to 'Bring homeless men and services together, working holistically to create solutions for future living' Men are assisted to re - settle back into the community. 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 GCC SWS Homelessness Emergency/Assessment Centre (3), page 4 of 24
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 0345 600 9527 or visiting one of our offices. GCC SWS Homelessness Emergency/Assessment Centre (3), page 5 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 unannounced inspection was undertaken by one inspector during the day time on 3 December 2014. Feedback was provided to the service manager at the conclusion of the visit on the same day. Face to face discussions with two service users, the service manager and four support staff formed part of the inspection process. As requested by us, the service sent us an annual return and a self assessment: this useful information was used to help us plan our inspection. We also looked at information such as notifications which the service had sent to us. Eight service users and seven members of staff completed our Care Standards Questionnaires and gave us their views about the service. In addition, we gathered evidence from various sources, including the relevant sections of policies and procedures, records and other documents including: - Care plans - Risk assessments - Staff training records and training plan - Minutes of staff meetings - Questionnaires for service users and carers - Staff supervision records - Accident and incident records - Minutes of meetings with service users - Reports from other care professionals - The services quality systems including questionnaires, outcome reports - The service information pack - Service newsletter - Clyde Place Continuous Improvement Plan GCC SWS Homelessness Emergency/Assessment Centre (3), page 6 of 24
Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org GCC SWS Homelessness Emergency/Assessment Centre (3), page 7 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: No Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The service submitted a self assessment as requested by us prior to this inspection. We discussed the content with the service and registered manager during our visit, and made suggestions as to how service users and carers could be more involved in this exercise at the service level. Taking the views of people using the care service into account We talked with two people using the service during our visit and six individuals returned our care standards questionnaires. Here are some of their comments: 'My support worker has helped and supported me in every way'. 'I could not fault the service, the staff are all great, very kind'. 'It is the Hilton of hostels'. 'Through my adult life I have been homeless on a number of occasions, and feel I have never had the support I am getting now. I think it's a great service here'. 'This service has really helped me to settle and get on my feet'. 'They have organised help for me when I leave here, that is really important.' GCC SWS Homelessness Emergency/Assessment Centre (3), page 8 of 24
Taking carers' views into account We were unable to meet with carers during this visit. Inspection report continued GCC SWS Homelessness Emergency/Assessment Centre (3), page 9 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 performance in relation to this standard statement was very good. We saw evidence of the service constantly striving to improve and encourage service users to comment on the service and the accommodation. The service was using a variety of methods to seek the views of the men using the service. These included the services' questionnaires, face to face sessions during the period of engagement, review meetings, house meetings, and other group activities such as the service user forum. Every service user was given an occupancy agreement and a welcome pack which included very useful information about the service, and how support would be provided. This also detailed how service users would be involved in planning and reviewing their support. Individuals that we talked to told us they felt comfortable to raise any issue with the staff and were confident it would be addressed promptly. A service user focus group had been established: the meetings focused on events and activities. GCC SWS Homelessness Emergency/Assessment Centre (3), page 10 of 24
The care plans that we looked at provided evidence of a person centred out come focused approach: service users were fully involved throughout the planning and evaluation process. The service staff sought the individuals views about what they wanted to achieve from the package of support: this resulted in good outcomes for the people being supported. Suggestions and comments could be posted on the 'talking wall' feature in the communal lounge. The actions taken as a result of feedback from service users were displayed in a 'You Said - We Did' format. Recent actions included improving the breakfast choice, and increased opportunities for outdoor activities such as football and cycling. Information was available in alternative formats and languages, and a sign language and interpreter service were available. Some service users had been supported by advocacy services, and information on available support was well displayed. The services' complaints policy and complaints forms were available in reception. The service brochure detailed how service users will be involved in the development and on going delivery and evaluation of their support plan. It was evident from our discussions with service users that the service was committed to providing the support that people wanted when they wanted it. The staff we talked with told us about the challenges in engaging with this service user group, and discussed the innovative ways they address this. During our visit, we saw evidence of a strong culture within the service that the meaningful involvement of the people using the service is key to the services' ongoing development. Areas for improvement Inspection report continued The format of the complaints procedure and Comments, Compliments, Complaints form for use by complainants should be further developed to be more relevant to the service. It should also detail the service users right to make a complaint to the Care Inspectorate. GCC SWS Homelessness Emergency/Assessment Centre (3), page 11 of 24
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued GCC SWS Homelessness Emergency/Assessment Centre (3), page 12 of 24
Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths The performance in relation to this standard statement was excellent. The service users we met with looked well and told us they were pleased with the standard of support being provided by the service staff. They told us about the positive impact of living at Clyde Place. Inspection report continued For some this meant feeling safe and secure, accessing meaningful activities in the community such as training, having access to health care, being supported to enter employment, becoming more confident to do things on their own, ultimately becoming more independent and self sufficient. Men we talked with during our visit told us how their sense of self worth and self esteem had increased whilst using the service. One described it as being a life - line, and helping him to get 'back on track'. Staff we talked with told us they promoted an 'enabling role' and explained the benefits of 'doing with' as opposed to 'doing for'. There was a real focus on identifying risk with an appropriate action plan to make sure people were supported to maintain good mental and physical health. For example individuals at risk of self harm had very detailed support plans which included the identification of triggers and coping strategies which were effective when someone was distressed. This ensured that staff had a consistent approach. There was evidence of full consultation and agreement with service users in developing their support plans. There was a transfer protocol which supported service users' movement between projects on the grounds of health and safety which meant that even in challenging situations the men could be kept safe. We saw evidence of people setting realistic and achievable goals with agreed timescales. Outcomes focused reviews showed the progress of these identified goals. It was evident that the staff team promoted service user involvement at every stage of the support plan. This individual support, assessment and assistance focused on assisting individuals to re settle back into the community. GCC SWS Homelessness Emergency/Assessment Centre (3), page 13 of 24
This was done on the basis of mutually agreed support plans and by using a strong network of partnership agencies and local service providers. These included Health and Addictions services, Social Work services, Criminal Justice, Mental health, Welfare Rights, Children and Families services, and Housing services. A community service which offered support to access education and employment visited the service twice a week service users we talked to were very positive about this service. Areas for improvement There were no areas for improvement identified at this visit Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 GCC SWS Homelessness Emergency/Assessment Centre (3), page 14 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 performance in relation to this standard statement was very good. Please refer to the strengths in Quality Theme 1 Statement 1 which are also relevant to this statement. Service users who we talked to and who completed our Care Standards Questionnaires reported a high level of satisfaction with the quality of the staff at Clyde Place. Satisfaction questionnaires included questions on the quality of the staff and suggestions for improvements or changes they may like. We saw evidence that the service had responded promptly and appropriately to any service users concerns about the quality of staffing. Areas for improvement The comments made in Quality theme 1, statement 1 are also applicable to this statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 GCC SWS Homelessness Emergency/Assessment Centre (3), page 15 of 24
Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths The performance in relation to this statement was very good. Inspection report continued We observed good open lines of communication between service users, staff and visitors during our visit. There was a feeling of warmth and caring, and relationships based on openness and trust. The staff team had remained consistent and had many years of experience working with this client group. Staff we talked to had a good knowledge of service users individual needs and had a good awareness of their hopes and aspirations. Therefore, they could provide a person centred type of support. There was a key worker and case management system in place. Service users we talked with were very complimentary about this system and told us about the valuable support staff provided. We saw evidence of effective team working within the team and with a wide range of other care professionals. All new staff underwent a comprehensive induction to help prepare them for their role. The staff team were highly trained in safety and risk assessment which was evident in the support plans and evaluations we looked at. We saw staff training records which evidenced that the staff had undertaken core and other training to ensure their practice was up to date and they could deliver support safely. Staff could access a variety of training course through the GOLD e learning system, and there was a system in place to record compliance with mandatory courses. Other care professionals had provided some staff training: this was a good basis for exchange of knowledge The staff had been trained to administer 'rescue medication' in the event of an overdose: this ensured that potential for recovery was improved. GCC SWS Homelessness Emergency/Assessment Centre (3), page 16 of 24
Staff had opportunity to be supported to undertake SVQ training which is a recognised care qualification. Staff were being matched to the type of client need, which ensured that the staff provided had the appropriate skills and experience. There was a comprehensive suite of policies and procedures to guide staff, including safe guarding policy and procedure to protect vulnerable adults. Staff supervision and appraisal systems were in place, and the records we looked at showed that these sessions were focused on performance, team working and personal development. This helped to ensure good outcomes for people using the service. Staff we talked to and who returned our questionnaires felt very well supported by the service managers. They also told us they felt consulted with and had opportunity to contribute to the development of the service. Staff confirmed their involvement in team meetings: minutes of these were available. We were pleased to note that the National Care Standards were on the agenda at team meetings and also discussed at supervision sessions. Supervisory staff who were required to be registered with a professional body held this registration; this contributed to ensuring the safety and protection of service users. Staff told us there was always a manager available at all times to provide support if needed, including providing an extra staff member for assistance. Staff described morale in the team as very good and told us they felt valued by the manager. The manager ensured that in the event of a critical incident, staff were provided with ongoing debriefing and support: this is very good practice. All line managers had undertaken specific and relevant management training. The staff we met with were motivated and committed to providing the best possible care. They reported a high level of satisfaction working in the service. Areas for improvement Inspection report continued The service should continue to source training which meets the specific needs of service users. The manager discussed possible options of sourcing this from other care providers. GCC SWS Homelessness Emergency/Assessment Centre (3), page 17 of 24
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued GCC SWS Homelessness Emergency/Assessment Centre (3), 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 performance in relation to this standard statement was very good. Please refer to the strengths in Quality Theme 1 Statement 1 which are also relevant to this statement. Service users and carers who we talked to and who completed our Care Standards Questionnaires reported a high level of satisfaction with the quality of the management staff at Clyde Place. The service manager was very visible within the service, and it was evident from our observations that she was well known to the men using the service. Areas for improvement The comments made in Quality theme 1, statement 1 are also applicable to this statement. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 GCC SWS Homelessness Emergency/Assessment Centre (3), 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 Performance in relation to this statement was very good. The organisation had quality assurance systems in place and there was very good evidence that these were being followed. Systems and activities were in place to assess the quality of care and support, staffing and aspects of management and leadership. We saw evidence of regular audits of all areas of service provision by the service manager. The findings were submitted to senior management every quarter in the form of an operational performance review. The progress with the subsequent action plan was closely monitored. There was also monitoring of the systems to support staff. This included staff meetings, supervisions, appraisals and compliance with staff training plans. All accidents and incidents were documented and analysed and a 'lessons learned' approach taken to manage risk. We saw evidence that the views of staff and other stakeholders were sought in the form of questionnaires and via meetings and other forums, for example there had been a recent city wide staff engagement session which had included a question and answer session. Staff had also been consulted on the key priorities for the following year. The service had developed a Clyde Place Continuous Improvement Plan which had been informed by the outcomes from its audit systems and feedback from service users, staff and other key people. This detailed the target group, the area of improvement, the lead person, target timescales and the date for review. We were satisfied that the service and external managers had a good overview of the service, and that issues would be identified quickly and prompt action taken. This helped to assure a quality service, in which service users were protected. Areas for improvement Inspection report continued The service should consider how it could better evidence the involvement of all key stakeholders in the next self assessment exercise. GCC SWS Homelessness Emergency/Assessment Centre (3), page 20 of 24
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued GCC SWS Homelessness Emergency/Assessment Centre (3), 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 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 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). GCC SWS Homelessness Emergency/Assessment Centre (3), page 22 of 24
5 Summary of grades Quality of Care and Support - 5 - Very Good Statement 1 Statement 3 5 - Very Good 6 - Excellent 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. GCC SWS Homelessness Emergency/Assessment Centre (3), 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 0345 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 0345 600 9527. Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: 0345 600 9527 Email: enquiries@careinspectorate.com Web: www.careinspectorate.com GCC SWS Homelessness Emergency/Assessment Centre (3), page 24 of 24