Dachaidh (Care at Home) Support Service Care at Home St. Vincent's Hospital Gynack Road Kingussie PH21 1LR Telephone: 01540 662356 Inspected by: Rod Coltart Type of inspection: Announced (Short Notice) Inspection completed on: 6 June 2012
Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 9 4 Other information 15 5 Summary of grades 16 6 Inspection and grading history 16 Service provided by: Dachaidh Community Support Ltd Service provider number: SP2004005784 Care service number: CS2004059327 Contact details for the inspector who inspected this service: Rod Coltart Telephone 01463 227630 Email enquiries@careinspectorate.com Dachaidh (Care at Home), page 2 of 17
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 There is a strong emphasis on participation with service users and carers throughout the organisation. The service is committed to providing very good quality training which ensures staff are equipped to care for service users. What the service could do better The service is to review written information provided to service users/carers linked to the Care Inspectorate. The Complaint policy should be further developed to include timescales for action and any changes to the contact address of the Care Inspectorate. What the service has done since the last inspection The service is working together with other providers to ensure that service users receive care which is tailored to their needs. Conclusion Dachaidh Support Service provides very good quality care which is tailored to each person's needs. The service is committed to ensuring that their staff are well trained and qualified and focussed on enabling people to live to their potential. Dachaidh (Care at Home), page 3 of 17
Who did this inspection Rod Coltart Dachaidh (Care at Home), page 4 of 17
1 About the service we inspected Dachaidh is registered to provide home care for up to 15 adults within the Badenoch and Strathspey area. Service users are referred to the service by the Community Mental Health Team in Badenoch and Strathspey. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 5 - Very Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. 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. Dachaidh (Care at Home), page 5 of 17
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 The service received an announced inspection where the Care Inspector gathered evidence by: Examining the relevant records and documents relating to the quality themes and statements. Discussions with the manager and carer. Collation of Care Standards Questionnaires which outlined service users' views as to the quality of the service. 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 Dachaidh (Care at Home), page 6 of 17
take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org Dachaidh (Care at Home), page 7 of 17
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. Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The Care Inspectorate received a fully completed self assessment document from the 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 heading that we grade them under. Taking the views of people using the care service into account We were not in a position to speak with service users on the day of the inspection. Views of service users were noted through the service questionnaires which were on file. Comments regarding the service provision remain positive. Taking carers' views into account No carers were available to speak with on the day of the inspection. Dachaidh (Care at Home), page 8 of 17
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 This quality statement has recently been inspected against. In line with National Guidance it has once more been audited. The participation strategy had been developed and we were able to evidence that the active participation of service users continues to be central to the way the service operated. Staff regularly review the support provided to service users and their carers. The small staff group work with a restricted number of service users. Given this, communication between various parties is easily maintained and is carried out through formal and informal means. The manager held regular structured supervision with the other staff member at which she would feed back the views of service users. Client Service Satisfaction Forms had been sent out. The information provided outlined service users' views as to the quality of the service they received. Care documentation continued to evidence "that service users or their representative were involved in the planning for their support". Carers could participate in the process if the service user wished. Information about independent advocacy services was provided, as were details about how to make a complaint should they wish. Areas for improvement The service continues to provide a number of formal and informal means to ascertain service users' views of the service provision. We discussed developing opportunities Dachaidh (Care at Home), page 9 of 17
for service users and/or their carers to comment on the service once it had ceased to be provided. The manager agreed to look into this area linked to quality assurance. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service user's health and wellbeing needs are met. Service strengths The manager and support worker have a long history of supporting service users in social care settings. Given the nature of the service it is apparent that staff are knowledgeable about the needs of the service users they currently provided care and support to. They continue to be focussed on their roles and responsibilities and highlight any changes in the level of support a service user needs with the appropriate agency or relative/carer. Personal plans examined contained very clear statements about the service user's needs and the tasks that staff would undertake in order to meet their support needs. This was further reflected in the quality of the service user contact sheets which explained clearly what support had been provided and the result of that support. We were informed that service staff are invited to the regular review meetings that are held with other professionals. We were shown written evidence outlining an external stakeholder's view that the service provided continues to underpin valued and key support functions helping with rehabilitation or the maintenance of service users in their own homes. Areas for improvement The service held records linked to the planned provision of care and support to service users. The information held was client centred and linked to the Care plans in place. The manager agreed to review how this information is recorded and organised within service users' individual files. This is to include pre printed sheets and numbered pages. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Dachaidh (Care at Home), page 10 of 17
Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good Statement 2 We are confident that our staff have been recruited, and inducted, in a safe and robust manner to protect service users and staff. Service strengths The service historically has had a stable workforce. This is the situation at present. The service has policies and procedures linked to the recruitment of new staff. These procedures were deemed to be appropriate and outlined the checks and references required prior to a candidate being offered a position within the service. We noted that the provider also had a statement linked to the responsibilities of an employer under Equal Opportunities legislation. The current staff members had been in post for some time. We noted that the updated Induction programme is to be instigated for "new starts". We spoke with both staff members during the inspection. It was evident that they understood their responsibilities regarding alerting partner agencies and carers to issues of concern. It was noted that the service had updated policies linked to Protecting Vulnerable Groups. The service continued to have in place a "Whistle blowing Policy". This policy is a standard policy provided to assist staff. It identifies action that should be taken if a staff member has concerns linked to other employees or linked workers failing to carry out their roles adequately. Areas for improvement We were informed the chairperson undertakes an annual review of the policies and procedures linked to the service. It is agreed that an ongoing review of policies and procedures is likely to benefit the outcomes for all stakeholders. It had been some time since staff had reviewed the Protecting Vulnerable Groups policy and the manager agreed to do so with relevant persons and if up dated training is required, this is to be organised. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Dachaidh (Care at Home), page 11 of 17
Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths We met with both staff members involved in the direct support of service users. It was obvious that the "team" worked to ensure the service provided remains client centred. The service evidenced a very good level of commitment to training. The manager had registered with the Scottish Social Services Council (SSSC) and was aware of the need for other staff to register with the SSSC and the timescales involved. The provider has been able in previous years to assist staff in accessing training linked to the needs of service users. Training provided has included: Moving and Handling Person Centred approach to support and care of people with Dementia Self Directed Care Care Planning Approach Creative Communication Dementia Care in remote and rural settings. We noted that the service continues to review practice and procedure and is keen to develop and improve the service provided. We noted an example of this linked to the development of a new format for recording Dachaidh Reviews. The service continues to distribute "Client service Satisfaction" forms to access ongoing feedback as to the quality of the service provided as well as areas of improvement. Areas for improvement We discussed the use of risk assessments linked to the care of service users with the manager. It was agreed that a review of how these are implemented is to take place. We agree with the manager of the service that there continues to be value in providing ongoing training for staff and would expect that this will continue. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Dachaidh (Care at Home), page 12 of 17
Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very Good Statement 2 We involve our workforce in determining the direction and future objectives of the service. Service strengths Staff indicated that due to the nature of the organisation they can easily make their views known to members of the committee. Questionnaires linked to the annual appraisal of staff elicits information which, where not confidential, is said to be shared directly with the chairperson of the charity. The manager is able to monitor the delivery of the service through ongoing daily communication with the support worker and regular supervision meetings take place every four to six weeks. Core business Information is shared with the committee and staff activities are reported upon. Staff training historically has been accessed to support staff with a specific interest in an area of practice and is linked to meeting service users' needs. We noted that training is also clearly linked to assisting staff to continue to meet the aims and objectives of the service. Areas for improvement It is noted that training can also be influential in determining the possible future direction of the service. The manager is keen to ensure that staff training remains linked to the needs of individuals. We would agree that training and exposure to new developments will assist in meeting the needs of service users. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Dachaidh (Care at Home), page 13 of 17
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 The staff stated that they very much "value external scrutiny" of the service. We noted that funding organisations the Highland Health Board and Social Work Services, monitored the service provision. Staff also valued the role of the regulator and the inspection regime which is in place. The service has been proactive in seeking views from service users linked to ongoing improvement. The "Client Satisfaction Questionnaire" requests that service users and/or their carers grade their response to set questions. Included in the questionnaire is a section asking if service users would be interested in attending the providers Annual General Meeting and whether they would like transport to the venue? We noted information provided by a partner agency which highlighted the excellent work of Dachaidh staff in the Badenoch and Strathspey area. Areas for improvement As stated earlier, staff remain open to external scrutiny. The seeking of external stakeholders' views could be developed further. Information provided will continue to be useful both for the service to feedback the results of individual support but also to make a case for more or different resources. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Dachaidh (Care at Home), page 14 of 17
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 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). Dachaidh (Care at Home), page 15 of 17
5 Summary of grades Quality of Care and Support - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Staffing - 5 - Very Good Statement 2 Statement 3 5 - Very Good 5 - Very Good Quality of Management and Leadership - 5 - Very Good Statement 2 Statement 4 5 - Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 24 Nov 2010 Announced Care and support 5 - Very Good Staffing Not Assessed Management and Leadership Not Assessed 10 Mar 2010 Announced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 16 Mar 2009 Announced (short notice) Care and support Staffing Management and Leadership 5 - Very Good 4 - Good 4 - Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Dachaidh (Care at Home), page 16 of 17
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 Dachaidh (Care at Home), page 17 of 17