Home Care Services - Mainstream Team Support Service Southbank House Southbank Business Park Kirkintilloch G66 1XQ Inspected by: (Care Commission Officer) Tanko R. Akpo Type of inspection: Inspection completed on: 15 October 2007 1/8
Service Number Service name CS2004082080 Home Care Services - Mainstream Team Service address Southbank House Southbank Business Park Kirkintilloch G66 1XQ Provider Number Provider Name SP2003003380 East Dunbartonshire Council Inspected By Inspection Type Tanko R. Akpo Care Commission Officer Inspection Completed Period since last inspection 15 October 2007 Eleven months Local Office Address Central West Region 4th Floor 1 Smithhills Street Paisley PA1 1EB 2/8
Introduction Home Care Services - Mainstream Team service is an integrated service of care at home and housing support. The service is run by East Dunbartonshire Council Social Work Department and is based in the Kirkintilloch area. The service provides care and support up to vulnerable people. These include: * older people * children and families experiencing difficulties * people with physical and sensory disabilities * people with learning disabilities * people experiencing mental health problems * people with dementia * people with alcohol and drug problems * people with HIV/AIDS At the time of this inspection, there were 1300 people on the roll of the service. The service provides both Care at Home and Housing Support to people living in East Dunbartonshire. The service has a staff team of a Team Leader, Home Care Organisers, Home Care Co-ordinators and Home carers. The Mainstream Team provides long-term support. The support provided includes personal care, emotional support, social support and housing support. The service is available from 8am to 10pm, seven days a week. However, there is currently a pilot out-of-hours service being provided for a period of one year, from 10pm to 8 am. The overall aims and objectives of the Home Care Services is to "support customers in their own home for as long as possible with competent staff operating to the national [care] standards for care at home" and to "provide support to carers to allow their relative, friend or neighbour remain at home as well as aid early discharge from hospital." Basis of Report Before the Inspection The Annual Return The service submitted a completed Annual Return as requested by the Care Commission. The Self-Evaluation Form The service submitted a self-evaluation form as requested by the Care Commission. Views of service users Four service user questionnaires were returned and two service users were spoken with on the telephone. Regulation Support Assessment This service was inspected after a Regulation Support Assessment (RSA) was carried out to determine the intensity of inspection necessary. The RSA is an assessment undertaken by 3/8
the Care Commission Officer (CCO) which considers: complaints activity, changes in the provision of the service, nature of notifications made to the Care Commission by the service (such as absence of a manager) and action taken upon requirements. The CCO will also have considered how the service responded to situations and issues as part of the RSA. This assessment resulted in this service receiving a low RSA score and so a low intensity inspection was required as a result. The inspection was then based upon the relevant inspection focus area (IFA) and follow up on any recommendations and requirements from previous inspections, complaints or other regulatory activity. During the inspection process Staff at inspection One Care Commission Officer, Tanko Akpo, undertook this announced inspection. Evidence During the inspection evidence was gathered from a number of sources including: A review of a range of policies, procedures, records and other documentation, including the following: - Information Leaflet - Service Users' support plans and Reviews - Child Protection policy and procedure - Adult Protection Policy - Challenging Behaviour Policy - East Dunbartonshire Multi-Agency Adult Protection Procedures - Staff training records - Audit of staff training - Learning and Development policy documents( performance management and development planning, training strategy and training directory) - Quality Assurance Reports( 2007) (Service Users and Staff) - Supervision records - Staff Meeting(minutes) - Lone-working Safe reporting procedure - Care Commission Inspection Report (2006) Discussion took place with staff including: - Acting Service Manager - The Manager - Performance Development Officer - Care Standards - 6 Members of staff Only four service user questionnaires were returned. Inspection Focus Areas and associated National Care Standards for 2007/08 This year s inspection focus areas (IFAs) have been developed from statutory and policy considerations and have been widely consulted upon. During this inspection the CCO inspected the following IFAs associated with National Care Standards Housing Support Services: Standard 3: Management and Staffing Arrangements and National Care Standards Care at Home:Standard 4: Management and Staffing. 4/8
1. Protection of People with sub-sections on: - Child Protection in services for adults - Restraint - Adult Protection - SSSC Codes and Staff Training Being a combined Housing Support and Care at Home service the IFAs have been reported on under National Care Standard Housing Support Services: Standard 3: Management and Staffing Arrangements. Fire Safety Issues The Fire (Scotland) Act 2005 introduced new regulatory arrangements in respect of fire safety, on 1 October 2006. In terms of those arrangements, responsibility for enforcing the statutory provisions in relation to fire safety now lies with the Fire and Rescue service for the area in which a care service is located. Accordingly, the Care Commission will no longer report on matters of fire safety as part of its regulatory function, but, where significant fire safety issues become apparent, will alert the relevant Fire and Rescue service to their existence in order that it may act as it considers appropriate. Further advice on your responsibilities is available at www.infoscotland.com/firelaw Action taken on requirements in last Inspection Report There were no requirements in the last inspection report. Comments on Self-Evaluation A fully completed self-evaluation document was submitted by the service. This was completed to a satisfactory standard and gave relevant information for each of the standards associated with the inspection focus area. The service identified its strengths and some areas for future development and gave good evidence of service user involvement. View of Service Users There were 40 service user questionnaires issued with only 4 returned. All four questionnaires and service users spoken with indicated that service users were very satisfied with the service. View of Carers During this inspection, there was a very complimentary letter from a relative acknowledging staff's prompt response to a a relative's needs. 5/8
Regulations / Principles National Care Standards National Care Standard Number 4: Care at Home - Management and Staffing Strengths This report does not include comments on elements 4 and 8 (Care at Home) and element 8 (Housing Support Services) of this standard as these did not apply at this visit. The service did not receive child visitors as staff provided support to service users in their own homes. Nevertheless, the organisation has a Child Protection Policy in place. A policy and procedure was in place with regard to managing challenging behaviour and keeping of records. There was evidence of staff having had "personal safety" training which incorporates issues on restraint. The Manager stated that staff were not involved in direct physical restraint. There were copies of 'Rights, Risks and Limits to Freedom' (2006) and 'Safe to Wander' (2003) - Mental Welfare Commission Best Practice documents, in place. All service users had a generic individual risk assessment which was reflected in their support plans and reviewed every six months or earlier if required. The service had an Adult Protection Policy in place. Staff have been trained to an appropriate level such as Scottish Vocational Qualification (SVQs). The Manager informed that there have been no adult abuse concerns since the last inspection. A staff training needs assessment was in place as evidenced through supervision minutes. The Manager informed that there were plans to implement in the near future Performance Management and Development Planning(PMDP) which would also help identify staff training needs. There was a staff training directory in place and staff have had the relevant mandatory and non-mandatory training in for example, moving and handling, food hygiene, first aid awareness challenging behaviour and dementia awareness. There was a rolling training programme in place to allow all staff to access Scottish Vocational Qualification (SVQ) Levels 3/4 and thus register with the Scottish Social Services Council (SSSC). An evaluation of the effectiveness of staff training was in place. Areas for Development 6/8
Not all staff spoken with had an awareness of the organisation's child protection policy and understood how to implement it. There were also no policy review arrangements in place (see Recommendation 1) The service had an Adult Protection Policy in place which contained information such as: - staff/manager responsibilities - what the manager will do in an event of suspicions of abuse - information to be recorded - arrangements to ensure that adults have access to independent support/advice, as appropriate. However, the policy did not contain the following: - arrangements to ensure staff awareness - appropriate telephone numbers - arrangements for policy review. (see Recommendation 2) A copy of the Area Multi-Agency Adult Protection Procedures was in the service. However, the document did not have contact details including out of hours arrangements. (see Recommendation 3) The organisation had a training and development policy which was contained in various documents such as its training strategy paper, PMDP and training directory. The organisation should look into pulling these documents into one learning and development policy. 7/8
Enforcement There has been no enforcement action against this service since the last inspection. Other Information None Requirements None Recommendations 1. The provider should ensure that all staff were aware its child protection policy and understood how to implement it. Review arrangements of the policy should also be in place. NCH Housing Support Services: Standards 3.1 & 3.2: Management and Staffing Arrangements. NCS Care at Home: Standards 4.1 & 4.2: Management and Staffing 2. The organisation should further develop its Adult Protection Policy to contain the following: - arrangements to ensure staff awareness adult protection issues - appropriate contact telephone numbers - arrangements for policy review. All staff should be made aware of the policy and have access to appropriate training in adult abuse issues. NCS Housing Support Services: Standard 3: Management and Staffing Arrangements. NCS Care at Home: Standard 4: Management and Staffing 3. The Area Multi-Agency Adult Protection Procedures should be further developed to contain contact details including out of hours arrangements. NCS Housing Support Services: Standard 3: Management and Staffing Arrangements. NCS Care at Home: Standard 4: Management and Staffing Tanko R. Akpo Care Commission Officer 8/8