Threshold Glasgow Housing Support Service Unit 5 Building 5 - The Doge's Templeton Business Centre Bridgeton Glasgow G40 1DA Telephone: 0141 551 9204 Type of inspection: Unannounced Inspection completed on: 5 October 2017 Service provided by: Church of Scotland Trading as Crossreach Service provider number: SP2004005785 Care service number: CS2008182309
About the service Threshold Glasgow is a combined housing support and care at home service for adults with learning disabilities living in the community. The office base is located in the east end of Glasgow. The service is managed by Crossreach, an organisation that employs more than 2000 staff to support some of the most vulnerable people in Scotland. People who use the service are referred to as customers and so we have used this term in our report. The aims of the service include: - to help you think what a good life looks like for you - to plan with you how you can get this good life - to support you in ways that are respectful of your wishes and choices and not to over support you with things you can do yourself. Threshold Glasgow's ethos is that customers lead and manage their service along with the rest of the management team. The service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April 2011. What people told us People experiencing the service told us that they were very happy with the care and support they received. They gave us examples of how they had choice and control over their life and we could see that they had developed trusting and enabling relationships with staff and management. Family relatives told us that they also had a high regard for the service and could give us examples of how it had made a positive difference to their family member. A few relatives highlighted some areas for improvement which are noted in this report. Comments included, "Staff have a heart for the work" "My complaint was handled well" "Makes a massive difference to his life, he helps with meals, likes the company he is more sociable and independent". Self assessment The service did not require to submit a self-assessment as part of this inspection process. From this inspection we graded this service as: Quality of care and support Quality of staffing Quality of management and leadership 5 - Very Good 5 - Very Good not assessed page 2 of 6
What the service does well We found the service to be an excellent role model in many areas of practice as the outcomes experienced by most its customers were of a very high quality. In particular, involving and empowering customers to have a meaningful say in the care and support they received was impressive. Customer involvement in quality assurance and leadership, the training of staff and having a say in the wider developments in the field of learning disability was also noteworthy. Consequently, when we spoke to people we could see that they felt valued and that their views mattered. There were many examples where the service's culture of continuous improvement and innovation impacted positively on customers. For instance, the service had recently introduced 'Talking Mats' to communicate with the disengaged and those less vocal. Positive outcomes for customers resulted in them becoming healthier, more informed about their rights, being socially active as well as giving back to their community, for instance through volunteering and fund raising for local charities. During our home visits, we observed staff supporting people in an enabling way, accepting and inclusive, patient and person centred. We noted that customers responded positively to staff engagement and told us that they felt listened to, respected and well treated. We saw this in practice when we observed a staff member supporting a customer with warmth, kindness and compassion. Adult protection matters were taken seriously and involvement of relevant agencies, including social work services, was commonplace. Safeguarding was a regular training topic for staff and customers alike to ensure people were protected from harm. Wherever possible people were supported by regular teams of staff to promote consistency and continuity. People told us that this was reassuring because staff and customers worked well together. Support plans showed us the high priority given to supporting people's health and wellbeing, medical appointments nutrition and encouraging healthy lifestyles. Staff described management as approachable and supportive with regular opportunities for supervision and appraisal. Staff also welcomed the many opportunities to take on leadership roles. This led to an open culture where people were protected from harm by staff who felt valued and were clear about their role and responsibilities. The changing needs of customers were met by appropriate staff training, for instance, loss and grief training and palliative care training. Staff received and also presented relevant training along with customers. Consequently, this showed us that staff and management recognised customers to be experts of their own experiences, needs and wishes. What the service could do better The service was not performing to an excellent standard across all areas inspected. We discussed with the manager ways to improve the accessibility of support plans and make risk assessments more relevant to the person. This discussion included devising a clearer behaviour management plan, where appropriate, to ensure the person experienced a good quality of life. Such a plan would guide staff to identify when they needed to intervene and what the agreed nature of the intervention should be. page 3 of 6
Not all staff were demonstrating an understanding of basic housekeeping practice. This meant that some customers were not consistently receiving the high standards expected by the provider and service management. For instance, we found that appropriate standards of cleanliness were not always maintained. As well as regular unannounced spot checking, we would also want to see recruitment and induction processes focused more on testing people's motivation and competence to work in care (See Recommendation 1). Medication systems had been improved resulting in a marked reduction of medication errors. However, we continue to highlight medication management as an area for improvement given the significant number of repeated medication errors affecting one customer. As an area for improvement, managers should consider introducing a more effective call monitoring system. Requirements Number of requirements: 0 Recommendations Number of recommendations: 1 1. As well as regular unannounced spot checking of staff practice, we would also want to see recruitment and induction processes focused more on testing people's motivation and competence to work in care National Care Standards 4 Care at Home - Management and Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. Inspection and grading history Date Type Gradings 29 Aug 2016 Unannounced Care and support Management and leadership 22 Sep 2015 Unannounced Care and support page 4 of 6
Date Type Gradings Management and leadership 3 Sep 2014 Unannounced Care and support Management and leadership 23 Sep 2013 Announced (short notice) Care and support Management and leadership 14 Sep 2012 Unannounced Care and support Management and leadership 8 Nov 2010 Announced Care and support Management and leadership 4 Feb 2010 Announced Care and support 4 - Good 4 - Good Management and leadership 4 - Good page 5 of 6
To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at www.careinspectorate.com Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 Find us on Facebook Twitter: @careinspect Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 6 of 6