Carewatch Care Services - Inverclyde & North Ayrshire Housing Support Service 38 Union Street Greenock PA16 8DJ Inspected by: (Care Commission Officer) Type of inspection: Colin Goldie Announced Inspection completed on: 29 July 2005 1/11
Service Number Service name CS2003053843 Carewatch Care Services - Inverclyde & North Ayrshire Service address 38 Union Street Greenock PA16 8DJ Provider Number dummy Provider Name SP2004004438 Inverclyde & North Ayrshire Care Services Ltd Inspected By dummy Inspection Type Colin Goldie Care Commission Officer Announced dummy Inspection Completed Period since last inspection 29 July 2005 N/A dummy Local Office Address Paisley dummy 2/11
Introduction Carewatch Inverclyde and North Ayrshire has been registered with the Care Commission since 2004 to provide a Housing Support and Care at Home Service. Carewatch Inverclyde and North Ayrshire is a franchise of Carewatch Care Services Ltd, based in Brighton. Carewatch Inverclyde and North Ayrshire provides services to people, primarily older people, people with learning and/or physical disabilities and those with mental health problems, who require support to live independently in their own homes. The stated aim in the Statement of Purpose is "to provide an exemplary service to both service users and care workers alike...endeavouring to get it right the first time, every time and always meeting...service users and care workers expectations". Basis of Report This Inspection was undertaken on an announced basis between July and October 2005 by one Care Commission Officer. Prior to the inspection Carewatch Inverclyde and North Ayrshire returned Pre Inspection and Self Evaluation documentation containing information about the service. 18 service users, 8 interested party (relatives, other agencies) questionnaires and 11 staff returned questionnaires giving their views of the service. During the inspection the Officer spoke with between 15 and 20 staff in the Stevenson and Greenock Offices, the Regional Manager and manager. A range of policies, procedures and records were also looked at or sampled, including the following: Staff training records Support plans Complaint records Statement of Purpose Service User Guide Company Information Pack Staff handbook Written agreement Staff personnel files The Officer took all the above into account and reported on whether the service was meeting the Regulation of Care (Requirements as to Care Services) (Scotland) Regulations 2002. The following standards from the National Care Standards for 'Care at Home' and 'Housing Support Services' were considered: Care at Home, Standard 1 - Informing and Deciding Care at Home, Standard 2 - The Written Description Care at Home, Standard 3 - Your personal plan. 3/11
Care at Home, Standard 4 - Management and staffing. Housing Support Services, Standard 7 - Exercising Your Rights Care at Home, Standard 8 - Keeping Well - Medication Care at Home, Standard 11 - Expressing Your Views Action taken on requirements in last Inspection Report N/A Comments on Self-Evaluation The pre inspection return was completed in a comprehensive manner, containing relevant and appropriate information. The information provided was reflected in the findings of the inspection. View of Service Users A number of questionnaires had been issued to clients prior to the inspection of which 18 had been returned. Questionnaires commented positively on the service offered, for example - " Staff are most pleasant and willing to help" " Have never needed to complain as the service I receive is excellent" " Very considerate and caring" " All carers I had were very helpful" One questionnaire noted that when their regular carers were on holiday that other staff "Didn't always know the routine." Four service users were telephoned. Their opinions reflected those in the written questionnaires. View of Carers Carers comments were positive: " My mother says they are all exceptionally obliging and nice" 4/11
Regulations / Principles Regulation 3: SSI 114 Regulation 3 Statement of Aims and Objectives The service had produced a clear set of aims and objectives. Regulation 4: SSI 114 Regulation 4 (2) Welfare of Users The service had a range of policies and procedures in place to ensure that staff practice made proper provision for the health and welfare of service users. Those using the service confirmed that their privacy and dignity were respected. None identified at this inspection Regulation 5: SSI 114 Regulation 5 (2) Personal Plans Clients Personal Plans outlined the details of the service to be provided. These included a range of information, e.g. Moving and Handling Assessments. Care reviews were carried out on a regular basis with the client and, where appropriate, relatives being involved. The regional manager advised that support planning documentation was being updated. Progress with this will be reviewed during future inspections. Regulation 7: SSI 114 Regulatin 7 Fitness of Managers 5/11
The manager was deemed fit during the registration process. This covered areas such as experience and knowledge. Regulation 9: SSI 114 Regulation 9 Fitness of Employees Staff were recruited following an interview and the obtaining of references, one of which was the previous employer, and Disclosure Scotland checks. Staff had been provided with information concerning the Scottish Social Services Council. Further reference will be made to this under Standard 4 "Management and Staffing". Regulation 13: SSI 114 Regulation 13 Staffing The Officer was informed by Carewatch Inverclyde and North Ayrshire that an appropriate number of staff were employed. There were comprehensive policies and procedures to inform staff practice. Further reference will be made to this under Standard 4 "Management and Staffing". There were a range of training opportunities for staff. These were regularly reviewed. Staff spoken with found the training events relevant to their work. Staff spoken with showed commitment and enthusiasm. Regulation 19: SSI 114 Regulation 19 (1) Records Records were found to contain required information, e.g. clients name, next of kin and GP contact details. 6/11
Regulation 25: SSI 114 Regulation 25 Complaints Those using the service were provided with information concerning the projects complaints procedure. While the complaint procedure common to all Carewatch franchises did not make reference to the Care Commission, Carewatch Inverclyde and North Ayrshire had taken steps to ensure that the Care Commission was noted in its complaint procedure. Carewatch was aware of this omission. National Care Standards National Care Standard Number 1: Care at Home - Informing and Deciding Prior to receiving a service potential clients were provided with a range of information relating to the service. This included the range of services on offer and contact details. Once it was agreed that a service would be provided additional information was provided including the organisations complaints procedure and funding arrangements. The Officer was informed that 95% of clients were funded through Social Work. In these instances the service to be provided was dictated by Social Work in the first instance. Service users expressed no concerns regarding the information provided. National Care Standard Number 2: Care at Home - The Written Description While the initial agreement was often between Social Work and Carewatch the latter took steps to ensure that clients were involved in developing the written agreement between 7/11
themselves and the service. The agreement between Carewatch and the client noted the service to be provided, funding arrangements the start date and who would be involved in providing the service. National Care Standard Number 4: Care at Home - Management and Staffing Satisfactory procedures for the recruitment and selection of staff were in place with staff being selected through a selection process involving an interview, reference and Disclosure Scotland checks. Staff had been issued with identification badges. Systems were in place to ensure that identification badges were returned when staff were no longer employed by Carewatch. All workers were issued with the Scottish Social Services Council codes of practice. There was an ongoing programme of staff induction, training and development. Carewatch Inverclyde and North Ayrshire had an inhouse training coordinator. Systems were in place to monitor the quality of the service, including worker and service user questionnaires. Bi-monthly spot checks were carried out on staff to assess how well they were working with clients. Staff said that they had good support from their supervisors and management. Policies and procedures were in place that covered all legal requirements, including staffing and training, medication, risk assessment and Health & Safety. Care staff received a comprehensive handbook detailing policies and procedures. Incidents and accidents were recorded. Where alternative cover arrangements needed to be put in place the service took steps to ensure that clients were made aware of who would be covering or when the staff would arrive. Service users confirmed that staff treated them with dignity and respect. The organisation was aware that its Policies and Procedures made reference to English legislation and regulatory bodies and was in the process of ensuring that Scottish legislation and regulatory bodies were referred to. It will be a recommendation of this report that this 8/11
matter be progressed. While the manager said that staff had been issued with copies of Scottish Social Service Council Code of Practice, there were a number of staff questionnaires that indicated that some staff were not aware of this body. When this was brought to the managers attention she undertook to raise staffs' awareness of the SSSC. National Care Standard Number 7: Housing Support Services - Exercising Your Rights Confidentiality was maintained by the service. Staff had received training in this area and had signed the organisation's Confidentiality Policy. Clients were only required to provide information relevant to the service being provided. Information concerning clients was stored securely. Clients were allocated a named worker to ensure consistency in service provision. A copy of the clients Personal Plan was retained in their own home, if they wished. Personal plans explained rights and responsibilities for clients and what to expect from staff. There was a policy in place regarding the identification and reporting of abuse. National Care Standard Number 8: Care at Home -Keeping Well -Keeping Well - Medication (where help with taking medication is provided as part of the service) Staff were provided with training prior to being involved with medication. It was the role of staff to prompt and remind clients. Staff were not involved in medication administration. The service did not store medication. 9/11
National Care Standard Number 11: Care at Home - Expressing Your Views Clients spoken with said that they felt confident expressing their views, and that these would be listened to. Clients had been provided with a copy of the services complaint procedure. The service could, and had, supported clients to use the services of the local Independent Advocacy Service. Clients were supported and encouraged to take part in the inspection process. The manager said that inspection reports would be made available to clients. Clients could express their views or concerns with the staff providing care and the supervisor involved in reviewing their support plan. There was ongoing consultations with family members, social workers and other agencies. 10/11
Enforcement N/A Other Information The Officer had the opportunity to speak with staff in both the Stevenson and Greenock offices. Staff stated that they worked with a regular group of clients to ensure continuity of service delivery. There were differences amongst the staff group regarding their understanding of the role of the Care Commission and the Scottish Social Services Council. Staff said that they felt appropriately supported and involved in service delivery. Staff confirmed that their working practices were regularly monitored and appraised. 11 staff questionnaire's were returned. Those commented that: "I am happy with my work with Carewatch as there are plenty of opportunities for promotion." " The supervisors are very supportive and handle all dilemmas we encounter...with confidence and professionalism." "There are very good training opportunities." No negative comments were noted. As noted in Section 4 "Management and Staffing" there were a number of staff questionnaire's (5) stating that they were unaware of the Scottish Social Services Council. In discussion with the Regional Manager she said that it was often difficult to ensure continuity of service delivery as the Local Authority providing funding could decide to use another service provider. She said that there had been instances when clients had been unhappy with this decision. This was confirmed in conversation with a relative of a former client who was in the process of trying to get Carewatch to be reinstated as the service provider. Requirements None. Recommendations 1. The organisation should review all Policies and Procedures to ensure that Scottish legislation and regulatory bodies are referred to. Standard 4 - "Management and Staffing". Colin Goldie Care Commission Officer 11/11