Mid - Argyll, Kintyre, Islay and Jura Home Care Service Housing Support Service Old Quay Head Campbeltown PA28 6ED Telephone: 01586 559093 Type of inspection: Announced (short notice) Inspection completed on: 27 March 2017 Service provided by: Argyll and Bute Council Service provider number: SP2003003373 Care service number: CS2004079966
About the service The service is provided by Argyll and Bute Council. The service was registered by the Care Inspectorate in April 2011, but were previously registered with the Care Commission in November 2004. The service's statement of aims and objectives as detailed in the service brochure/leaflet is: - To provide support for individuals and families in their own home with the aim of improving and maintaining maximum independence. - To enable clients to exercise control over their own lives. - To support the individual or family in their own home. - To avoid the need to move to another setting. - To provide a service which is responsive to service users taking account of their race, age, gender and communication needs. - To ensure an appropriate service which is responsive to service users' culture and religion and is delivered in an anti-racist way. - To provide a service which is responsive to carers' needs. - To support informal and other formal carers in caring. - To provide a choice of practical and caring support to which people have equal access. - To provide a service of high standard. - To eliminate discrimination on unlawful grounds and to promote the concept of equality. What people told us Generally people who use this service stated that emotional support alongside the physical care being delivered, added to their wellbeing. People confirmed that good communication across all areas was clearly in evidence throughout all discussions. Comments included: "Feel staff give 100%" "If I have a problem I pop in and it's fixed with quite quickly." Self assessment The Care Inspectorate received a fully completed self-assessment document from the provider. We were satisfied with the way the provider completed this and with the relevant information included for each heading that we grade services under. The provider identified what it thought the service did well, some areas for improvement and any changes it had planned. From this inspection we graded this service as: Quality of care and support Quality of staffing Quality of management and leadership Quality of care and support page 2 of 9
Findings from the inspection We were told by people using the service that there were very good relationships between staff, management and service users. Staff spoke professionally and knowledgably about the people they supported. All the service users we spoke with told us that staff were approachable, responsive and listened to their views. We saw that the personal plans were subject to frequent evaluation and updating. The plans were found to be informative and included a range of risk assessments. From reading these plans we gained a real insight into that individual person, their preferences and their support needs. For example, in the 'personal care' section of the plan there was clear detail about what an individual could do independently and clear guidance on what help was required from staff. This included details such as 'does not like to use talc or deodorant'. These detailed assessments helped staff identify any changes which may require action such as increasing the service. We saw cases where staff had been proactive in identifying changes and they had worked with external staff like social workers, GP's and community nurses to review and meet service users' needs. For many, the social activities and security of knowing staff well had really improved their quality of life. The service should continue to develop person-centred plans in partnership with service users, their families and representatives. They should ensure that information gained is easily accessible to service users. The service should continue to develop participation methods to ensure service users', carers' and stakeholders' views are sought and contribute to service improvements. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good Quality of staffing Findings from the inspection The staff could give examples of how they built up people's confidence and encouraged them to be more involved and feel more able to express their opinions. Staff were motivated to provide a level of care and support that resulted in positive outcomes for the service users. Staff were very respectful of each other (and service users), and commented positively on the way the team worked and shared information. In general, staff's feedback about access to training was positive they felt able to make suggestions and knew management would try and source that training. We found the service to be good at promoting the health and wellbeing of the people they support. Requirements Number of requirements: 0 page 3 of 9
Recommendations Number of recommendations: 0 Grade: 4 - good Quality of management and leadership Findings from the inspection Managers operated an 'open door' policy where they were available for general conversations and discussions with service users and their relatives. People we spoke with told us that the managers responded to their concerns and got back to them. As noted throughout this report we found that the staff team were supportive and considerate of the needs of the service users. We found that the registered manager and the local managers knew service users very well and had knowledge of individuals changing needs and preferences. There were examples of staff 'going the extra mile' to ensure that needs were met. Staff were clear about their duty to report concerns if poor practice was ever observed and about how to report concerns about individual's wellbeing. Staff told us that they could report concerns and were sure that they would be supported by management. Staff were aware of 'codes of conduct' that must be adhered to and most staff had a good understanding of the National Care Standards they should work towards. The staff team were professional and knew that their views were valued, this in turn, resulted in them being confident in making day-to-day leadership decisions. The service should continue to assess the abilities of service users to self-administer medications and remain proactive in seeking alternative services where necessary. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good page 4 of 9
What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 All staff must receive clear guidance and support on the safe handling of medication in their current role which is to prompt service users to take their medication. Appropriate training in medication awareness should be made available to staff and effective recording systems put in place to ensure accountability. This is to comply with: The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) Regulation 4(1)(a) - Health and Welfare of Service Users. Timescale: 30/4/2016. This requirement was made on 11 February 2016. Action taken on previous requirement Records held and interviews with staff confirmed that appropriate training had been delivered regarding expanding the staff team's knowledge of medication issues. Members of the management team confirmed that there is now in place clear systems for planned observation of working practice with staff. Met - within timescales What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 In line with good practice, people who use the service should participate in staff recruitment. This recommendation was made on 16 February 2016. The manager clarified how service users are involved and consulted during the probation period for new staff. This was confirmed by records held and service user interviews. The recommendation has been met. page 5 of 9
Recommendation 2 The manager needs to further develop consultation processes to ensure that people who use the service have an opportunity to participate in assessing and improving the quality of service. This recommendation was made on 18 February 2016. The service have tried different methods to gage the views of service users and families. However, due to the wide geographical areas covered still need to continue to explore a variety of methods to increase meaningful participation. Not met ongoing. Recommendation 3 Support should be provided in a consistent way and at a consistent time. People who use the service should be notified in advance of any necessary changes to the timing of their service or changes of worker. Cover arrangements when workers are sick or absent should be provided in the introductory pack when people start to use the service. This recommendation was made on 18 February 2016. A clear record is kept regarding changes or delays with service delivery. This enables the service to communicate effectively with people using the service. Recommendation has been met. Recommendation 4 Identified training needs should be addressed to ensure that staff use methods which reflect good practice. This recommendation was made on 18 February 2016. Staff interviewed and training records held clearly evidenced that this recommendation has been met. Recommendation has been met. Recommendation 5 Record keeping should be improved to demonstrate the plan of support and how this is provided. This recommendation was made on 18 February 2016. Care plans have continued to improve with updated information contained in the care plans sampled. Recommendation has been met. Complaints Please see Care Inspectorate website (www.careinspectorate.com) for details of complaints about the service which have been upheld. page 6 of 9
Enforcement No enforcement action has been taken against this care service since the last inspection. Inspection and grading history Date Type Gradings 7 Dec 2015 Unannounced Care and support Management and leadership 19 Mar 2015 Announced (short notice) Care and support 3 - Adequate Management and leadership 13 Dec 2013 Announced (short notice) Care and support 5 - Very good Management and leadership 12 Dec 2012 Announced (short notice) Care and support 5 - Very good Management and leadership 30 Jul 2010 Announced Care and support 5 - Very good Management and leadership 26 Aug 2009 Announced Care and support 5 - Very good Management and leadership 19 Jun 2008 Announced Care and support page 7 of 9
Date Type Gradings Management and leadership 3 - Adequate 3 - Adequate page 8 of 9
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 9 of 9