Mid - Argyll, Kintyre, Islay and Jura Home Care Service Housing Support Service Old Quay Head Campbeltown PA28 6ED Telephone:

Mid - Argyll, Kintyre, Islay and Jura Home Care Service Housing Support Service Old Quay Head Campbeltown PA28 6ED Telephone: 01586 552 659 Inspected by: Elspeth Gibb Type of inspection: Announced (Short Notice) Inspection completed on: 12 December 2012

Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 11 4 Other information 17 5 Summary of grades 18 6 Inspection and grading history 18 Service provided by: Argyll and Bute Council Service provider number: SP2003003373 Care service number: CS2004079966 Contact details for the inspector who inspected this service: Elspeth Gibb Telephone 0141 843 6840 Email enquiries@careinspectorate.com Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 2 of 19

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 4 Good Quality of Management and Leadership 4 Good What the service does well The inspection showed that the manager and the staff team are enthusiastic and committed to the people they support. There is a positive, responsive ethos throughout the service and the management team are approachable and caring in their approach. The people using the service were positive about the way staff support to them in their daily lives. We found that staff were keen to improve the service for each person and worked effectively with health teams and other professionals to make sure that people's needs were being met. The service was developing its assessment and care planning procedures to improve outcomes for people who used the service and their relatives or carers. What the service could do better Although staff have regular access to management support if they have any concerns, individual supervision arrangements for staff are not in place. Care plan systems are being improved to include more detail about how each person wishes their personal care to be arranged. Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 3 of 19

What the service has done since the last inspection Inspection report continued There has been a lot of uncertainty about the future of this service and staff have managed this difficult time very well. They have continued to provided a very good and valued service to the older people of Mid Argyll. Conclusion The management team are committed to the ongoing improvement of the service across all the Quality Themes. Who did this inspection Elspeth Gibb Lay assessor: Not Applicable. Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 4 of 19

1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Prior to 1 April 2011, this function was carried out by the Care Commission. Information in relation to all care services is available on our website at www.careinspectorate.com. The Care Inspectorate will award grades for services based on findings of inspections. Grades for this service may change after this inspection if we have to take enforcement action to make the service improve, or if we uphold or partially uphold a complaint that we investigate. The history of grades which services have been awarded is available on our website. You can find the most up-to-date grades for this service by visiting our website, by calling us on 0845 600 9527 or visiting one of our offices. Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve its service, we may make a recommendation or requirement. A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service but where failure to do so will not directly result in enforcement. A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reforms (Scotland) Act 2010 and Regulations or Orders made under the Act, or a condition of registration. Where there are breaches of the Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Inspectorate. Mid - Argyll, Kintyre, Islay and Jura Home Care Service provides a care service to adults and older people in their own homes. It is registered with the Care Inspectorate as a combined Support Service (Care at Home) and Housing Support Service. The service operates from office bases in Campbeltown, Lochgilphead, Bowmore (Islay) and Craighouse (Jura). The service is available to people throughout this rural area. A respite and short break service is also provided to people in a specifically designated flat in the Jura Progressive Care Centre. The service is provided by Argyll and Bute Council. The service was registered by the Care Commission in November 2004. Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 5 of 19

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 user's culture and religion and is delivered in an anti-racist way. To provide a service which is responsive to carer's 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. 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 4 - Good Quality of Management and Leadership - Grade 4 - 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. Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 6 of 19

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 We wrote this report after a short term announced inspection that took place over two days - 31st October 2012 and 12th November 2012. Feedback was given to the external manager on 12th December 2012. The inspection focused on the service provided in Mid Argyll. As requested by us, the care service sent us an annual return. The service also sent us a self assessment form. We issued questionnaires to a sample of people who used the service, their family, friends or carers and took their responses into account when planning the inspection and writing the report. In this inspection we gathered evidence from various sources, including relevant sections of policies, procedures, records and other documents, including: Evidence from the service's most recent self assessment and annual return Discussion with the service manager, homecare organisers and 10 care staff Personal plans of people who use the service and records held electronically Staff training and supervision records, team and managers meeting minutes Quality Assurance systems Service user involvement information including minutes from forum meetings Visiting 3 people who used the service and speaking to families. We took all of the above information into account during the inspection process and reported on it. 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. Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 7 of 19

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 take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 8 of 19

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. We 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 of the headings that we grade them under. The service provider identified what they thought they did well, some areas for development and any changes they planned. Taking the views of people using the care service into account Everyone who returned questionnaires were happy or very happy with the quality of service they received. Those involved directly in the inspection were very positive about the service they received. Their comments included: "I am very happy. I think I am very lucky to have this service" "I am delighted with the staff - they are so good to me" "It is a well run service and the staff are all very good to us" "I can't speak highly enough about the way I am looked after and I am so pleased to be able to stay in my own home" Taking carers' views into account The views expressed in questionnaires and on the telephone were all very positive. Comments included: "I am very grateful that my mother gets looked after so well" Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 9 of 19

"I think the staff and the managers are all very good" Inspection report continued Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 10 of 19

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 We found the performance of this service to be very good in the areas covered by this statement. We concluded this after we consulted with service users in their own homes, engaged in discussion with all the staff available on the day of inspection and examined a wide range of documentation relating to the service. Each person has a care plan which gives a brief outline of their needs. Discussion with staff and managers showed that they knew people's needs well. Within the personal plans we could see that people had regular review meetings to evaluate the service. The people who use the service could choose who they wanted to attend their review meetings. The service adheres to Argyll and Bute Council's participation strategy that outlined how people would be involved in different aspects of the service. There are complaints and suggestions leaflets readily accessible to service users and relatives. The people that we spoke with told us that they felt they were involved in making decisions about their own life. There is a Homecare Forum which meets quarterly and people who use the service and their families can use this forum to raise issues. Relatives spoken with thought highly of staff and they said that the care is good and staff are sensitive. They also said that communication was good between themselves and the management staff and that any issues they had raised had been dealt with satisfactorily. Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 11 of 19

Areas for improvement Care plan systems are being reviewed to include more detail about individual preferences and person lifestyle choices. The service should continue to explore ways of involving people and consider ways of gathering and recording information about involvement and participation. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Care plan systems are being reviewed and improved to include more detail about each person's needs. Currently staff cannot administer medication and this has had an impact on some people using the service. This issue is being addressed and appropriate training put in place for staff. Areas for improvement Care plan systems are being reviewed and improved to include more detail about each person's needs. Currently staff cannot administer medication and this has had an impact on some people using the service. This issue is being addressed and appropriate training put in place for staff. A new Dementia team has been set up and this is greatly valued by staff and those using the service. The self assessment notes the intention to build on practice examples to make consistent use of this team to support individuals and their carers. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 12 of 19

Quality Theme 3: Quality of Staffing Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths Details of the general procedures and methods used to promote participation are included at Quality Theme 1, Statement 1. Areas for improvement The inspection showed that staff continue to look for ways to improve involvement and participation. Areas for development relating to participation and involvement are noted at Quality 1, Statement 1. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths We found this service was performing very well in the areas covered by this statement. We concluded this after we spoke to the manager and the staff team, reviewed staff training plans and talked to people who use the service. Staff felt that the management team was approachable and they could raise issues and concerns. The inspection showed that there was an open and supportive approach to managing the service. The management team work very well together and showed by their actions and discussion that they were strongly committed to staff development, training and the development of a strong person centred approach to supporting people. Regular staff meetings take place to discuss issues and pass information from senior management. An appraisal system for staff is currently being implemented. Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 13 of 19

The organisation has very well established policies and procedures which underpin practice and all staff are aware of the SSSC codes of practice. All staff are supported to attend courses run. Some staff already have SVQ qualifications and others are about to commence this training. All mandatory training in moving and handling and food hygiene is up to date and staff have access to training courses in relevant subjects run by Argyll and Bute Council. Areas for improvement Some members of staff have not attended staff meetings for some time. During the inspection we discussed ways of involving all staff in setting the agenda for staff meetings and ways of sharing feedback. The self assessment highlighted the need for feedback from HR about any concerns raised by staff who have left the service. There has been considerable impact on staff from the lengthy period of uncertainty whilst the external tendering process was completed. However, this process is now complete and staff look forward to a more stable time ahead. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 14 of 19

Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths Details of the procedures and methods used to promote participation are included at Quality Theme 1, Statement 1. Strong relationships were observed between the management staff and staff teams and there is an open and accessible management style across the service. Areas for improvement The management team are aware of the need to further develop the care planning and review system which will promote involvement in the management of the service. Details of the areas for development noted in relation to participation are included at Quality Theme 1, Statement 1. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 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 very positive ethos which exists in the service and the open, supportive management style of the home care organisers, contribute very positively to the way the service receives feedback from those who use the service. The service has a link officer in the quality assurance department who contributes to the external monitoring of the service. A new external manager has been appointed and she is currently getting to know staff whilst exploring ways to ensure that the improvement focus is maintained. Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 15 of 19

Areas for improvement The implementation of effective individual support, supervision and appraisal for all staff is a noted area for development. Internal quality assurance procedures could be developed further to ensure quality across all aspects of the way the service is managed. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. An effective staff supervision and appraisal system should be put in place. NCS 4 Care at Home - Management and Staffing Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 16 of 19

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). Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 17 of 19

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 - 4 - Good Statement 1 Statement 3 5 - Very Good 4 - Good Quality of Management and Leadership - 4 - Good Statement 1 Statement 4 5 - Very Good 4 - Good 6 Inspection and grading history Date Type Gradings 30 Jul 2010 Announced Care and support 5 - Very Good Staffing 4 - Good Management and Leadership Not Assessed 26 Aug 2009 Announced Care and support 5 - Very Good Staffing 4 - Good Management and Leadership 4 - Good 19 Jun 2008 Announced Care and support 4 - Good Staffing 3 - Adequate Management and Leadership 3 - Adequate All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 18 of 19

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 Mid - Argyll, Kintyre, Islay and Jura Home Care Service, page 19 of 19