ASA International Nurse Agency 6 Coates Crescent Edinburgh EH3 7AL

ASA International Nurse Agency 6 Coates Crescent Edinburgh EH3 7AL Inspected by: Aileen Scobie Type of inspection: Unannounced Inspection completed on: 18 December 2013

Contents Page No Summary 3 1 About the service we inspected 4 2 How we inspected this service 6 3 The inspection 9 4 Other information 18 5 Summary of grades 19 6 Inspection and grading history 19 Service provided by: ASA International Ltd Service provider number: SP2006008270 Care service number: CS2006118363 Contact details for the inspector who inspected this service: Aileen Scobie Telephone 0131 653 4100 Email enquiries@careinspectorate.com ASA International, page 2 of 20

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 Information 5 Very Good Quality of Care and Support 5 Very Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well The service has very good introductory information which they provide to potential clients. Safe staff recruitment systems are in place. What the service could do better The management should review and further develop systems to gain feedback from clients about the quality of information and personnel supplied by the Nurse Agency. What the service has done since the last inspection We found that the service had implemented many of the areas for improvement as identified during the last inspection in December 2010. Conclusion The quality of the service continues to be at a very good level. The service should continue to identify and progress service developments. Who did this inspection Aileen Scobie ASA International, page 3 of 20

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. This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April 2011. 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. ASA International is a large recruitment organisation which has specialist autonomous divisions, one of which is a nurse agency which supplies and/or introduces registered nurses to other care providers. The nurse agency has offices in Edinburgh, Glasgow, Aberdeen and Kirkcaldy. Based on the findings of this inspection this service has been awarded the following grades: Quality of Information - Grade 5 - Very Good Quality of Care and Support - Grade 5 - Very Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very Good ASA International, page 4 of 20

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. ASA International, page 5 of 20

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 The inspection of ASA International was carried on 18 December 2013. During the inspection, evidence was gathered from a number of sources including: Discussions with the senior management team and training department of the service. Examination of a sample of the policies, procedures, health & safety records which the service is required to maintain: staff handbook staff records including training records records of complaints insurance certificates quality assurance systems, records and reports 2 staff personnel files NMC checks client's reference manual staff placement database. 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. Details of what we found are in Section 3: The inspection ASA International, page 6 of 20

Inspection Focus Areas (IFAs) Inspection report continued 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 ASA International, page 7 of 20

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 completed self assessment document from the service provider. This was completed to a satisfactory standard and gave relevant information for each of the Quality Themes and Statements. The service provider identified what they thought they did well, some areas for future development and how they planned to implement changes and further develop the service. Taking the views of people using the care service into account Not applicable for this type of service. Taking carers' views into account Not applicable for this type of service. ASA International, page 8 of 20

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 0: Quality of Information 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 information provided by the service. Service strengths The service provides clients with detailed information about the agency. This includes copies of the agency's Aims and Objectives, information leaflet, complaints procedure, financial charges and contact names and phone numbers. The service has an informative website. This help keep people up to date with what's happening in the agency. The agency matches staff with the skills, experience and ability that are appropriate to meet the specifications of the client. The agency manager carries out visits to care homes they supply nurses to and also telephones services to gain feedback from them. Questionnaires are supplied to clients to gain feedback on the quality of service and staff. Clients also have opportunity to provide feedback using the complaints procedure. The management team meet regularly to determine if the information given out is comprehensive and meets the needs of clients. Areas for improvement The service should maintain its very good opportunities for all users of the service to 'have a say' in the quality of information provided. ASA International, page 9 of 20

Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 ASA International, page 10 of 20

Statement 4 We ensure that information held about service users is managed to ensure confidentiality and that the information is only shared with others if appropriate and with the informed consent of the service user. Service strengths We found that the service had very good systems in place to ensure that information held about service users was managed confidentially. All administrative staff are required to sign a confidentiality agreement and nurses'/carers' employment contracts include a confidentiality clause in their terms and conditions. Staff are reminded of their obligations regarding confidentiality. The agency nurses were also bound by the Nursing and Midwifery (NMC) Codes, and carers through the Scottish Social Services Council (SSSC) Codes of Practice. We found that information kept within the office base was stored appropriately and securely. Areas for improvement The manager is commited to ongoing monitoring to ensure that no confidential documents are in sight or accessible to those with no right to see or have them. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued ASA International, page 11 of 20

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 As already noted in Quality Theme 0, Statement 1, the agency has systems in place to gain the views of clients and enable them to contribute to the improvement of the service. The service regularly seeks feedback from clients as to the performance of agency nurses. A log of all contacts and communication with clients is maintained. Any areas for improvement are quickly followed up and remedial action taken. There was evidence of staff review, monitoring visits and gaining feedback from clients which informed staff appraisals. Areas for improvement The service should continue to encourage the agency nurses/carers to take part in the annual appraisal, as this was a very good opportunity for them to 'have their say'. The service should continue to explore meaningful ways of gaining the views of all users of the service users. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 ASA International, page 12 of 20

Statement 3 We ensure our service provides care staff who are most suitable to meet individual service user needs. The care and treatment received by the individual service user, is supported by evidence based practice and up to date policies and procedures. These reflect current legislation (where appropriate Scottish legislation). Service strengths Examination of a sample of staff personnel files evidenced the service has robust recruitment procedures which reflect the standards of safer recruitment. The service has regular contact with the clients who use its services and sought to match their requests with the most appropriately trained and experienced staff. The service has a variety of policies and procedures in place to inform and guide staff practice. Details of these are included in the staff handbook which is given to each member of staff. The manager advised that the staff would also have to work to the policies and procedures of the care services they are placed with. There was a staff training plan and a schedule of appraisal in place. Areas for improvement The service should continue to review its processes in relation to this statement to ensure that services are receiving the most appropriately skilled and experienced staff to meet their requirements. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued ASA International, page 13 of 20

Quality Theme 3: Quality of Staffing 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 staffing in the service. Service strengths The evidence for the grade awarded in this statement is included in Quality Theme 1, Statement 1, Service Strengths above. Areas for improvement The areas for development for this statement are included in Quality Theme 1, Statement 1, Areas for Improvement above. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 ASA International, page 14 of 20

Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths The agency ensures all nurses have valid registration with their professional body, the Nurses and Midwifery Council (NMC). Registration status is checked prior to employment and annually thereafter. All Registered Nurses are required to adhere to the NMC Code of Conduct. An annual training programme was in place for nurses and care staff. Recent training had included induction, moving & handling, food hygiene, medication and dementia. Training is reviewed annually and there are systems in place to monitor and ensure nurses address the continuous professional development requirements of the NMC. Job descriptions were also in place that clearly outlined the role of nurses and care staff. Areas for improvement The service should continue to provide training based on best practice to ensure staff knowledge and skills meet the requirements of the clients. The manager is committed to ensuring monitoring of staff practice is ongoing. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued ASA International, page 15 of 20

Quality Theme 4: Quality of Management and Leadership 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 management and leadership of the service. Service strengths The evidence for the grade awarded in this statement is included in Quality Theme 1, Statement 1, Service Strengths above. Areas for improvement The areas for development for this statement are included in Quality Theme 1, Statement 1, Areas for Improvement above. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 ASA International, page 16 of 20

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 service has a quality assurance system, and we saw evidence of analysis of information, action plans and outcomes. There is a complaints procedure in place, and we saw evidence of the service addressing concerns raised. The service has an understanding about the issues it would be expected to notify to the Care Inspectorate and professional regulatory bodies such as NMC and SSSC. A system of staff appraisal is in place to monitor and assess practice and adherence to policies and procedures. A log of accidents and incidents is maintained. A telephone log is maintained. This helps ensure all communications are recorded and followed up. Areas for improvement The service should continue to review and strengthen the quality assurance systems, identifying improved outcomes are achieved. The service should further consider how it communicates outcomes and improvements to clients and other key stakeholders, and how it plans to involve them in the strategies development of the service. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued ASA International, page 17 of 20

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 the Care Inspectorate re-grading a Quality Statement within the Quality of Management and Leadership Theme (or for childminders, Quality of Staffing Theme) as unsatisfactory (1). This will result in the Quality Theme being re-graded as unsatisfactory (1). ASA International, page 18 of 20

5 Summary of grades Quality of Information - 5 - Very Good Statement 1 Statement 4 5 - Very Good 5 - Very Good Quality of Care and Support - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Staffing - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Management and Leadership - 5 - Very Good Statement 1 Statement 4 5 - Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 21 Dec 2010 Announced Information Not Assessed Care and support Not Assessed Staffing 5 - Very Good Management and Leadership Not Assessed 19 Mar 2009 Announced Information 4 - Good Care and support 4 - Good Staffing 4 - Good Management and Leadership 4 - Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. ASA International, page 19 of 20

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 ASA International, page 20 of 20