Threshold Support Services - Residential Care Home Service New Cross Centre Lamb Street Hamilton ML3 6AH Telephone: 01698 423335 Type of inspection: Announced (short notice) Inspection completed on: 23 December 2016 Service provided by: Church of Scotland Trading as Crossreach Service provider number: SP2004005785 Care service number: CS2003001401
About the service Threshold Support Services - Residential is a care home service for adults with learning disabilities. The service is provided in three houses in South Lanarkshire, one in Hamilton, one in Larkhall and one in South Lanarkshire. Two of the houses are purpose built bungalows and the other is a more traditional detached house. Each house can accommodate four people and twelve people were using the service at the time of our inspection. Each person has their own bedroom and share the living room, dining room, kitchen, utility room and accessible bathrooms. There is an enclosed accessible garden, parking area and office space for staff's use at each house. The service was previously known as the Cornerstone Project. It was registered with the Care Commission and has been registered with the Care Inspectorate since the Care Inspectorate was formed in 2011. The service is provided by the Church of Scotland trading as Crossreach. Their mission statement is, "In Christ's name we seek to retain and regain the highest quality of life which each individual is capable of experiencing at any given time". What people told us We received completed care standard questionnaires from nine people the service supports. They had been helped to complete the questionnaire by an advocacy worker. They all agreed, four of the nine strongly agreeing, they were happy with the quality of care and support they get from the service. Comments included: "Staff here know me really well and know how to react and support me in different situations." "My communication skills are very hard to understand if you don't know me. My staff team have spent a lot of time and have great patience to ensure they understand what I am telling them." "I have a steady and consistent team to support me." "More individual time would be a benefit." "Staff have supported me for a number of years and are aware of all my personal needs and my likes and dislikes. I have regular reviews and this keeps my support plan up to date." We met everyone the service supports during our visits. Most people were not able to tell us their views about the service. We saw that staff understood their communication well and were responsive to them. They were very relaxed and comfortable with staff and in their home. Their non verbal communication told us they were happy with the service. One relative returned a questionnaire. They said they were happy with the care and support their family member got. They said they had seen more bank and agency staff used due to staff shortages and would like more regular staff. We spoke to one relative by phone. They told us about concerns they had about relationships between the people living in the house and the effect this was having on their family member. This reflected comments included on questionnaires from people living in that house. These concerns were being addressed by the service with advocacy workers, social work and community learning disability team colleagues. The relative we spoke to felt the service was doing everything they could to get the situation resolved for everyone, but would like to see changes being made more quickly. page 2 of 7
Self assessment We received a fully completed self assessment document from the provider. They identified what they thought the service did well, some areas for improvement and any changes they had planned. They told us how people using the service and their families were involved in improving the quality of the service. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership 5 - Very Good not assessed not assessed 5 - Very Good What the service does well The staff knew the people living at Threshold residential services very well. The teams worked very well together with all staff very committed to making sure everyone enjoyed the best quality of life possible. People experienced genuinely warm and compassionate care. They and, where relevant, their family were very involved in making decisions about their life and support. They were: - Staying as well as they could, with the service encouraging healthy eating and exercise and supporting them to use health services. - Having things to do like going swimming, out for meals, shopping and going on holiday. - Seeing people, including their family and people in the local community. The service had started to use Talking Mats to help people communicate their choices. This was a very positive development with people being able to tell staff things they would like to do. Everyone benefited from an experienced manager who showed strong leadership. They had audit systems with all staff taking responsibility for checking different aspects of the service. People could feel confident the service was managed to ensure safe, positive and improving outcomes. Crossreach continued to be very good at involving people in improving services locally and nationally. People could feel their views were listened to and acted on. The management style and commitment of the manager had a very positive impact on morale and enthusiasm throughout the team. What the service could do better The service could continue to develop outcomes focused support and review by: - Supporting staff to understand outcomes. - Being clear what's expected. - Helping key workers to feel confident about completing the support plan, outcome plan and review paperwork. The work the service is doing with social work to address concerns about relationships in one of the houses should result in improved quality of life for all four people living there. page 3 of 7
Completing the PDQP (performance appraisal) process with all staff and making sure everyone has the opportunity for regular 1:1 support and supervision would support continued improvement in the service. They could use this as an opportunity for staff to identify areas of expertise or interest where they would like to "champion" best practice in the service. The manager needs to make sure she carries out the manager's checklist in each house regularly and makes sure improvement plans are carried out. Crossreach needs to develop a new quality assurance system as they are no longer using "Towards Quality". They should take account of the new care standards and Keys to Life priority outcomes when developing this. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 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 21 Jan 2015 Unannounced Care and support Management and leadership 24 Jan 2014 Unannounced Care and support Management and leadership 5 Jun 2013 Unannounced Care and support page 4 of 7
Date Type Gradings Management and leadership 31 Oct 2012 Announced (short notice) Care and support 3 - Adequate 3 - Adequate Management and leadership 24 Oct 2011 Announced (short notice) Care and support 3 - Adequate Management and leadership 30 Jan 2011 Unannounced Care and support Management and leadership 3 - Adequate 6 Oct 2010 Announced Care and support 2 - Weak Management and leadership 2 - Weak 9 Feb 2010 Unannounced Care and support Management and leadership 26 Aug 2009 Announced Care and support Management and leadership 20 Nov 2008 Unannounced Care and support Management and leadership 6 Jun 2008 Announced Care and support page 5 of 7
Date Type Gradings Management and leadership page 6 of 7
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 7 of 7