Quality Care Resources Ltd - Care at Home Support Service Madelvic House Granton Park Avenue Edinburgh EH5 1HS Telephone: 0131 552 2271 Type of inspection: Announced (short notice) Inspection completed on: 31 January 2017 Service provided by: Quality Care Resources Ltd Service provider number: SP2010010843 Care service number: CS2010251716
About the service we inspected Quality Care Resources Ltd - Care at Home provides a care at home service which supplies care workers to support and care for people living in their own home. The provider of this service is Quality Care Resources Ltd. This company operates mainly in the Edinburgh area. The office is located on the ground floor of Madelvic House, Granton Park Avenue, Edinburgh. How we inspected the service We compiled this report following a short notice announced visit over one day, 31 January 2017. The inspection was carried out by two Care Inspectorate inspectors. We gave feedback to the provider, service manager and care co-ordinators on the same day. During the inspection, we spoke to service users in their own homes to find out their views about the care and support provided. We also spoke with the provider, service manager and care co-ordinators. Documents sampled included: - Policies and procedures - Registration certificate - Information leaflet - Complaint policy and records - Accident and incident records - Personal plans - Recruitment information - Staff supervision records - Training records. Taking the views of people using the service into account This service currently has a small client list. We took the opportunity to visit two service users in their own homes. They commented positively about the service they received and about the care workers who supported them. Taking carers' views into account We did not have the opportunity to talk with carers during this inspection. page 2 of 11
What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 The service provider must ensure that medication is being managed safely, in line with best practice guidance and to comply with registration condition 4 on their registration certificate. In order to do this, the service provider must ensure the following: - The policy and procedure to guide staff regarding medication management must be reviewed to fully reflect how medication will be managed for the service type. - That staff receive training regarding the policy and procedure for safely managing medication for people who use the service. - That staff are assessed regarding their competency to safely support people with their medication. 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) and Regulation 15(a)(i). This requirement was made on 8 July 2016. Action taken on previous requirement The service provider had updated its policy and procedure to guide staff in the safe management of medication. We saw that there were records to show that support staff had received training regarding the safe management of medication. The service had a system to assess the competency of staff regarding safely supporting service users with their medication. This included assessment of staff knowledge and spot checks of staff practice when supporting service users in their homes. Met - outwith timescales Requirement 2 The service provider must ensure that each person using the service has a written agreement which clearly defines the service to be provided, the terms and conditions for receiving the service and arrangements for changing or ending the agreement in line with the principles of the National Care Standards. This is to comply with: The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210), Regulation 3. page 3 of 11
This requirement was made on 8 July 2016. Action taken on previous requirement We saw that there were written agreement in place which detailed the service to be provided, the terms and conditions for receiving the service and arrangements for changing or ending the agreement in line with the principles of the National Care Standards. Met - outwith timescales Requirement 3 The service provider must make proper provision for the health, welfare and safety needs of service users. This is with specific reference to the safe recruitment of staff working in the service. In order to do this, the service must undertake the following: - Adhere to the organisation's recruitment policies and procedures and best practice regarding the safe recruitment of staff from the Scottish Government Safer Recruitment through Better Recruitment. - Obtain appropriate references prior to recruitment decisions about employment in the service being made. - Apply for and receive verification of applicants' membership of the Protection of Vulnerable Adults scheme from Disclosure Scotland prior to recruitment decisions about employment in the service being made. - Ensure references sought are objective and verifiable. - Evidence interviews of applicants and how decisions to employ are made. - Develop job descriptions for all levels of staff in the service. 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). This requirement was made on 8 July 2016. Action taken on previous requirement We looked at the services' systems to ensure that staff were safely recruited following best practice guidance. We saw that the organisation had a recruitment policy and procedure in place that referenced best practice guidance regarding safe recruitment. We looked at the recruitment documentation for newly recruited members of staff and confirmed that the process had adhered to best practice regarding safe recruitment of care staff. This included the gathering of appropriate references and the verification of applicants' membership of the Protecting Vulnerable Groups (PVG) scheme from Disclosure Scotland prior to recruitment decisions about employment in the service. There was information about the outcome of applicants' interviews. page 4 of 11
We saw evidence that the new staff members had an induction to their role. The induction programme included information about the organisation and the service to ensure that new staff were made aware of the policies and procedures of the organisation. Job descriptions were in place informing new staff about their role and responsibilities. Met - outwith timescales Requirement 4 The service provider must ensure that all staff receive training appropriate to their role including up to date mandatory training. This is to comply with: The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210), Regulation 15(a) and 15 (b)(i). This requirement was made on 8 July 2016. Action taken on previous requirement We saw that there was a four day induction programme in place for newly recruited staff. This included core mandatory training which included moving and assisting, medication management, infection control and protecting vulnerable people. We saw that there was a system to record and track training undertaken by staff. We noted that all support staff had received up to date core training. The service had employed a training coordinator who had the responsibility to ensure that staff received training appropriate to their role. Met - outwith timescales Requirement 5 The service provider must make proper provision for the welfare and safety of service users by ensuring that a satisfactory quality of service is consistently provided. In order to do this, the service must undertake the following: - Develop and fully implement a quality assurance system which includes the use of internal audits to check key areas. - Ensure that any issues found through the audit process are highlighted and an action plan developed with timescales for any actions required taken. - Ensure that policies and procedures are updated to reflect Scottish legislation. - Ensure that policies and procedures are appropriate for the type of service being provided. - Monitor staff practice to assess that it is of a standard which ensures the safety and wellbeing of all who use the service. page 5 of 11
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). This requirement was made on 8 July 2016. Action taken on previous requirement The service provider had reviewed policies and procedures to ensure that they were appropriate for the type of service being provided and reflected Scottish legislation. We saw that the service had introduced some systems to assess and monitor aspects of service delivery. This included spot checks of care workers' practice and knowledge. However, there was a continued need for the service to develop and fully implement a quality assurance system which included the use of a range of internal audits to check key areas. This includes monitoring the content of service users' personal plans, carrying out regular evaluation and formal reviews of the care packages in place. Not met What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 The service provider should ensure that they evidence that personal plans have been developed and agreed in consultation with the person receiving the service or their representative. The plan should include the date the service commenced. National Care Standards for care at home: Standard 3 - Your personal plan. We looked at a sample of personal plans for people using the service. The content of the plans was basic and continues to need further development to reflect a person centred approach to managing service users' care and support needs. The service should evidence consultation with the person receiving the service or their representative in the development of personal plans. This recommendation had not been implemented and will continue. We will monitor progress at the next inspection. page 6 of 11
Recommendation 2 The service provider should implement a system to monitor that the service delivered for the contracted amount of time and that people who use the service are notified in advance of any necessary changes to the timing of their care at home service. The service was planning to introduce a system to monitor that the service is delivered for the contracted amount of time. This system was not in operation at the time of the inspection. This recommendation had not been implemented and will continue. We will monitor progress at the next inspection. Recommendation 3 The service provider should develop a smoking policy and procedure in line with NHS guidance. The service should ensure that people who use the service who smoke are aware of the smoking policy and procedures. The service had developed a smoking policy and procedure in line with NHS guidance. This recommendation had been implemented. Recommendation 4 The service provider should review the information supplied in the brochure and on the website to ensure it reflects accurately the level and type of service that can be provided in line with the National Care Standards for care at home. National Care Standards for care at home: Standard 1 - Informing and deciding. The service was in the process of reviewing the information supplied in the brochure and on the website. However, the existing information about the service remained in place. This recommendation had not been implemented and will continue. We will monitor progress at the next inspection. Recommendation 5 The service provider should ensure that they implement a system to record and track the validity of Residency permits. page 7 of 11
We saw that there was a system in place to record and track the validity of Residency permits. This recommendation had been implemented. Recommendation 6 The service provider should assess the skills and competencies of staff to assist with the deployment of staff who are proficient to meet the assessed care and support needs of people who use the service. Currently, the service has a small group of staff and service users and was able to deploy staff to service users using the knowledge of office based staff. The service was planning to introduce an electronic system which will fully record the skills and competencies of staff to allow for the allocation of the appropriate staff to meet the individual service users' care and support needs. This electronic system was not in place at the time of the inspection. This recommendation had not been fully implemented and will continue. We will monitor progress at the next inspection. Recommendation 7 The service provider should implement the induction programme for staff to ensure that they are prepared for the role they have been recruited for. We saw that there was an appropriate induction programme in place for newly recruited staff. There was evidence that new staff had recently undertaken the full programme of induction. The service had also ensured that existing staff undertook the induction programme to ensure that they had an awareness of the changes to the provider's updated policies and procedures. This recommendation had been implemented. Recommendation 8 The service provider should develop a schedule of supervision and ensure that staff have regular access to supervision sessions. page 8 of 11
The service had started to carry out staff supervision. It is important that staff have access to regular supervision sessions to support them, offer opportunity to discuss concerns, look at their practice and discuss their training and development needs. It also gives management the opportunity to evaluate that any training has had a good impact in improving staff practice. As part of the quality assurance process, staff should have regular access to supervision sessions. There was a continued need to develop and implement a schedule of supervision. This recommendation had not been fully implemented and will continue. We will monitor progress at the next inspection. Recommendation 9 The service provider should ensure that the self assessment document for the service is submitted within the timescales requested. This would allow the content of the self assessment to be utilised to inform the inspection plan and identify areas of focus for the inspection visit. The service was in the process of updating its self assessment. This recommendation had been implemented. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com Enforcement No enforcement action has been taken against this care service since the last inspection. page 9 of 11
Inspection and grading history Date Type Gradings 7 Jun 2016 Announced (short notice) Care and support 2 - Weak Environment Not assessed Staffing 2 - Weak Management and leadership 2 - Weak 16 Jun 2011 Unannounced Care and support 3 - Adequate Environment Not assessed Staffing 3 - Adequate Management and leadership 3 - Adequate page 10 of 11
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 11 of 11