Turning Point Scotland - The Mile End Project Housing Support Service Studio 908 Mile End Mill Abbey Mill Business Centre Paisley PA1 1TJ Inspected by: Daphne Ndlovu Type of inspection: Announced (Short Notice) Inspection completed on: 18 June 2012
Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 9 4 Other information 16 5 Summary of grades 17 6 Inspection and grading history 17 Service provided by: Turning Point Scotland Service provider number: SP2003002813 Care service number: CS2007151974 Contact details for the inspector who inspected this service: Daphne Ndlovu Telephone 0141 843 6840 Email enquiries@careinspectorate.com Turning Point Scotland - The Mile End Project, page 2 of 18
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 6 Excellent Quality of Staffing 6 Excellent Quality of Management and Leadership 6 Excellent What the service does well The service uses a range of methods to hear the views of those who use it. These views help the service to improve it's quality. Many positive comments were received from those who use the service and their relatives in relation to the standards of care provided and the positive relationships and interactions with staff. What the service could do better The service should remember and include the names of all who have contributed to documents such as care plans. What the service has done since the last inspection The ways by which the service involves service users in improving the quality of management and leadership has increased since the last inspection. Conclusion The manager and staff of the service continue to work well to deliver an individualised person centred service. The people who use the service tell us that it is a good service and that they are happy and satisfied with the quality of service delivered. Turning Point Scotland - The Mile End Project, page 3 of 18
Who did this inspection Daphne Ndlovu Turning Point Scotland - The Mile End Project, page 4 of 18
1 About the service we inspected Turning Point Scotland is a nation wide organisation which provides health and social care to adults with wide ranging needs across Scotland. services are provided in a variety of community settings and geographical areas. The Mile End Project is managed by Turning Point Scotland and was deemed registered with the Care Inspectorate since April 2011. The Mile End Project provides an integrated Housing Support and Care at Home service for adults with learning disabilities. The office accommodation is based close to Paisley town centre. Individuals which include a mixture of shared tenancies and singleton services. These services are spread throughout Renfrewshire. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 6 - Excellent Quality of Staffing - Grade 6 - Excellent Quality of Management and Leadership - Grade 6 - Excellent 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. Turning Point Scotland - The Mile End Project, page 5 of 18
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 compiled the report following a short notice announced inspection. The inspection was carried out by Daphne Ndlovu, an inspector from the Care Inspectorate. The inspection took place over 3 days, Wednesday 13 June 2012 from 10am until 4pm, Friday 15 June 2012 from 10.30am until 12noon. Feedback was given to the service manager at the end of the inspection on Monday 18 June at 9.30 am. The service submitted an annual return. The service also submitted a detailed fully completed self assessment. In this inspection we gathered evidence from various sources including the relevant sections of policies, procedures and other documents, including: support plans service's self assessment service's annual return completed care standard questionnaires minutes of meetings annual report participation information quality audit records staff training records 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 Turning Point Scotland - The Mile End Project, page 6 of 18
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 Turning Point Scotland - The Mile End Project, page 7 of 18
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. 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. Taking the views of people using the care service into account The following are some of the comments that the people who use the service made: 'I am happy with the support I receive.' 'Staff help me with different things like cooking.' 'I like the staff that I have.' 'I know my keyworker.' 'I like it here.' 'They listen to me.' Taking carers' views into account Although we did not meet any carers on the day of the inspection, we got their comments from the completed questionnaires that were returned to us. These included: 'I keep in touch with my sister's keyworker by phone on a regular basis.' 'My sister is always happy and content and shows loving gestures by hugging.' 'I am very happy with the care and support that my son receives.' Turning Point Scotland - The Mile End Project, page 8 of 18
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: 6 - Excellent 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 When we spoke with some of the people who use the service they told us that they were listened to and that they were happy with the support that they received. We could also see this in the keyworker meetings that were held regularly to talk about the individual's support needs and to review these if this was required. Within minutes of review meetings, it was clear that the people who use the service and/or their representatives were fully involved. People were involved in the recruitment of staff. There was also evidence to indicate that if someone was not completely happy with a staff member that supported them, they could request that they got someone else. Service users had a big input in a recent conference that the organisation held. Three people who use the Mile End project had been part of the planning group for the conference. The three had previously indicated that they wanted to be involved in making decisions. Service users were responsible for deciding what shape the conference would take. At the end of the conference all service users were asked to give feedback on it. It is hoped that this will improve future conferences. One of the comments a service user made about the conference was: ' It was great to get some answers from people with the power.' Comments that service users raised in one of the workshops at the conference, have been put together into a booklet which is sent out to anyone applying for a post within the organisation. These comments let the applicants know what is expected of them before they decide whether they wish to continue with their application. We saw an annual report that service users, staff and management in the service, had put together. The annual report told of how the service had performed in the last year. It also outlined plans that the services had for the future. The annual report and Turning Point Scotland - The Mile End Project, page 9 of 18
all who had contributed to it, had received praise from the organisations Chief Executive for it's contents and for the way it was laid out. The people who use the service were now involved in writing up policies within the service and the organisation. The need for this had been identified through the National involvement network in which the Mile End project has a representative. The service had realised that it was not meeting one of the points of the charter for involvement' which was to do with service users being involved in policy writing. Areas for improvement The service is currently maintaining an excellent standard in this area and should continue to do so. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Inspection report continued Turning Point Scotland - The Mile End Project, page 10 of 18
Statement 3 We ensure that service user's health and wellbeing needs are met. Service strengths Within the support plans we could see that health care assessments had been carried out on individuals when they started using the service. There were also detailed support strategies that staff followed to support individuals. These were reviewed on a regular basis. People were supported to attend annual health checks. We could see from the information in the support plans and staff communication diaries that people were supported to attend different appointments in the community. Contact details of other health professionals involved in the individual's continuing care were available within the personal files. We could also see evidence that people were supported to access other health professionals whenever they needed to. Staff took guidance and followed instructions given by dietitians, speech and language therapy or physiotherapy, to support people who had different health issues. The medication profiles that we saw had good detail in them. They identified any allergies an individual had. They also outlined what support needs an individual had with managing and taking medication. All staff had received medication training. In order to demonstrate what they had learnt from their training, staff had completed a medication skills and competency workbook. Those people who use the service who fell under an identified age group, had been supported to be part of the bowel screening programme. While respecting individual's choice, staff promoted healthy eating when supporting people with food purchases or menu choices. Areas for improvement Although the people that we spoke with told us that they contributed to their support plans, the support plans did not mention service users or their relatives as having contributed to them. We have asked that the service includes this information. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Inspection report continued Turning Point Scotland - The Mile End Project, page 11 of 18
Quality Theme 3: Quality of Staffing Grade awarded for this theme: 6 - Excellent Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths The service strengths outlined under statement 1.1 also apply to this statement. Areas for improvement The service is currently maintaining an excellent standard in this area and should continue to do so. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Turning Point Scotland - The Mile End Project, page 12 of 18
Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths The staff that we spoke with, were motivated and spoke highly of a supportive management. The service had a stable staff team. The people who use the service liked this as they felt they knew the staff that worked with them well. When we asked staff about the National Care standards, they were well aware of them and how these impacted on the work that they did. Staff also knew about the codes of conduct, and legislation surrounding social care. Staff we spoke with told us that they received regular supervision. We could also see this from the supervision records that the service kept. Staff also received annual appraisals. We saw a training plan that showed us what training staff would be undertaking and when this would take place. Staff training records were also in place. All mandatory refresher training appeared to up to date. We saw minutes of team meetings. These took place on a regular basis. The organisation had policies and procedures for protecting people. All staff had been issued with adult support and protection (ASP) packs to read through. The manager then followed this up by checking staff understanding of the content of the pack. A staff survey had been carried out in May 2012. This was mainly to find out what help support staff required from administration support staff. Although we did not speak with any recently recruited staff, we looked at the induction pack and were satisfied that staff received a good induction when they first started in the service. Areas for improvement The service was currently maintaining an excellent standard in this area and should continue to do so. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Inspection report continued Turning Point Scotland - The Mile End Project, page 13 of 18
Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 6 - Excellent 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 service strengths outlined under statement 1.1 also apply to this statement. Areas for improvement The service is currently maintaining an excellent standard in this area and should continue to do so. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Turning Point Scotland - The Mile End Project, page 14 of 18
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 had a good notification history, whereby they notified all relevant bodies including the care inspectorate, of any incidents that required to be notified. The service kept a log of complaints and concerns that came in. We could see that these were responded to and addressed appropriately and within the timescales that the provider had specified. The service was scrutinised by other agencies including the council's review teams. The organisation had also been awarded the Investors in People award. The senior operations manager had also carried out service practice audits. There was evidence to demonstrate that service users and staff also played a part in assuring the quality of the service. This was evident in the annual report that the service had put together. We also saw a project plan which showed what the service plans were for this year. Students who had been on placements within the service commented very positively about it. They described the service as a good learning environment. The service had it's own quality assurance systems which included; Inspection report continued health and safety audits house audits weekly checks of medication doset boxes service practice audits. checks of individuals accounts audits of team meetings to ensure accuracy and standard of content. The organisation published a newsletter which shared news of different things that were happening within it. Areas for improvement The service was currently maintaining an excellent standard in this area and should continue to do so. Grade awarded for this statement: 6 - Excellent Number of requirements: 0 Number of recommendations: 0 Turning Point Scotland - The Mile End Project, page 15 of 18
4 Other information Complaints There was one complaint raised against the service since the last inspection. 3 recommendations arose from the complaint. 1. The provider should make sure that all service users are involved in planning their service. 2. Appropriate records should be clearly available to evidence that all aspects of the service are individualised according to individual's needs and wishes. 3. The provider should make sure that staff awareness of person centred choice and support, is enhanced. The service had taken steps to address these and we were satisfied that these have now been met. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information None. 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). Turning Point Scotland - The Mile End Project, page 16 of 18
5 Summary of grades Quality of Care and Support - 6 - Excellent Statement 1 Statement 3 6 - Excellent 6 - Excellent Quality of Staffing - 6 - Excellent Statement 1 Statement 3 6 - Excellent 6 - Excellent Quality of Management and Leadership - 6 - Excellent Statement 1 Statement 4 6 - Excellent 6 - Excellent 6 Inspection and grading history Date Type Gradings 24 Jun 2010 Announced Care and support 6 - Excellent Staffing Not Assessed Management and Leadership 6 - Excellent 1 Jun 2009 Announced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership 4 - Good 1 Jun 2009 Announced Care and support 5 - Very Good Staffing 5 - Very Good Management and Leadership 4 - Good 7 Aug 2008 Announced Care and support 5 - Very Good Staffing 4 - Good Management and Leadership 5 - Very Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Turning Point Scotland - The Mile End Project, page 17 of 18
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 Turning Point Scotland - The Mile End Project, page 18 of 18