Hamilton Supported Living Service - Housing Support Service Housing Support Service Flat 3 5 Raeburn Crescent Hamilton ML3 9QD Telephone: 01698 823900 Type of inspection: Unannounced Inspection completed on: 29 August 2017 Service provided by: Lanarkshire Association For Mental Health Service provider number: SP2004005810 Care service number: CS2004068390
About the service Lanarkshire Association for Mental Health (LAMH) is a registered charity. It provides a range of services to support people who are experiencing mental health difficulties, as well as their carers. Hamilton Supported Living Service is one of five services provided by LAMH. At the time of this inspection, it provided support to fifteen people in their own homes across the areas of Hamilton and Lanarkshire. The mission statement for the service is - "We are committed to working in partnership to deliver quality mental health services and resources that promote independence and inclusion and challenge stigma". What people told us During our inspection we visited and spoke to a number of service users who stated that they were very happy with the service they received, and in particular with the staff who supported them. Comments made, by people who use the service, about the service and their staff included: - "Excellent, nothing wrong with them" - "Very good" - "Brilliant service, get on well with every single worker couldn't fault any of them" - "Very good service, very comprehensive" - "Gives me peace of mind and sense of security" - "Helps me keep a routine" - "Would say it is excellent". Service users spoke of the enabling effect of support upon their lives, how routines that were important to them were supported and independence promoted. They spoke highly of the outings the service arranges for them, twice a year. Self assessment The service was not asked to submit a self-assessment. From this inspection we graded this service as: Quality of care and support Quality of staffing Quality of management and leadership 5 - Very Good 4 - Good 4 - Good Quality of care and support page 2 of 9
Findings from the inspection Each service user had a personalised support plan that clearly set out assessed care needs and how these would be met by the service. Support plans included outcomes that had been agreed with those that were using the service. The Manager had introduced an assessment process for new service users, this is used together with the Social Work Co-assessment and information from the service user at the initial meeting, to establish the level of support required and to develop the personalised support plan. Services had been reviewed regularly, well within the set timescales, as well as when circumstances had changed. Inspectors saw clear evidence that those using the service were fully involved in the review process and were actively reflecting upon the service they were receiving and if the agreed outcomes had been met. Where changes were agreed as part of the review process, the support plan was updated to reflect this. Inspectors saw that staff delivering the service were also actively involved in the review process. The Manager was seen to be regularly liaising with the social Work Department, to ensure that where changes to service provision were required, they were agreed quickly, to the benefit of those that use the service. Inspectors met with some of those that use the service. They informed inspectors that they liked their staff, they felt safe and secure with the service, they had regular reviews and the Manager was always available if required. It was apparent to Inspectors that the Manager knew all of those that use the service and their individual needs. Inspectors found that support plans were available in the office. Staff that were delivering the service, attended the office after each visit and recorded their notes. The service has agreed to make support plans and notes available in the homes of those that use the service. Requirements Number of requirements: 0 Recommendations Number of recommendations: 1 1. The service should make care plans and service delivery notes available in the homes of those that use the service. This is order to comply with: National Care Standards Care at Home - Standard 3(2). National Care Standards Support Services - Standard 4(8). Grade: 5 - very good Quality of staffing page 3 of 9
Findings from the inspection Inspectors sampled the minutes of staff meetings that had taken place in October and November 2016 and January and April 2017. A meeting was programmed for 28/8/17. There was an agenda for this meeting on the staff notice board. These meetings were used for professional discussions and reflections on current service provision. Inspectors sampled staff files and found that each individual staff member had a matrix of all training attended. The service is now working on an overview that includes all staff. The service could better assess the success of its training, and the impact on improved outcomes for those that use the service, by including reflective accounts on how training has been put into practice, as part of the Supervision process. We will look at this again at the next inspection. The service have agreed to provide training to in application of eye drops and topical creams. Supervision and appraisal records were sampled. The Manager had changed the supervision format to include staff welfare. Inspectors found that the supervision form was not easy to use and needed to be updated. Appraisal forms were not always fully completed. Inspectors found that all staff had a regular opportunity to meet with the Manager. Inspectors met with a group of eight staff. Staff advised Inspectors that they were ready for their professional registration with the Scottish Social Services Council. One member of staff had enrolled on an SVQ course and the remainder of the workforce were already qualified. A variety of service delivery subjects were discussed. Staff said that people who use the service would benefit, if staff received first-aid training. The Manager has now agreed to provide this, we will look at the impact this has on outcomes for those that use the service, at the next inspection. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good Quality of management and leadership Findings from the inspection Inspectors found that the Manager had a very good understanding of the needs of those that used the service and the skills and knowledge of the staff delivering the service. Inspectors found that actions recorded in action plans did not have specific time scales for achievement, dates for completion of actions were recorded as on going or asap. Action plans could be made more effective by including target dates for achievement and reporting progress at the next meeting. page 4 of 9
Incident and Accident reports were contained within the relevant persons file, as well as in an overview of events. The service is looking at ways to evaluate this information to the benefit of those that use the service. The service had not received any complaints since last inspection. The Manager has designed a survey, to assess Quality of Management and Leadership and also the Quality of Information. It is easy to understand and has multiple choice answers. We will look at the results of this, including any actions that have been taken as a result of the feedback, at the next inspection. Inspectors saw evidence that notifications that were submitted by the Manager, to the Care Inspectorate, were effectively followed-up by the service, with reviews and support plan updates, where these were required. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 1. The service must ensure that for those service users whose monies and medication is managed by them and no legal authority is in place to do so, the written authority of the service user must be obtained. This will include the regular allocation of funds and the provision of medication which is kept under lock and key. This should be carried out with immediate effect. NCS 8 Care at Home - Keeping Well - Medication. NCS 3 Housing Support Services - Management and Arrangements 8 You know that whenever staff are involved in any financial transaction, it will be carefully recorded. This will be done in a way that can be checked by the Care Commission. This requirement was made on 1 September 2016. Action taken on previous requirement The service has a `written authority form` signed by the person using the service and the service manager. These were seen to be in use, in the files sampled, as part of this inspection. Met - within timescales page 5 of 9
Requirement 2 2. At the point of referral and retrospectively where applicable, the service must carry out their own needs assessment of a service user based upon but not exclusive to the available Social Work assessment. This will form the basis of service provision and should be amended as required. This should be completed within three months of the finalisation of this report. SSI 2011/210 5 Personal plans. This requirement was made on 1 September 2016. Action taken on previous requirement The service has a needs assessment form in use. This is used in conjunction with the Social Work assessment and the information is used to develop the support plan. These forms were seen to be in use in the files sampled as part of this inspection. Met - within timescales Requirement 3 3. The service must ensure that all staff receive an appraisal of their performance at least annually. This process should commence with immediate effect. NCS 3 Housing Support Services - Management and Arrangements. This requirement was made on 1 September 2016. Action taken on previous requirement An overview of appraisals was viewed at inspection. Met - within timescales What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 The service should standardise the structure of Support Plans and thereafter monitor them for accuracy and currency. This recommendation was made on 1 September 2016. Action taken on previous recommendation The structure of support plans are standardised, those sampled as part of this inspection were to a good standard and regularly updated. page 6 of 9
Recommendation 2 The service should identify activities of interest to service users and thereafter produce an Activity Plan to follow for reference purposes. This recommendation was made on 1 September 2016. Action taken on previous recommendation Activities have been identified and included within the support plan. Recommendation 3 The service should produce an identifiable Training Matrix for each staff member to demonstrate staff competence. This should include a progression through induction, shadowing and subsequent role related learning. This recommendation was made on 1 September 2016. Action taken on previous recommendation Each staff member has a training matrix within their staff file. Recommendation 4 The service should ensure that the staff supervision process is focussed upon the welfare and performance of the staff member. This can include their support of service users but should not be exclusively so. This recommendation was made on 1 September 2016. Action taken on previous recommendation Supervisions were found to be a mix between staff welfare and support of those that use the service. 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 7 of 9
Inspection and grading history Date Type Gradings 1 Sep 2016 Unannounced Care and support 4 - Good 4 - Good Management and leadership 4 - Good 27 Aug 2015 Unannounced Care and support 2 - Weak 3 - Adequate Management and leadership 2 - Weak 13 Aug 2014 Unannounced Care and support 5 - Very good 5 - Very good Management and leadership 5 - Very good 26 Jul 2013 Unannounced Care and support 4 - Good 5 - Very good Management and leadership 5 - Very good 17 Dec 2012 Announced (short notice) Care and support 5 - Very good 5 - Very good Management and leadership 5 - Very good 25 Jan 2011 Announced Care and support 4 - Good Management and leadership 12 May 2009 Announced (short notice) Care and support 4 - Good 5 - Very good Management and leadership 4 - Good page 8 of 9
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 9 of 9