The Richmond Fellowship Scotland - Shared Lives Service Adult Placement Service Unit 2 Pickering House Netherton Road Wishaw ML2 0EQ

The Richmond Fellowship Scotland - Shared Lives Service Adult Placement Service Unit 2 Pickering House Netherton Road Wishaw ML2 0EQ Inspected by: Arlene Woods Type of inspection: Unannounced Inspection completed on: 15 March 2012

Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 10 4 Other information 18 5 Summary of grades 19 6 Inspection and grading history 19 Service provided by: The Richmond Fellowship Scotland Limited Service provider number: SP2004006282 Care service number: CS2009234408 Contact details for the inspector who inspected this service: Arlene Woods Telephone 01698 208150 Email enquiries@careinspectorate.com The Richmond Fellowship Scotland - Shared Lives Service, 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 Care and Support 4 Good Quality of Staffing 4 Good Quality of Management and Leadership 4 Good What the service does well The service has individual support plans which are developed with the service users and take account of any legal restraints to choices made by them. These are written in plain English and each service user has a copy to help them understand the support agreed and how this will be delivered. As service users and carers visit each others homes and interact with each others families the sharing of the support plan is important to help everyone understand the limits to that interaction. What the service could do better The Richmond Fellowship has many ways of obtaining their service users opinions of their service. These were available to the service but had not been used at the time of the inspection due to the service starting supporting people in September 2011. We noted that these were planned to be used soon after the inspection. The service should ensure it uses these tools throughout the year as planned. What the service has done since the last inspection This is the first inspection of the service since it was registered Conclusion This new service was well set up with support plans and monitoring systems in place. As it admits more service users it should use these systems to ensure consistency in the quality of the support plans. The Richmond Fellowship Scotland - Shared Lives Service, page 3 of 20

Who did this inspection Arlene Woods The Richmond Fellowship Scotland - Shared Lives Service, page 4 of 20

1 About the service we inspected Lanarkshire Shared Lives Service supports people over 16 years of age who live in Lanarkshire and have various support needs. The service helps them to live independently in the community. They also offer support for short periods to help people to move from care into their own homes. This support can be day time support, evening support, overnight support and short breaks. The service is based in offices in Wishaw North Lanarkshire. At the time of the inspection only three people were being supported by this service. This service had started to support people in September 2011. The Shared Lives Carers provide care and support from their own home. They open up their home, family life and social connections to one service user. The service matches the service user with a Shared Lives Carer who shares the service user's interests. The service aims to "help you set and achieve your goals to help improve your life including; Having a break from day to day routines Experiencing new things Making new friends Developing your hobbies and interests Getting time to rest and recharge your batteries Improve your health and wellbeing Being more independent" The service was formerly registered with the Scottish Commission for the Regulation of Care (the 'Care Commission'). The Care Commission merged on 1 April 2011 with the Social Work Inspection Agency and the section of HMIE responsible for inspecting services to protect children, to form the new scrutiny body SCSWIS' Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 4 - Good Quality of Staffing - Grade 4 - Good Quality of Management and Leadership - Grade 4 - Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. The Richmond Fellowship Scotland - Shared Lives Service, page 5 of 20

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. The Richmond Fellowship Scotland - Shared Lives Service, page 6 of 20

2 How we inspected this service The level of inspection we carried out In this service we carried out a medium intensity inspection. We carry out these inspections where we have assessed the service may need a more intense inspection. What we did during the inspection In this service we carried out a medium intensity inspection. We wrote this report after an unannounced inspection by Arlene Woods that took place between 10am and 4pm 15 March 2012. As requested by us, the care service sent us an annual return. The serviced also sent us a self assessment form. We issued 3 Questionnaires to friends, relatives or carers of people who used the service. One Questionnaire was returned before the inspection. This questionnaire agreed strongly that people were treated with dignity and that care and support needs were met. In this inspection we gathered evidence from various sources, including: * Evidence from the service's most recent self assessment * Personal plans of people who use the service * Training records * Health and safety records * Accident and incident records * Complaints records * Questionnaires that had been requested, filled in and returned to the care service from people who use the service, their relatives or advocates, and staff members * Discussions with various people, including: * the manager * care staff * the people who use the service * observing how staff work 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 The Richmond Fellowship Scotland - Shared Lives Service, page 7 of 20

themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) 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 The Richmond Fellowship Scotland - Shared Lives Service, page 8 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: No 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 fully completed self assessment document from provider. We were satisfied with the way 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 "... is good, I like going out with her" "... takes me to places I want to go to, I'm not lonely during the day" "I like... family" "I'm sometimes on my own and I like that, but when I'm not feeling too good she comes over and can stay the night" Taking carers' views into account There were no carers available at this inspection and no questionnaires had been returned by any carers. The Richmond Fellowship Scotland - Shared Lives Service, page 9 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 1: Quality of Care and Support Grade awarded for this theme: 4 - 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 The service had The Richmond Fellowship written participation strategy to inform service users and their carers of the different ways they could give their opinions on the quality of the service received. This included questionnaires, service reviews, consultation meetings and the complaints procedure. Each service user was involved in developing and regularly reviewing their outcomes based Service User Plans. People had signed their plans to show that they agreed with them. There was a system in place to ensure all service reviews were held a minimum of 6 monthly in line with current legislation. This would give people a regular familiar opportunity to raise any issues about the service they receive and whether they want it to continue. "How well are We Doing" questionnaires were available to be distributed annually to people they supported. These asked questions about the quality of a range of topics including care and support, staff and the management of the service which are the themes the Care Inspectorate inspect against. These were in large font and had numbers to rate the answers. This made them easy to understand and should encourage people to complete them. There was a system in place for analysis and feedback to service users. There were three monthly consultation meetings planned for throughout the year. These were to be used to obtain views on how the service should be rated. This would then feed into the Care Inspectorates self assessment document to give service users the opportunity to participate in the inspection process. The first meeting for this service was planned for just after our inspection. The advanced planning of this activity demonstrated the services commitment to using the systems put in place by the Richmond fellowship to obtain the opinions of their service users. The Richmond Fellowship Scotland - Shared Lives Service, page 10 of 20

The Complaints Leaflet was sent to service users and their Carers twice a year. Staff were reminded of this each time they were distributed to highlight the need to help people to understand it and complete it if they wished. There was a system in place to analyse complaints information monthly at service level. This practice was regularly monitored by the Area Manager. This ensured that the procedure was being followed and any patterns were quickly identified. The one complaint that had been made had been addressed in line with the Richmond Fellowships procedure. This demonstrated the services commitment to being responsive to service users' issues to improve the service received. Information on Advocacy was available in the introduction pack. This told people how to obtain help to state their preferences and choices on how they lived their lives. Shared life carers and those they supported told us they could approach the manager at any time to raise issues. Areas for improvement The Richmond Fellowship had many systems in place to obtain the opinions of its service users. This service had those available and written plans of when they would be used. Due to the service having only three service users and starting supporting people in September 2012 we recognised that there had been a lack of opportunity to use these systems. The service should use the systems in place to obtain the opinions of it service users' throughout the year as planned. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 2 We enable service users to make individual choices and ensure that every service user can be supported to achieve their potential. Service strengths The support plans were outcome focused. Each one was individually designed and person centred using plain language and recorded the person's needs, wishes and choices. The plans focused on people's strengths and abilities and what was important to them. This could make the document more accessible to the people they supported and encourage their engagement in its evaluation and goal setting. The support plans recorded information on how someone would be involved in making decisions. This included whether they were subject to a Compulsory Treatment Order or had a Welfare Guardian. These would limit the choices they could legally make. The plans included the best way to communicate with people and The Richmond Fellowship Scotland - Shared Lives Service, page 11 of 20

whether there were any communication methods or tools needed to be used for example giving time to respond or speaking clearly in the preferred ear. There was also a household rules sheet that recorded who was in control of what happened in their homes when shared life carers were there. This reminded shared life carers and service users of their position within the house and helped people to feel secure in their role. All activities had been risk assessed and signed by the service user. This would support the service users to take some risk in their activities in a planned and considered way. Areas for improvement This service had just begun to support people. Its support plans were new and there were few of them. As the service grows they should monitor these plans regularly to ensure this good practice it maintained. This could help to deliver good outcomes for people consistently. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Service user plans held clear information on Welfare Guardianship and Community Treatment Orders (CTO). This kept staff aware of their legal responsibilities to inform hospitals or the police of who could give permission for treatment and with the CTO what that treatment must be. This meant that there would be a smooth transition of care between services making this process less stressful and more effective for the service user. Personal Support and Development Plans held details of people's health care needs. There were records of healthcare professionals involved in their care and contact details for example GP, Dentist or Optician. Records were maintained of appointments attended and the outcomes. This information was used to update the support plans and further appointments planned. This meant that people would receive the correct healthcare support if the support staff changed. Support plans held information on how to support people with a healthy diet and exercise. This would encourage a healthy lifestyle for people but this was guidance and was not always adhered to by service users. This information gave the service users the opportunity for informed choice on their health. The Richmond Fellowship Scotland - Shared Lives Service, page 12 of 20

All staff had read and signed the medication policy/procedure which was recently updated. This should ensure that all medication is administered according to best practice guidelines and the service user is kept safe and well. Areas for improvement The service should continue with the current good practice being demonstrated until it becomes established practice. The service should monitor its support plans to ensure consistency in the quality of the information and evaluations of progress towards set goals. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 The Richmond Fellowship Scotland - Shared Lives Service, page 13 of 20

Quality Theme 3: Quality of Staffing Grade awarded for this theme: 4 - 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 opportunities for commenting on the staff group were as reported under Quality statement 1:1 All areas of the participation strategy involved asking the opinions of people about the quality of the staff. The service users were being asked about their relationship with their shared lives support worker at each care plan meeting. This gave them the confidence that the service was receptive to comments about the staff who were supporting them. The service had a policy of asking service users about staff performance before staff received their monitoring meetings. (this is a one to one meeting with their manager to identify staff progress and support and training needs). Areas for improvement These are listed under Quality statement 1:1 Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 2 We are confident that our staff have been recruited, and inducted, in a safe and robust manner to protect service users and staff. Service strengths The service vetted applicants for registration with them as shared lives workers. This process included Protection of Vulnerable Groups (PVG) registration, two references, and a pre assessment meeting. The assessment period has no set timescale and includes meetings with managers to discuss and ensure understanding of the ethos of the service and the limits to their involvement with the service users. This was important as the support was offered on a flexible basis and involved access to their homes and their families and friends. We saw records that this process had been followed for each shared life worker. The shared life workers we spoke to confirmed that they had been recruited in line with the procedure. They explained their experience of the assessment process and their The Richmond Fellowship Scotland - Shared Lives Service, page 14 of 20

understanding of the limits to the support they could offer. Shared life workers met with the manager regularly to review the support plan with the service user. At that time they could raise any issues or seek clarification on their performance. Areas for improvement The service should continue with the current good practice being demonstrated until it becomes established practice. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued The Richmond Fellowship Scotland - Shared Lives Service, page 15 of 20

Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 4 - 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 opportunities for commenting on the staff group were as reported under Quality statement 1:1 All areas of the participation strategy involved asking the opinions of people about the quality the management of the service. Areas for improvement These are listed under Quality statement 1:1 Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 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 systems in place to monitor how regularly team meetings and staff supervisions were being held. This also monitored attendance at training events. This ensured that people were supported by staff who had up to date knowledge and were confident in their role. There were systems in place to spot check staff performance and ensure this took place regularly. This allowed the service to identify and deal with any issues on staff performance quickly which should improve the experience of those who used the service. There were systems in place to monitor accidents, incidents and complaints. This helped the manager identify any common traits and address these issues quickly to maintain the safety and satisfaction of the people they supported. The were systems in place to monitor the monthly evaluations of the support plans to ensure they were up to date and complied with the services support plan writing The Richmond Fellowship Scotland - Shared Lives Service, page 16 of 20

guidance. There was a system in place to ensure all service users were offered a review of their service at least every six months. This helped service users to receive consistent appropriate support as their needs and wants changed. There was an internal system of monitoring the quality of the service which used Key Performance Indicators to assess the quality of service. The provider used an external quality assurance assessor, Investors in People, to independently monitor its performance. This service was to be involved in this award scheme this year. This audit included interviewing staff as well as managers. This will help the service identify areas where it can develop its practice to improve the experience of the people who use the service. There was evidence that service users and their carers were regularly involved in all areas of the quality assurance systems. This was good practice as it helped to give them a view of the service they would not otherwise obtain. This could help ensure any developments to the service were felt positively by those using it. Areas for improvement The service should make good use of these systems to identify issues and address them before they have a negative effect on the support received. The service should continue with its very good practice of monitoring its performance in all areas including staff support and service users support planning. This should ensure good outcomes for the people they support. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 The Richmond Fellowship Scotland - Shared Lives Service, 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 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). The Richmond Fellowship Scotland - Shared Lives Service, page 18 of 20

5 Summary of grades Quality of Care and Support - 4 - Good Statement 1 Statement 2 Statement 3 4 - Good 5 - Very Good 5 - Very Good Quality of Staffing - 4 - Good Statement 1 Statement 2 4 - Good 5 - Very Good Quality of Management and Leadership - 4 - Good Statement 1 Statement 4 4 - Good 5 - Very Good 6 Inspection and grading history All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. The Richmond Fellowship Scotland - Shared Lives Service, 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 The Richmond Fellowship Scotland - Shared Lives Service, page 20 of 20