The Courtyard Care Home Service Hansel Alliance, Hansel Village Broad Meadows Symington Kilmarnock KA1 5PU Telephone: 01563 830340 Type of inspection: Unannounced Inspection completed on: 3 November 2017 Service provided by: Hansel Alliance Service provider number: SP2003000261 Care service number: CS2003001304
About the service The Courtyard was registered in April 2011 to provide a residential based care service to adults with a learning disability. The service is provided by Hansel in accommodation built on the grounds of the Hansel Estate in Ayrshire. It consists of four houses with accommodation for up to 15 people as follows: - five service users at No 3 The Courtyard - two service users at No 4 The Courtyard - four service users at No 5 The Courtyard - four service users at No 8 The Courtyard. No 8 The Courtyard, also known as 'Meadowview' is a detached house which has been specially designed and purpose-built to accommodate four people with profound physical and learning disabilities. The other houses are bungalows adjoining each other but with their own bedrooms, kitchens, living rooms and dining areas. At the time of the inspection 14 people were being supported at The Courtyard across the four houses. The stated aims and objectives of the service are "to comply with the National Care Standards through promoting dignity, privacy, choice, safety, realising potential and equality and diversity". What people told us Prior to the commencement of the inspection we sent 20 care standard questionnaires to the service, receiving seven back from staff and six from relatives of people who use the service. During the inspection we also spoke with three family members via telephone or in person and met with nine people using the service. Overall they were very happy with the support provided, comments included: "Staff are excellent in the care of my daughter and follow her care plan explicitly" "My daughter is secure at Hansel village and is so well cared for" "I choose what/where I want to do/go with my support worker" "My support staff have meetings with the managers and also with my relatives, I also attend with a social care person" "I always have someone there who looks out for me" "I am always welcomed into the service, any difficulties are settled very quickly." Self assessment The service had not been asked to complete a self assessment in advance of the inspection. We looked at their own improvement plan and quality assurance paperwork. These demonstrated their priorities for development and how they were monitoring the quality of the provision within the service. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing 4 - Good not assessed 5 - Very Good page 2 of 7
Quality of management and leadership 4 - Good What the service does well We spent time within all areas of the service during our visit and observed very good interactions between residents and those working within the Courtyard. We noted a warm, caring and values based approach to providing care and support. Trusting, working relationships have been formed over time which has resulted in residents feeling completely at home in this environment. Feedback from families that we spoke with during the course of the inspection reflected our findings in relation to this. All felt that the hard work of the staff members within the team has contributed to the positive effect that the Courtyard has had on each resident. We examined a range of care plans, finding them to be well presented and of a good standard. We noted evidence throughout of the work done by the service on the Keys to Life, especially in demonstrating how the outcomes of this document are important to the way the service supports each individual. Each resident has a six monthly review of their care package which is done via a multi-disciplinary meeting of all those involved in their care and support. Residents are invited to and take part in contributing to these meetings as well as development of the service and its staff team. Choice and control are an integral part of daily life within the Courtyard. Each resident has the opportunity to engage in a range of activities, entirely decided by their own interests. the attitude of the staff towards these activities and the choices available to the residents ensures that they are able to fulfil their potential to suit their own pace. Staff within all areas of the Courtyard were noted to be committed to their roles, working closely with vulnerable adults. We observed sound values based support which evidently made a difference to all residents. Staff told us that they felt well supported by Hansel in terms of being offered regular development opportunities such as training, team meetings and regular supervision and appraisal meetings. These opportunities allow staff to develop in their roles to increase their knowledge and skill base which in turn benefits the residents being supported. Staff also told us of their voice being valued within the service and that all were encouraged to bring their own opinions and expertise to the fore. This means that all can affect change and the direction of travel for the service as a whole. What the service could do better During the course of the inspection we spoke at length with staff and members of the management team with regards to the documentation required to ensure that care plans were as effective and straightforward as they could be. page 3 of 7
We noted instances of staff being able to tell us of processes and systems in place however no evidence was produced to outline exactly what should be in done in any given circumstance. Examples included dietary guidance/restrictions for specific residents and local emergency procedures for staff. We noted the absence of clear, personalised outcomes for residents which can be measured and progressed during the course of each calendar year. As we noted above, work has been done on achieving the generic outcomes from the Keys to Life recommendations, we would now like to see the service work with residents and their families, care managers and any other stakeholders to look at personal outcomes which they have been involved in setting. These will be specific to their own needs and preferences and will allow the service to measure their development throughout the year. We have provided the service with a copy of the Joint Improvement Team's document on outcomes entitled "Talking Points, Personal Outcomes Approach" to assist in their work on outcomes. We noted a range of issues relating to the storage and documentation of medications within the Courtyard, these were discussed at length with the management team during the inspection. These issues included the incorrect recording of 'as required' medicines. We were pleased to see that work had commenced by the end of the inspection to ensure that these issues were addressed in a timely fashion, including the development of a new auditing system. We will examine the progress made in this area at the next inspection. We noted that in relation to the quality assurance of staff competency and practice, the resources are in place however they are not being used. In this regard the management are not able to adequately evidence the strengths and development areas of the team to a satisfactory level. We have suggested regular and documented observational monitoring and reflective practice sessions be used with staff to ensure that the service can evidence their capabilities while the staff will also be able to showcase their learning and development in relation to their own roles and responsibilities. Requirements Number of requirements: 0 Recommendations Number of recommendations: 2 1. Where advice is received from healthcare professionals support plans should be updated to reflect this advice. National Care Standards, Care homes for people with learning disabilities, Standard 6: Support arrangements 2. The manager should ensure that information in care plans is monitored regularly to ensure that it is accurate and current. National Care Standards, Care homes for people with learning disabilities, Standard 5: Management and staffing arrangements page 4 of 7
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 11 Jan 2017 Unannounced Care and support Management and leadership 1 Dec 2015 Unannounced Care and support Management and leadership 25 Sep 2014 Unannounced Care and support 6 - Excellent Management and leadership 12 Nov 2013 Unannounced Care and support Management and leadership 13 Nov 2012 Unannounced Care and support Management and leadership 17 Nov 2010 Unannounced Care and support Management and leadership 8 Mar 2010 Unannounced Care and support page 5 of 7
Date Type Gradings Management and leadership 3 May 2010 Announced Care and support 6 - Excellent Management and leadership 12 May 2009 Announced Care and support Management and leadership 18 Mar 2009 Unannounced Care and support Management and leadership 16 Sep 2008 Announced Care and support Management and leadership 4 - Good 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