The Richmond Fellowship Scotland - Dumfries Support Service Queensberry House 147 High Street Dumfries DG1 2QT Inspected by: (Care Commission Officer) Clive Pegram Type of inspection: Inspection completed on: 17 July 2007 1/9
Service Number Service name CS2004061384 The Richmond Fellowship Scotland - Dumfries Service address Queensberry House 147 High Street Dumfries DG1 2QT Provider Number Provider Name SP2004006282 The Richmond Fellowship Scotland Inspected By Inspection Type Clive Pegram Care Commission Officer Inspection Completed Period since last inspection 17 July 2007 12 months Local Office Address Dumfries 2/9
Introduction The Richmond Fellowship Scotland will be referred to as TRFS within this report. It provides a Housing Support Service and Care at Home service to people living throughout Scotland. This inspection is for TRFS Dumfries service which has six different services. Each service has its own service manager. The service covers the localities of Nithsdale, Upper Nithsdale or Annandale and Eskdale area. At the time of the inspection the service was providing care or support to 75 service users. The service was registered with the Care Commission on 25th August 2004. The Locality Manager had made arrangements for service users and staff to visit the office for a buffet lunch to meet with the officer. The officer discussed with eight service users how they found the service provided by TRFS. The officer found throughout the inspection process that service users and staff were aware of the inspection function and the positive promotion of this by TRFS. TRFS provide a lot of information regarding its service throughout Scotland. In their Charter of Values it states 'The mission of the Richmond Fellowship Scotland is to provide high quality services that promote inclusion and maximise individual potential'. Within their Commitment they state that 'We believe in, support, the rights of people who have a mental health difficulty or learning disability...etc. To strive to ensure that the best possible high quality service continue to be delivered in respect of individuals with mental health difficulties or learning disabilities'. Basis of Report Before the visit: The report was written following an announced inspection which took place from Friday 6th July 2007 and on Tuesday 17th & Wednesday 18th July. The service has completed and submitted the Annual Return as requested by the Care Commission. The service has completed and submitted a Self-Evaluation Form. Views of service users were gathered during the inspection by the completion of service user questionnaires:- 20 service user questionnaires were sent out and 6 were returned. The officer also met with eight service users. This service was inspected after a Regulation Support Assessment (RSA) was carried out to determine the intensity of the necessary inspection. The RSA is an assessment undertaken by the Care Commission officer (CCO) which considers: complaints activity, changes in the provision of the service, nature of notifications made to the Care Commission by the service (such as absence of a manager) and action taken upon requirements. The CCO will also have considered how the service responded to situations and issues as part of the RSA. This assessment resulted in this service receiving a low RSA score and so a low intensity inspection was required as a result. The inspection was then based upon the relevant inspection focus area and followed up on any recommendations and requirements from previous inspections, complaints or other regulatory activity. 3/9
The inspection was undertaken by Clive Pegram Care Commission Officer. The Care Commission Officer spoke with the Locality Manager, service managers and members of staff during the inspection process. Evidence: During the inspection evidence was gathered from a number of sources including: Service Users Files Staff Files Training Records Service Brochure A review of a range of policies, procedures, records and other documentation, including: Corporate Policies & Procedures Staff Manual Health & Safety Adult Protection Child Protection Risk Assessment Policy Restraint Briefing Paper Discussion took place with a range of care staff including: the Line Manager; Service Managers; Support Workers; Assistant Support Workers; 23 staff questionnaires were sent out and 87% were returned. The officer attended two staff meetings and visited a housing support service. All of the above information was taken into account during the inspection process and was reported on. The inspection focus areas (IFAs) have been developed for each specific inspection. The focus covered for this inspection was: Protecting People The 2007/08 inspection also focussed on the associated National Care Standards for Care at Home and Housing Support Services*: Standard 4: Management and Staffing Arrangements Standard 8: Expressing your Views* The Fire (Scotland) Act 2005 introduced new regulatory arrangements in respect of fire safety, on 1 October 2006. In terms of those arrangements, responsibility for enforcing the statutory provisions in relation to fire safety now lies with the Fire and Rescue service for the area in which a care service is located. Accordingly, the Care Commission will no longer report on matters of fire safety as part of its regulatory function, but, where significant fire safety issues become apparent, will alert the relevant Fire and Rescue service to their existence in order that it may act as it considers appropriate. Further advice on your responsibilities is available at www.infoscotland.com/firelaw 4/9
Action taken on requirements in last Inspection Report The following two requirements were made in the last inspection year with regard to the Care Commission's inspection theme of 'Safer Recruitment' which was carried out at TRFS headquarters, and were met within the timescales given. (1) The service must develop and implement a checking and recording system for applicants/staff that identify that they have relevant qualifications. This is to comply with SSI/114 Regulation 19(2)(a) Records and National Care Standards - Care at Home - Standard 4: Management and Staffing. Timescale: within 6 months of the date of this report. (2) The service should develop and implement a system to ensure that professional register checks are carried out as per registration requirements. This is to comply with SSI/114 Regulation 9 2(c) Fitness of employees and National Care Standards - Care at Home - Standards 4: Management and Staffing. Timescale: within 6 months of the date of this report. Comments on Self-Evaluation The self-evaluation documentation was completed comprehensively and thoroughly and provided valuable information on the strengths and areas of development as identified by the Locality Manager and staff. View of Service Users Comments from service users, who met with the officer, included:- 'That the service provided by TRFS was meeting their needs', 'The service was to suit you', 'Staff are kept up to date' 'It is a good service', 'Could not ask for anything better' 'Able to talk to staff, order in my Chaos' View of Carers No carers took part in this inspection. 5/9
Regulations / Principles Regulation : Strengths Areas for Development National Care Standards National Care Standard Number 4: Care at Home - Management and Staffing Strengths Not all elements of this standard have been reported on. The elements included in this report are 1, 2, 5 & 6. The officer met with the two locality managers for The Richmond Fellowship Dumfries Service and Galloway Service (TRFS) to address all the issues covered by this standard and the Inspection Focus Area - Protecting People which are relevant to both the services. The locality managers were asked to identify the corporate approach taken regarding Child Protection in services for adults and for Adult Protection. The inspection also looked at the Scottish Social Services Council (SSSC) Codes of Practice and staff training. The locality managers, two service managers and staff stated that they may come into contact with children when they support adults within a family and sometimes children may visit service users who have tenancies within a service. The service has two policies and procedures for the Care and Protection of Children and Young People and Children visiting services. The staff teams visited were aware of these procedures and that they were being discussed through staff meetings and supervision. The service does have information and guidance regarding 'Positive Behaviour Support Policy' and a restraint briefing policy for staff and staff were aware of this information. The service does not currently use restraint. If they did, then two risk assessments would be completed and the Risk Assessment/Challenging Needs Assessment & Management Form would be sent to 'The Positive Behavioural Support Team' who would then advise the locality manager on how a service user will be supported. See Area of Development. One service visited completes the Risk Assessment/Challenging Needs Assessment & Management Form as a matter of practice for all service users. There is specific risk assessment training for staff and this is undertaken by Aberdeen University. Where it is identified that 'restraint' may be required then only the staff team involved in working with the service user would be given specific training relating to the service user restraint needs; this is called CALM training. Any restraint identified is on a strict individual service user need only. The staff team would receive annual refresher training and each month must practice the specific moves within their staff team. No member of staff can 6/9
undertake restraint of a service user without this specific training. Where restraint is identified then the service user would have a review every three months and if an incident occurred this would be reported on and each month an 'Incident Reporting Report' is sent to the 'The Positive Behavioural Support Team'. If there has been no restraint that month a 'Nil' return is completed. The service has an 'Adult Protection Policy' (which includes the Dumfries & Galloway Adult Protection Procedures) this has been discussed at locality/service managers meetings and is in the process of being discussed at team meetings and individual staff supervision. This was seen to be happening when the officer visited services; also staff had an awareness of this Policy and Procedure. Within TRFS there is a 'Learning Pathway' which has a clear training programme for all staff to undertake from induction through to achieving an SVQ. This has been closely aligned to the Scottish Social Services Council staff registration requirements. TRFS is hoping for 75% of staff to have an SVQ or equivalent qualification by the end of 2007 and all staff by 2009. The locality managers confirmed that all staff would undertake the mandatory course 'Recognising & Responding to Abuse'. Staff members spoken to all confirmed that they had undertaken both mandatory and non-statutory training which they found beneficial ie Mental Health First Aid, Communication Skills, Drugs & Alcohol Awareness, Self Harm plus SVQ vocational training etc. Each member of staff completes their 'Learning & Development Plan' which is discussed with their manager and also at subsequent staff supervisions. When a member of staff completes training then an evaluation of that course has to be completed by the member of staff. Staff identified that they found the training provided by TRFS helped them in their work practice. Service users also commented that staff had the skills and knowledge to help with their care and support needs. Services users commented that they have been invited by TRFS to take part in the recruitment and selection process when there have been staff vacancies, all identified that they enjoyed being a part of this process. Areas for Development On the Risk Assessment Form (Appendix 1) it identifies different reasons why the 'Risk Assessment/Challenging Needs Assessment & Management Form' should be completed. However, it does not identify any restraint issues. It states 'A person with history of high risk behaviour eg fire-raising, self-harm, aggression'. It is recommended that working regarding restraint should be included within this assessment and should include the different areas of restraint ie physical, environmental etc., as identified within the Mental Welfare Commission 'Rights, Risks and Limits to Freedom'. See recommendation 1. It was identified in last year's inspection report and again this year that staff have to use their own personal mobile phones to keep in touch with TRFS office or other workers during their working week. However, since last year staff are aware with regard to reimbursement for calls made. TRFS should continue to look at this issue in the light that some services supply mobile phones to members of staff and others do not. 7/9
National Care Standard Number 8: Housing Support Services - Expressing Your Views Strengths The Officer met with a total of eight service users from the different support teams and services within TRFS Dumfries service at a 'drop in' session held between 1.00pm and 3.00pm that had been organised by the service with a buffet lunch for people attending. The service users present spoke positively about the service provided by TRFS, that they were all treated with respect by the staff members and they had the knowledge and skills to meet their individual needs. Some service users were aware that staff did go on training courses. Service users were aware that they had 'support/personal plans' (PSDAs) and that these would be discussed with them by their support staff, that they would also meet at a 'review' with other people involved with their support and discuss how they were progressing. In general the support, agreed in their support/personal plans, was provided as identified by TRFS. Service users said they would go to their support worker or telephone the service manager if they had a problem and that staff are helpful and would know what to do. Some service users commented that they were given information about how to complain in their PSDA information which includes their support plan information. Everyone who took part in the inspection said they felt safe with the service provided by TRFS. Service users were very positive about the support/care provided by the service and some felt that they would not be able to cope without the support provided. Areas for Development A service user thought that people who used the different services provided by TRFS could meet up in a social capacity, which would help them to communicate with other people in a familiar and safe environment. The officer discussed with the locality managers the new inspection system for next year and how the service will have to ensure that there is clear service user and carer involvement with how the service will grade themselves for the inspection process for 2008/09. This could involve different kinds of service user and carer participation strategies that has lead to improvements in the service and how independent advocacy has been involved in this process. See recommendation 2. 8/9
Enforcement None Other Information The headquarters of TRFS have moved since the last inspection and the registration certificates displayed had the wrong address for TRFS. This was identified at the inspection and new certificates will be issued by the Care Commission. Requirements None Recommendations 1. The Risk Assessment Form (Appendix 1) should be revised to include the different areas relating to restraint. National Care Standards Care at Home Standard 4: Management and Staffing Arrangements. 2. The service should evaluate and introduce a system to ensure that service user and carer participation can be identified for the new inspection system being introduced by the care commission from 2008/09 inspection year. National Care Standards - Housing Support Service - Standard 8: Expressing Your Views Clive Pegram Care Commission Officer 9/9