Temporary Accommodation Management Unit Housing Support Service Lindsay House 37 Kittoch Street East Kilbride G74 4JW Inspected by: (Care Commission Officer) Type of inspection: Barbara Montgomery Announced Inspection completed on: 20 November 2006 1/11
Service Number Service name CS2004066411 Temporary Accommodation Management Unit Service address Lindsay House 37 Kittoch Street East Kilbride G74 4JW Provider Number dummy Provider Name SP2003003481 South Lanarkshire Council Inspected By dummy Inspection Type Barbara Montgomery Care Commission Officer Announced dummy Inspection Completed Period since last inspection 20 November 2006 9 months dummy Local Office Address Hamilton dummy 2/11
Introduction TAMU, South Lanarkshire Councils Temporary Accommodation Management Unit provided accommodation and support to homeless individuals and households to whom The Council had a statutory responsibility under the Housing (Scotland) Act 2001 and the Homelessness Act (Scotland) 2003. This service was managed by Housing and Technical Resources. It has been registered with the Care Commission as a Housing Support Service since 2004. It was also subject to regulation by Communities Scotland and to review by South Lanarkshire Council Supporting People Team. Some of the people who used this service were housed in temporary accommodation at Lindsay House in East Kilbride, a staffed unit for up to 26 people with single rooms, family rooms and bedsits, or in one of 335 furnished units dispersed across South Lanarkshire. Some were in Bed & Breakfast establishments or in accommodation provided by housing associations or voluntary organisations and some were living temporarily with friends or family. People who had moved from temporary to permanent accommodation also received a service and young people moving out of Care Homes could also access it. Many of those who used this service had complex needs with health or social problems related in some instances to their mental health ; alcohol or drug abuse or imminent discharge from prison and some were fleeing violence. TAMU provided information, advice and support to service users from the point of initial referral through to eventual resettlement into more permanent accommodation. At the time of the inspection the 30 (26.5wte )staff in the TAMU team were providing a service to 327 individuals and families. Lindsay House staff provided an on site service 24 hours a day, 7 days a week to service users there and an advice and information service 24 hours a day, 7 days a week to those in dispersed accommodation. Housing Officers supported service users with medium and high support needs living in all other types of temporary accommodation. Tenancy Support Workers and Supported Accommodation officers supported people who had moved from temporary into a permanent accommodation.specialist workers included Resettlement Officers who provided housing support to high risk ex offenders; Child Support workers who engaged with families who had children and liaised with other agencies and services and the' NEST 'Officer who provided support to clients and families affected by substance abuse. This service was inspected following a Regulation Support Assessment (RSA) to determine what level of support was necessary. The RSA is an assessment undertaken by the CCO which considers: complaints activity, changes in the provision of the service, nature of notifications made to the Care Commission by the service, action taken upon requirements, size of care packages etc. This service was required to have a medium level of support that resulted in an inspection based on the national inspection themes, the core standards for the inspecting year and any recommendations and requirements from previous inspections, complaint or other regulatory activity Basis of Report The inspection took place over the course of a week in November 2006. The Care Commission gave the service advance notice of when the inspection would take place.the 3/11
Manager sent back a completed self evaluation and a pre inspection return form containing up to date information about the service The Care Commission sent questionnaires to 100 service users ( 21 in Lindsay House; 50 in scatter flats in Rutherglen/ Cambuslang,Larkhall,Blantyre & Clydesdale and 25 in Bed & Breakfast establishments). 10 service users and 5 of their relatives or representatives returned completed questionnaires. The Care Commission Officer also had the opportunity to meet and speak with 12 service users when she accompanied four workers on visits to people living in some of the furnished units and Bed and Breakfast accommodation. She also attended a tenants meeting at Lindsay House. The Care Commission Officer also met with the Manager and all TAMU staff and examined a range of policies, procedures and records. The Care Commission Officer took all of the above into account and reported on whether the service was meeting the following National Care Standards: Housing Support Services Standard 2. Your Legal Rights Standard 3. Management and Staffing Arrangements Standard 4. Housing Support Planning Standard 6 Choice & Communication Action taken on requirements in last Inspection Report No requirements were made Comments on Self-Evaluation Completed in full View of Service Users Questionnaires :All 10 service users who sent back questionnaires said they were satisfied with the service they received and considered staff to be professional, polite and respectful and to have the knowledge skills and training to meet their needs. Comments included''staff are very helpful/ they are always there to provide support/staff are always very supportive/ being in Lindsay House has made me feel safe and secure and the staff are very helpful''. Seven people said they got the support that had been agreed for them and had a plan detailing this support, one said it was a verbal not a written plan.three said they didn't have a plan or that none had been agreed. Seven people said they knew how to make a complaint or voice a concern and three said they didnt. Service users the CCO met conveyed their satisfaction with the service from their TAMU worker. Not everyone in the scatter flats understood the distinction between the role of TAMU staff and other housing officers. And some of the people staying in Bed and Breakast did not appreciate what TAMU was or how it could help them. Those who had specialist support because of a substance abuse problem were very positive about their experience of the service and one rated it as' the best thing that had ever happened to them.' 4/11
The seven people/those who attended the meeting at Lindsay House had mixed views about some aspects of the service. Some were quite critical of some of the house rules and spoke about how important it was for staff to be non judgemental and how that had not always been their experience. Others were very positive about the support they had received. Some thought it unfair that someone with a subtance abuse problem moving into permanent accommodation could be offered more help than others because of the lottery funded NEST Project. View of Carers The five spouses/partners, social workers or others who returned a questionnaire said they were satisfied with the service. Two said they knew how to make a complaint or voice a concern and two said they didnt. 5/11
Regulations / Principles Regulation : Strengths Areas for Development National Care Standards National Care Standard Number 2: Housing Support Services - Your Legal Rights Strengths Because the extent to which this standard was met was considered in full last year this part of the inspection concentrated on progress with recommendations made in the last inspection report. Service users were now given an 'occupancy agreement 'rather than a 'temporary accommodation lease'. Work on developing a service agreement which will ''define the housing support service, set out terms and conditions for receiving it and arrangements for ending it '' along with a schedule explaining what is meant by Housing Support services and listing the range of services they can access from TAMU was being progressed. A draft version of this was currently being considered by the Councils legal department. The Council said that further work was needed on this and that they would welcome guidance. The Council were aware that the agreement and schedule as well as being given to those in Lindsay House or 'scatter' flats should also be offered to those staying in Bed and Breakfast and to those still being supported after a move to a permanent tenancy. The agreement should also make clear whether a housing support plan was being offered or not. The Care Commission Officer was advised that a copy of the Care Commission inspection report was on display on the notice board at Lindsay House and available in local housing offices and Q & A offices. Areas for Development none National Care Standard Number 3: Housing Support Services - Management and Staffing Arrangements Strengths This standard was considered in full last year. This years inspection concentrated on 6/11
progress with recommendations made in the last report, recruitment practice and training. Recruitment:The Care Commission is inspecting 'Safer Recruitment' for all registered care services in Scotland this year; this means checking for example whether providers take up references, criminal record checks, checking qualifications etc. As South Lanarkshire Council personnel records are held centrally at the Council Offices in Hamilton this part of the inspection took place separately. This audit of the Council s corporate recruitment policies and procedures and of Housing and Technical Resources personnel records resulted in four recommendations which are highlighted in this report. An action plan has been received from South Lanarkshire Council which addresses these recommendations and the area for development. Training : A training needs analysis was being carried out so that a comprehensive training plan could be put in place to ensure that staff have the necessary qualifications to meet the registration requirements of the SSSC. In keeping with Council policy performance development reviews were offered to all staff. Areas for Development Recruitment :It is suggested that best practice is followed by undertaking Enhanced Disclosure Scotland checks for staff appointed to their present post before April 2002. Consideration should also be given to introducing a system for re-checking Enhanced Disclosure Scotland checks. Training : Because of the wide age range catered for combined with diversity of need including mental health, learning disability; substance abuse ; physical disability; domestic abuse; offending behaviour this service requires a staff group with a mix of skills and specialist knowledge. There has been a marked increase in the number of service users with mental health problems and challenging behaviour. While a good range of training was already on offer workers identified an urgent need for more mental health awareness training and also training that would help them better meet the needs of those with challenging behaviours. At the moment staff have no powers of restraint and consideration should be given to training in an accredited approach such as TCI already used by the council in some other services. It was hoped that the different approach to recording violent incidents now being used will assist staff to manage these more effectively. Staff in Lindsay House who may be more used to working with older homeless people would also benefit from training that would help them work more effectively with the increasing number of young people staying there. Beacsue it can be difficult to find courses with the right emphasis courses run by external agencies are sometimes more appropriate than Council ones and delays in getting on these can occur. Staffing Levels: At the time of the last inspection TAMU did not have the staff capacity to offer everyone in dispersed accommodation and Bed and Breakfast a support service and this situation is unchanged. The Council has carried out a review of TAMU staffing levels and workers remits and proposed radical changes that it hopes will make it possible to staff the service in way that ensures that all service users housing support need can be met. These proposals which entail a reconfiguration of almost the entire service, with the exception of Lindsay House 7/11
which will be largely unchanged, are discussed in the other information section of this report. National Care Standard Number 4: Housing Support Services - Housing Support Planning Strengths The format for a Client Needs Assessment and Housing Support Plan which was was being pilotted at the time of the last inspection was now in use. The standard of recording in completed plans sampled was high. How comprehensive these plans could be very much depended on the agreement of the service user to share personal information. Areas for Development As noted at the time of the last inspection not everyone could be offered a full assessment and a housing support plan.the Council anticipate that improved staffing levels following the proposed changes to the service will make it be possible for everyone to be offered a full clients needs assessment and a housing support plan. National Care Standard Number 6: Housing Support Services - Choice and Communication Strengths Service users are helped to make choices about the service TAMU provides. The kind of information people need in order to make those choices gets conveyed in various ways including Council and TAMU literature, during book in procedures and in the course of regular meetings with workers. Service users have a choice about whether they wish to take advantage of the service or have an assessment and support plan. They also have a choice about the sharing of information with other agencies which is only done with their written permission. Where a legal provision applies to a service user then their choices might be restricted in some way. This would apply in situations where a child protection order, a childrens panel order or a mental health order were in place; where a high risk offender was referred or a restriction of liberty order applied. In these circumstances TAMU staff might have role in supporting service users to comply with orders and where an order was not complied with they would have a responsibility to inform the appropriate agency. Some times service users actions while in temporary accommodation might have a direct bearing on the service they received. For instance some sanctions can be imposed for not sticking to house rules in Lindsay House. Because sticking to the terms of occupancy agreement in Lindsay House and in dispersed accommodation is mandatory, choosing to do something like use illegal substances might lead to a move to alternative accommodation but not a withdrawal of the housing support service. This is explained in the service users information booklet.to comply with Council policy tenants can no longer smoke in communal 8/11
areas in Lindsay house. Some times service users make lifestyle choices which place them or others at risk such as not exercising enough control over who comes into their house; borrowing money unwisely ;not looking after themselves by eg not putting their heating on, not eating properly, not calling a doctor when unwell. In these kind of situations TAMU staff knew what action to take, such as explain the risks when appropriate, do what they could to minimise risks and if necessary make sure the appropriate agency was informed. Areas for Development None 9/11
Enforcement none Other Information 1.Progress with previous recommendations. Standard One Informing and Deciding: Work on developing and improving literature about TAMU had been progressed and was almost complete. An Information booket for people staying at Lindsay House was now available along with four booklets for those in dispersed accommodation, tailored for each of the geographical areas - Rutherglen/ Cambuslang;Hamilton/ Blantyre /Larkhall; East Kilbride and Clydesdale. A child support worker information leaflet and a leaflet for anyone serving a prison sentence had also been produced. Literature about the throughcare servicewas being worked on. It was noted that the Councils homelessness service leaflet does not mention TAMU. It wa also noted that some of the people staying in Bed and Breakfast did not know much about TAMU and literature should be routinely available to them. 2. Referral protocals were not always followed by some hospitals. Staff were concerned about an increased incidence of inappropriate referrals from hospitals discharging people with complex needs that could not be met by housing support service staff. A lack of background information from hospitals made this worse. The Council advised that protocols were being revised and would be reinforced. 3.Reconfiguration of the service: It is proposed that the service to people in Bed and Breakfast, in scatter flats and in permanent accommodation across South Lanarkshire would be provided in a dispersed way from the Councils 8 area housing offices instead of centrally from East Kilbride. The service provided by Lindsay House staff and by specialist workers would be unchanged. The Council hope to create a more seamless service which will allow TAMU staff to focus much more on their support function. A consequence of this would hopefully be to make it clearer to service users what TAMUs role is, The proposal includes the removal of the property management role from staff freeing up more time for housing support tasks. It was also hoped that travelling time would be reduced. Exactly how much more staff capacity will be created is uclear and the Council acknowledge that the appointment of additional staff may be necessary. A lot of the detail had still to be firmed up including location of staff; job titles; job specifications and line management. The Council recognised the importance of job specifications which ensured TAMU staff did not find themselves taking on other local housing functions. They also recognised the importance of giving continuity to service users moving from temporary to permanent tenancies who still needed a lot of support. TAMU staff were particularly concerned that TAMU will no longer be or be seen as a 'stand alone' service making it less easy for them to advocate on behalf of service users and if necessary challenge housing decisions which they felt were not in the best interests of service users. Isolation was another concern and the Council recognised the importance of building in good staff support networks. 4. Intensive Support Project : A new specialist service to families has recently started up which will be a discreet branch of TAMU in the same way that the 10/11
NEST project is. 5.Registration :The proposed reconfiguration of the service will affect its conditions of registration in terms of location; manager; size and possibly name and should be agreed with the Care Commission.The Manager of this service has recently moved to a new post and no new manager is in post yet. The new Intensive Support Project does not need to be separately registered and does not change TAMUs conditions of registration in any way. It will be inspected in the future as part of the overall service. Requirements none Recommendations 1. To improve recruitment practice:. A copy of the memo from the Occupational Nurse confirming fitness should always be placed in files.. Two references including one from previous employer should be on file for all new Council employees.. The acceptability of the practice of taking up only one reference for internal appointments should be clarified in written procedures.. Records should indicate whether Disclosure Scotland checks were at enhanced level.. Where applicable copies of certificates should be kept on file to verify any qualifications listed on the application form. ( Standard 3 Management and Staffing ) 2. Staff Training should be improved in ways described in this report ( Standard 3 Management and Staffing) 3.The Council should be in a position to offer every service user a full clients needs assessment and a housing support plan as soon as possible.( Standard 4 Housing Support Planning ) 4. The Councils homelessness service leaflet should mention TAMU. TAMU Literature should be routinely available to people staying in Bed and Breakfast establishments (Standard 1 Informing and Deciding) 5. The Council should keep the Care Commission informed of progress with plans for the reconfiguration of this service. Barbara Montgomery Care Commission Officer 11/11