Beyond Homecare Housing Support Housing Support Service Dewar House 1 Loch Road Tranent EH33 2JX Telephone: 01875 616 666 Type of inspection: Unannounced Inspection completed on: 12 June 2017 Service provided by: Pamoja beyond Homecare Ltd T/A Beyond Homecare Service provider number: SP2003003308 Care service number: CS2007165533
About the service Allan Ross Nursing and Homecare was established in 2002, providing care at home and housing support services to people in East Lothian. In 2016 the company was taken over by Pamoja, an organisation led by two social entrepreneurs, Gavin and Louis Stedman-Bryce. The company was then re-launched as Beyond Homecare. The provider's website states: Pamoja's mission, driven by Gavin and Louis, is to improve people's lives through inspiring change. With a strong record of accomplishment in training and development, Pamoja leads the way in helping charities and other not for profit organisations measure and demonstrate the value and impact of their work. Pamoja's expertise and collaborative approach will shape Beyond Homecare's development and growth, streamlining systems and looking at where technology and innovation can improve our customers' experience. What people told us From the questionnaires we received before the inspection, we could see that while most service users were happy with the quality of service, there had been recent difficulties maintaining continuity of care for people in some locations in East Lothian. This is reflected in the range of views we received on some of the questionnaires: "I am very appreciative of the work done by the girls in helping me to stay and have some independence in my home. They are all very helpful, kind and caring"; "Allan Ross are now trying to keep consistency with their carers as changes and varying carers confuse and upset my mum"; "Whilst generally happy with the delivery of the support, I have concerns that the administration does not communicate in the scheduling of the delivery in implementing change ie no schedule for 7 weeks"; "Lack of continuity is a major concern due to high staff turnover. When a carer is unavailable or late, the client should be kept fully informed"; "I am never told who is coming. No weekly rota. Can have, as today, 4 different carers for the day. Carers are good but I think a regular carer is better. As I never know the time anyone is coming. I think the fault lies not enough staff"; "The carers are changed around too often. One lot of carers get to know me and my needs and then they all change. Not confident they will all be adequately trained to use the hoist which I will need to get up"; Never know who is coming in or what time. No communication from office, never inform you of change of carers"; "service has been a little erratic in recent weeks and we no longer receive a copy of the rota for the coming weeks which was useful". We discussed this with the manager of the service, who was aware of the issues and the provider was working hard to try to respond to the difficulties. This is discussed further within the main report. During the inspection we visited and spoke with people who used the service and their relatives. As with the questionnaires, their views reflect the inconsistent service received by some people, as well as the very good service received by others: "I'm very happy, [named care worker] is the number one carer. She knows what needs done and how I like things done"; "I'm really happy with the service, especially with [named care worker]. She works none-stop!"; "The service has been very good, no problems, they come on time and the consistency is good"; "Staff are all very attentive, remembering everyone's fads!"; "Generally they come on time and are very pleasant; sometimes 1 or 2 changes but usually very good"; "It's difficult at present. I sometimes don't know who is coming, or it is changed at short notice with no phone call to let me know. The girl in the office tries really hard to get the information to you"; "My carers are all lovely, no complaints at all"; "No complaints, I'm very well looked after, I page 2 of 7
have two regular carers, they're very good, very punctual"; "I had a young girl today, only her 2nd day on the job. She was so keen to make sure everything was just so"; "Some of them are very good, very obliging. I'm delighted with my regular carers"; "The carers themselves are absolutely brilliant. Their organization could be improved. They are over-stretched and sometimes we don't get the allocated carer and get an unfamiliar carer. They do try to get consistency"; "It's been fine except they have been short of staff for the past 2-3 months and I don't always know who is coming. It's sometimes frustrating but they are lovely girls. I'll be delighted when it gets back to regular teams"; "It's been a bit up and down, it seems to be quite difficult with new staff. Some timings are not good, they do eventually turn up. I'm hoping they get it right. Instead of 5 or 5.30 they have been coming at 6 or 6.30. Overall the girls have tried hard, I try to be reasonable about it"; "They come when they should. They are excellent, most of them are regular, sometimes it's others, but they always come on time". Self assessment We did not request a self assessment from services this year. We considered the service's own development plan as part of this inspection. From this inspection we graded this service as: Quality of care and support Quality of staffing Quality of management and leadership 4 - Good not assessed 4 - Good What the service does well People using this service generally experienced good quality support from a consistent team of care workers. We observed warm compassionate interactions between care workers and people using the service. We could see that choice was promoted by skilled staff who formed strong relationships with people who used the service. Care workers showed a detailed knowledge of people's routines and personal preferences when providing care. People were involved in their personal plans, which were very detailed and were written in the first person, which made them more personalised. Risk assessments helped to keep people safe while care was carried out and care workers recorded daily information electronically. Reviews were carried out every 6 months in line with legislation. The service had introduced an electronic scheduling system and staff logged in and out at each visit. This helped the service to know that each person received care at the right times. Care workers were well supported by the management team, and there was good communication between office staff and care workers. Care workers praised the new owners' approach to modernising the service. All new staff received an induction to ensure that they were well prepared for starting work, and the service held regular supervision meetings with care workers. Recruitment carried out by the service was in line with best practice guidance (Safer Recruitment Through Better Recruitment (Scottish Government, 2016)) which meant people using the service could be confident that the provider had carried out all the necessary checks before employing a member of staff. The management team have introduced new systems of working, including compliance monitoring, audits and surveys. Other improvements are planned, for example regular surveys of the views of people using the service. These systems and processes were not yet fully in place, but as they become established they will help the page 3 of 7
service to improve and develop. Overall this service provided good care and support, and will be able to build on this to develop the service further. The staff and management team were committed to continuing to improve the service. What the service could do better Some people experienced significant disruption to their care service due to difficulties with recruitment and retention of staff. This meant that some people had unfamiliar care workers providing visits at irregular times. This disruption was further compounded by the fact that the new computer system was not able to provide a printed schedule to let people know when their care worker would be arriving. The impact of this for some service users was to cause them anxiety and frustration over a period lasting several months. This has been reflected in our decision to reduce the grading for care and support from 'very good' to 'good'. However, the management team were working hard to respond to these difficulties and restore a better quality service to people who were affected. Each person using the service should know who is coming and when; they should have a consistent group of regular care workers, and where there are changes to this, they should be informed in advance. We could see that the management team took the concerns seriously and we were reassured that the difficulties would be resolved. The provider had introduced a range of new systems and processes to modernise its ways of working. This meant substantial changes which take time to become established. We agreed with the manager that these changes will lead to improvements in how people using the service experience the care they receive. We will review the impact of the changes at the next inspection. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. page 4 of 7
Inspection and grading history Date Type Gradings 29 Jun 2016 Unannounced Care and support Management and leadership 20 Aug 2015 Unannounced Care and support 4 - Good 4 - Good Management and leadership 4 - Good 2 Oct 2014 Unannounced Care and support Management and leadership 14 Nov 2013 Unannounced Care and support Management and leadership 23 Nov 2012 Care and support Management and leadership 26 Oct 2010 Announced Care and support 6 - Excellent Management and leadership 23 Sep 2009 Announced Care and support 6 - Excellent 6 - Excellent Management and leadership 6 - Excellent 1 Sep 2008 Announced Care and support page 5 of 7
Date Type Gradings Management and leadership 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