Aberdeen Supported Living Services Housing Support Service

Aberdeen Supported Living Services Housing Support Service 18-22 Provost Mitchell Circle Dubford Bridge of Don Aberdeen AB23 8AP Inspected by: (Care Commission Officer) Type of inspection: Rod Wood Announced Inspection completed on: 14 November 2006 1/10

Service Number Service name CS2003055091 Aberdeen Supported Living Services Service address 18-22 Provost Mitchell Circle Dubford Bridge of Don Aberdeen AB23 8AP Provider Number dummy Provider Name SP2003000203 Capability Scotland Inspected By dummy Inspection Type Rod Wood Care Commission Officer Announced dummy Inspection Completed Period since last inspection 14 November 2006 14 months dummy Local Office Address Johnstone House Rose Street Aberdeen AB10 1UD dummy 2/10

Introduction Aberdeen Supported Living Service was registered by the Care Commission to provide Housing Support and Care at Home Services. The organisation, Capability Scotland who administers the service, originally registered two services, Harrow Road and Dubford, both in Aberdeen City in August 2004. The organisation varied the registrations of these services to combine them into one service in September 2005. The service supports 16 Adults with Learning Disabilities to occupy their own accommodation and maintain their own tenancies in the two areas of Aberdeen City. Basis of Report This report was written following an announced inspection carried out by one Care Commission Officer. This service was inspected after receiving 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 requirement 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. Before the visit the service completed a annual return on line giving information about the service. The service also completed a self evaluation on line. During the visit which took place on 14 November 2006 the Care Commission Officer spoke with: The Locality Manager The Manager 2 Team Leaders 1 Support Worker 1 Service User The Care Commission Officer also looked at a range of policies, procedures and records including the following: Medication policy and procedure Medication administration record Medication training journal Health and Safety policy Written agreement Financial records of 1 service user. Personal plan of 2 service users The Care Commission Officer took all the above into account and reported on whether the service was meeting there following National Care Standards for Care at Home and Housing 3/10

Support Services: Standard 2: The Written Agreement Standard 4: Management and Staffing Standard 6: Eating Well Standard 6: Choice and Communication (Housing Support Service Standard) Standard 8: Medication Action taken on requirements in last Inspection Report One requirement was made at the last inspection: 1. The service cease using the bedroom in the Service User's home as an office base immediately. Regulation of Care (Scotland) Act 2001 Section 29 (10) (b). Timescale: Immediate and ongoing. This requirement has been actioned. See body of report for detail. Comments on Self-Evaluation Well completed giving an objective and honest appraisal of the service. View of Service Users Only one service user was available for interview. This service user had previously completed a questionnaire which was returned to Care Commission. The service user had mentioned some areas of the service he was not happy with. However, during interview the service user did not mention these areas again even after prompt. He indicated he was very happy with the service he received. Two other questionnaires were completed by service users. However, none were available for interview. View of Carers No family or relatives were spoken with. 4/10

Regulations / Principles National Care Standards National Care Standard Number 2: Care at Home - The Written Agreement Strengths Discussion with the Locality Manager and the Manager indicated that there were difficulties with developing a written agreement and an information pack, or indeed any written information, that could be understood by the service users, particularly at the Dubford service, owing to the high level of their learning disability. This was an area that was currently being further examined and researched by the organisation. It was hoped that the use of a Board Maker and other communication aids may be helpful. Areas for Development A copy of a written agreement was examined. This did not contain the required detail of this standard. For example the charges a service user had to pay were not included. The written agreement was not signed by either the organisation's representative or the service user. At the inspection carried out on the 22 September 2005 a recommendation was made that the service was to ensure that all service users received a written agreement which was in accordance with this Standard. A recommendation was also made at that inspection that an information pack was also to be developed. Neither had yet been developed. Both of these recommendations remain. The Locality Manager stated that a new written agreement and information pack were currently in the process of being developed by the organisation. It was hoped that these would be in place within the next month. These will be further examined at the next inspection. The Manager was advised at feedback that consideration should also be given to seeking the assistance of relatives or an advocate where it was considered beneficial. National Care Standard Number 4: Care at Home - Management and Staffing Strengths The service had comprehensive and detailed policies in place which covered all legal requirements. These were viewed on the day of the inspection. These were available to staff at all times. The records of service users finances were examined and found to be well kept and regularly checked and audited by staff. Staff had recently received comprehensive and thorough training in the administration of medication which had been undertaken through Aberdeen College. A journal completed by a staff member for this training was examined. 5/10

Staff were seen to be appropriately dressed for their duties. At the inspection carried out on 22 September 2005 a requirement was made that the service ceased using the room of a service user at Harrow Road, as an office. The service had now acquired an office nearby to the service at Harrow Road which served the administration requirements of the service. This requirement has been actioned. A recommendation was made at the last inspection that all records were compliant with the Data Protection Act. This particularly referred to information in personnel records. The Locality Manager explained the process that was now in place to ensure that these records were now compliant. This recommendation has been action. A recommendation was made at the last inspection that individual risk profiles be regularly updated. Discussion with the Locality Manager and examination of one service user's personal plan showed that this recommendation had been actioned. An audit of the service s safer recruitment policies and procedures has been carried out by the Care Commission on 14 September 2006 resulting in the requirement and recommendations highlighted in the report. Following receipt of the audit report, the organisation has been addressing the issues raised. This progress will be reported on in the subsequent inspection. The previous Manager had recently been appointed to a promoted post. A temporary Manager was in post. It was expected that the temporary position would remain until the end of December. A fitness of Manager form needs to be completed for the temporary Manager. Areas for Development A recommendation was made at the last inspection that service users were aware of their individual support staff in advance. The Locality Manager stated that the use of photographs had been tried at the Dubford service which had limited success. The use of visual timetables was now being considered. Progress with this will be examined at the next inspection. This recommendation remains. The service was currently experiencing difficulty recruiting staff to vacant posts, despite carrying out recruitment campaigns. However, agency staff were being used to fill vacant hours. National Care Standard Number 6: Care at Home - Eating Well Strengths All staff had undertaken Basic Food Hygiene Training. Menus were planned between the service user and the Key Worker and a 5 week menu plan prepared. Changes in choice could be easily dealt with as required. Service users would accompany staff to purchase food as required. Dieticians would be involved where necessary. 6/10

None of the service users required assistance with eating their food. Staff mainly played a prompting or observing role during meal times. Where difficulties were observed with eating or drinking staff would refer the service user to the appropriate health professional. Discussion with one service user indicated that he and his partner were happy with the meals they chose and were involved in the purchase of the food as well as assisting with setting the table for meals. A bowl of fruit was observed in their flat which they chose from when they wished. Areas for Development None identified at this inspection. National Care Standard Number 6: Housing Support Services - Choice and Communication Strengths The service had difficulty with communication with the service users at the Dubford service owing to the very high level of learning disability. The Locality Manager explained the organisation was in the process of introducing more visual contact with the service user and making use of Makaton and Board Maker. Training for staff was being planned for staff in the near future. This will be progressed at the next inspection. At the other service at Harrow Road service users were in the main more able to communicate through speech quite well and written information was available for the service users. One service user made use of an independent advocate. Staff were regularly undertaking training to ensure that best practice prevailed and that staff communicated effectively with regard to service user needs. Areas for Development None identified at the next inspection. National Care Standard Number 8: Care at Home -Keeping Well - Medication (where help with taking medication is provided as part of the service) Strengths Records examined showed that medication administered was being appropriately recorded. Service users were being assisted by staff with their medication in accordance with the service users abilities. A detailed medication policy and procedure was in place. Staff had recently undertaken a comprehensive programme of training in medication administration. 7/10

Areas for Development Medication was received in bulk on a weekly basis from the Pharmacist. However, the service did not see the Prescription Forms or annotate the reverse of the Prescription Form prior to it being received by the Pharmacist. The organisation's medication policy stated that the service should receive confirmation of the medication prescribed from the GP. The Manager should discuss this matter with the GP in order to agree the best method for communication prescription requests and repeat prescriptions in accordance with best practice guidance. This matter will be further examined at the next inspection. 8/10

Enforcement There has been no enforcement action by the Care Commission on this service. Other Information At the inspection carried out on 22 September 2005 the following recommendations were made: 1. The service to develop an information pack which encompasses all aspects of this standard. This pack should be in a format that service users can understand. National Care Standard 1. This recommendation has still to be actioned. The service is in the process of developing an information pack. This recommendation remains. 2. The service to ensure all service users are to receive a written agreement defining how the service will meet their needs. National Care Standard 2. This recommendation has still to be actioned. This receommendation remains. 3. All personnel records be compliant with the Data Protection Act. National Care Standard 4.1 This recommendation has been actioned. 4. Service Users be made aware in advance of the individual staff support in a format suitable to their needs. National Care Standard 4.6. This recommendation has still to be actioned. 5. Individual risk profiles to be regularly updated. National Care Standard 7.1. This recommendation has been actioned. 6. The service to evidence Service User or representative involvement in the individual Personal Support Plans. National Care Standard 7. 5. This recommendation has been actioned. Service users were involved in their support plans to the level they were able to cope with and understand. The reviewing process was well recorded and showed involvement of the service user and identified other professionals input. 7. Staff to adhere to medication administration recording procedures. National Care Standard 8.3. This recommendation has been actioned. Records examined showed that medication was being appropriately recorded. Staff had also undertaken training in medication administration. 8. Information about Advocacy Services be available in the service for any Service User. National Care Standard 11.4. This recommendation has been actioned. Information about advocacy services was available in the service and one service user curently used the services of an advocate. Requirements There were no requirements made at this inspection Recommendations 1. The service to develop an information pack which encompasses all aspects of this standard. This pack should be in a format that service users can understand. National Care Standard - Care at Home -Standard 1. 2. The service to ensure all service users are receive a written agreement defining how the 9/10

service will meet their needs. National Care Standard - Care at Home - Standard 2. 3. Service users are to be made aware in advance of the individual support staff support in a format suitable to their needs. National Care Standards - Care at Home - Management and Staffing. 4.6 Rod Wood Care Commission Officer 10/10