Johnstone & Paisley Supported Living Services Housing Support Service 90 Burns Drive Johnstone PA5 0HB Telephone: 01505 325 422 Inspected by: Alison McEleny Type of inspection: Unannounced Inspection completed on: 22 March 2012
Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 10 4 Other information 18 5 Summary of grades 19 6 Inspection and grading history 19 Service provided by: Quarriers Service provider number: SP2003000264 Care service number: CS2009193470 Contact details for the inspector who inspected this service: Alison McEleny Telephone 0141 843 6840 Email enquiries@scswis.com Johnstone & Paisley Supported Living Services, page 2 of 20
Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 5 Very Good Quality of Staffing 5 Very Good Quality of Management and Leadership N/A What the service does well Service users and their relatives were involved in the planning of their support and assessing the service provided. Support plans contained relevant details in care plans and risk assessments. Staff training was appropriate to the care provided, staff development days and supervision meetings were held to discuss practice issues. Staff were observed to be motivated and have very good working relationships with service users and their relatives. What the service could do better The manager was informed of the changed timescales in relation to care reviews from annual to six monthly. Any amendments to support plans and reviews of risk assessments needed to be dated and signed. Where medications were 'as required', they needed to be clearly recorded in support plans. Problems with the alarm system in the Johnstone service were still evident. The Johnstone & Paisley Supported Living Services, page 3 of 20
organisation should review the alarm system to ensure that it is adequate to meet service users needs. The service needed to continue with staff supervision meetings, review the consistency of minutes across both services and the frequency of meetings. What the service has done since the last inspection The service had met the majority of the recommendations highlighted in the last inspection report. Conclusion There was evidence of the service being responsive to service users needs and progressing any areas for improvement which had resulted in improved quality grades at this inspection. Very positive feedback was received from all service users and relatives about the level of care and support provided. Who did this inspection Alison McEleny Johnstone & Paisley Supported Living Services, page 4 of 20
1 About the service we inspected Johnstone and Paisley Supported Living Services is a combined housing support and care at home service provided by Quarriers. It provides individual support to 11 adults who have learning disabilities including autistic spectrum disorders living in their own tenancies in two houses in Johnstone and Paisley. Service users have their own individual support packages and are supported with everyday household management tasks as well as being supported to participate in the community. Before 1 April 2011 this service was registered with the Care Commission. On this date the new scrutiny body, Social Care and Social Work Improvement Scotland (SCSWIS), took over the work of the Care Commission, including the registration of care services. This means that from 1 April 2011 this service continued its registration under the new body, SCSWIS. The service aims to provide individuals with support to live in their own tenancies in the community and operates in a flexible way based on individual need and uses a person centred approach. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 5 - Very Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - N/A This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website www.scswis.com or by calling us on 0845 600 9527 or visiting one of our offices. Johnstone & Paisley Supported Living Services, page 5 of 20
2 How we inspected this service The level of inspection we carried out In this service we carried out a medium intensity inspection. We carry out these inspections where we have assessed the service may need a more intense inspection. What we did during the inspection This report was written following a short notice inspection which was carried out on the 22 March 2012 between 10:00 am and 6.00 pm. Feedback was provided at the end of the inspection visit. As requested by us, the care service sent a self assessment and an annual return We issued questionnaires to relatives and staff. Seven completed questionnaires were returned before the inspection. In this inspection we gathered evidence from various sources, including the relevant sections of policies, procedures, records and other documents, including: * Service users support plans * Staff training and supervision records * Meeting minutes * Discussions with service users, staff and manager. Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Johnstone & Paisley Supported Living Services, page 6 of 20
Fire safety issues Inspection report continued We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org Johnstone & Paisley Supported Living Services, page 7 of 20
What the service has done to meet any recommendations we made at our last inspection Statement 1.1 People using the service and, if appropriate, their families should be notified in advance of any changes to their worker. Progress reported under Statement 1.1. Met. Statement 1.3 The service should ensure that accurate records are kept when helping people to take their medication. Progress reported under Statement 1.3. Met. Statement 3.3 Staff should have the opportunity to discuss practice in order to feel confident in difficult situations. Progress reported under Statement 3.3. Met. Statement 4.4 Parents or families of people who use the service should be made aware of how to make a complaint or comment on the service. Progress reported under Statement 1.1. Met. The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Johnstone & Paisley Supported Living Services, page 8 of 20
Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. We received a fully completed self assessment document from the service provider. We were satisfied with the way the service provider had completed this and with the relevant information they had given us for each of the headings that we grade them under. The service provider identified what they thought they did well, some areas for development and any changes they planned. The service provider told us how the people who used the care service had taken part in the self assessment process. Taking the views of people using the care service into account Service users were spoken with during the inspection visit. Any feedback or comments received are highlighted within the report. Taking carers' views into account Three questionnaires were returned from relatives. They agreed that they were happy with the overall quality of care received. Some comments received were: 'the level and input of some support workers could be improved with better supervision and training' 'some are better than others' Johnstone & Paisley Supported Living Services, page 9 of 20
3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths The organisation had a Participation Strategy which detailed how services user would be involved in their support and service development. The strategy aimed to help develop, deliver and promote ways of achieving active and effective participation of people within services. It stated that 'people we supports' involvement in decision making is fundamental to an effective service' and 'the people we support want us to listen and act upon decisions made together'. We saw minutes of weekly group planning and individual meetings to discuss areas such as menu planning, shopping, activities, any suggestions and issues. Individual meetings showed discussions about their support and needs. Any issues raised were addressed. One example given related to one service user who was unhappy about their staffing arrangements was able to discuss this with the manager and immediate steps were taken to address the situation. Service users and relatives spoken with during the inspection visit, confirmed that the service involved them in decision making and that they were very happy with the level of involvement. The inspection questionnaires returned from relatives indicated that they had a support plan which detailed their support needs and preferences, the service asked for their opinions about how to improve and regularly checked that they were meeting their needs. They were also happy with the overall quality of care and support provided. Areas for improvement The service should continue with the current processes in place. Johnstone & Paisley Supported Living Services, page 10 of 20
The service's self assessment indicated that they were looking at developing a satisfaction questionnaire for both people they supported and their relatives. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Johnstone & Paisley Supported Living Services, page 11 of 20
Statement 3 We ensure that service user's health and wellbeing needs are met. Service strengths Each service user had an individual and person centred support plan. Two support plans were viewed, one from each house. There was a very good level of detail throughout the support plans with any changes to care recorded. There were details about relevant personal information, communication, religion, important dates, reviews, amendments, health care including medication, weekly and daily routines, finances and future plans. Specific guidelines for managing behaviours that challenge were also evident. There were very good health intervention records indicating health checks and input from health professionals such as psychologist, chiropodist, dentist, GP, Community Psychiatric Nurse and optician. The staff team and those involved in the service user's support, including relatives and advocacy were evident. Medication records viewed showed no gaps in the administration of medication. Individual finance records were kept and included a budget plan including regular income and expenditure. The organisation's finance audit was due to be carried out soon. The Team Leader carried out monthly checks on each service user's communication diary, medication, risk assessment, financial, cleaning schedule, menu, shopping and activity records. We were told that the concerns highlighted in the last inspection report about the number of people using the kitchen in the Paisley service at any one time to prepare meals had been addressed. Areas for improvement Inspection report continued The manager was informed of the changed timescales in relation to care reviews from annual to six monthly. Any amendments to support plans and reviews of risk assessments should be dated and signed. Where medications were 'as required', how these were to be used and when needed to be clearly recorded in support plans. Medication records should also accurately record the amount and the date received. Handwritten scripts should be countersigned by two staff. Johnstone & Paisley Supported Living Services, page 12 of 20
Problems with the alarm system in the Johnstone service were still evident. The manager stated that the alarm company had visited regularly but that they were not able to alter the system as was needed. The organisation should review the alarm system to ensure that it was adequate to meet service users needs. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Johnstone & Paisley Supported Living Services, page 13 of 20
Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths The methods of service user participation reported in statement 1.1 remain relevant for this statement. The service's self assessment stated, 'when we are recruiting staff the known needs and preferences of individuals are seriously taken into account giving particular attention to gender preferences'. Service users and relatives spoken with during the inspection visit were all very positive about the staff who worked in the service. The inspection questionnaires returned from relatives indicated that: * staff treated service users with respect * they were confident that the staff had the skills to support service users * staff had enough time to carry out the agreed support and care. Areas for improvement The areas for development reported in statement 1.1 remain relevant for this statement. Alternative ways of involving people in recruiting staff other then being directly involved in the interview should be considered. Involvement in staff appraisals and training should also be considered. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Johnstone & Paisley Supported Living Services, page 14 of 20
Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Inspection report continued The organisation has a training programme in place to ensure staff are aware of the importance of service user's health and well-being needs. Courses included administration of medication, protection of vulnerable adults, food hygiene and supporting people in the community. The service had a staff induction programme which included training and the opportunity to shadow more experienced staff when they started. Staff local induction days had been held in December 2011 and March 2012 which included recording procedures, individual support plans, training requirements, in-house protocols, roles and responsibilities. The organisation had a training plan with various topics and dates. Staff choose relevant topics to attend including mandatory updates such as safer handling of people, child protection, medication administration, adult protection, autism 1-3, disability awareness, first aid, epilepsy and rescue medication. Individual staff training records showed that staff had received training in epilepsy awareness, administration of medication, adult protection, autism, intensive interaction, CALM, rescue medication, safe handing of people, food hygiene, fire risk assessment, infection control, working with difficult people and person centred approaches. Staff development days had been held regular throughout 2011 with the latest one being held in March 2012. These covered topics such as positive behaviour intervention strategies, accident and incident recording, fire training, team building exercises, risk assessments, development plans and policies. There was evidence of some supervision meetings with staff where training, any service user or personal issues were discussed. Staff were observed to be motivated and have very good working relationships with service users and their relatives. The staff questionnaires returned and staff spoken with indicated that they felt supported and received relevant training to support service users. Areas for improvement The format of the supervision record was different between each house and the frequency of meetings were not regular (see Recommendation 1). Johnstone & Paisley Supported Living Services, page 15 of 20
Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. The service should continue with staff supervision meetings, review the consistency of minutes across both services and the frequency of meetings. National Care Standards for Care at Home: Standard 4 - Management and staffing arrangements; National Care Standards for Housing Support services: Standard 3 - Management and staffing arrangements. Johnstone & Paisley Supported Living Services, page 16 of 20
Quality Theme 4: Quality of Management and Leadership - NOT ASSESSED Johnstone & Paisley Supported Living Services, page 17 of 20
4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information None. Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1). Johnstone & Paisley Supported Living Services, page 18 of 20
5 Summary of grades Quality of Care and Support - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Staffing - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Management and Leadership - Not Assessed 6 Inspection and grading history Date Type Gradings 23 Jun 2010 Announced Care and support 4 - Good Staffing 4 - Good Management and Leadership 3 - Adequate All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Johnstone & Paisley Supported Living Services, page 19 of 20
To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on 0845 600 9527. This inspection report is published by SCSWIS. You can get more copies of this report and others by downloading it from our website: www.scswis.com or by telephoning 0845 600 9527. Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: 0845 600 9527 Email: enquiries@scswis.com Web: www.scswis.com Johnstone & Paisley Supported Living Services, page 20 of 20