Crossroads Caring Scotland - Clackmannanshire Support Service 2/6 The e-centre Cooperage Way Business Park Alloa Clackmannanshire FK10 3LP Telephone: 01259216760 Type of inspection: Unannounced Inspection completed on: 1 March 2017 Service provided by: Crossroads Caring Scotland Service provider number: SP2007008963 Care service number: CS2014332299
About the service This service registered with the Care Inspectorate on 4 March 2015. The service provides a care at home service to people living in their own homes in the Clackmannanshire area. Crossroads Caring Scotland, the provider of the service, is a national voluntary organisation, Scottish Charity and a company limited by guarantee. All local services have the same mission and objectives 'to relieve stress on persons or families caring for the elderly or people with physical, mental or sensory impairment who are living at home' and 'to care in appropriate circumstances for the elderly or people with physical, mental or sensory impairment who are living alone'. What people told us We got feedback about the service from talking to people receiving support and some of their carers/main family members. We also got some feedback through questionnaires we sent out to people prior to our inspection visit. Overall, many people gave us good feedback on the service and were complimentary about the staff. However, some people told us that at times in the last year the service had not provided the support they required as well as they'd have wished. They did say, though, that it had improved again in recent months and they felt more listened to now. Self assessment The Care Inspectorate received a fully completed self-assessment from the provider. It was completed to a good standard and stated what it had done well and improvements it had made. The selfassessment clearly identified some key areas that the provider believed can be improved and showed how the service intended to do this. From this inspection we graded this service as: Quality of care and support Quality of staffing Quality of management and leadership 4 - Good 4 - Good 4 - Good Quality of care and support Findings from the inspection The service was providing a good level of care and support. People supported had regular opportunities to discuss their wishes and needs. The service was good at involving the person's main family member/carer. Overall, it assessed well people's social care and health needs. When something was not going smoothly with page 2 of 9
the home care provided to a person we found that the co-coordinator or manager was quick to try and make things better. This was good as it meant people were listened to and were happier with their support. People told us that they found it easy to talk to their support workers. They were comfortable with them and felt respected. We saw that the service had improved in its communication with people supported and their main family member/carer. For instance, people usually now were always told of any changes to the staff member visiting. Not being told about changes can be frustrating and isn't respectful so it was good to see this happening. The service had developed good local working relationships with health and social care professionals and agencies. This really helps with meeting people's needs and wishes and ensuring they stay safe, well and as happy as they can be. We discussed with the manager where we saw room for improvement. One aspect we discussed was that support plans and other information about personal risk assessments sometimes lacked detail. We thought there wasn't enough detail to guide staff. We thought that people's support file information should be examined. The service should check that documents and forms are kept in the right order in a person's file, there are no gaps in information that is meant to be there and they have had sufficient detail to be helpful. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good Quality of staffing Findings from the inspection People who received support and their carers/family members told us that they could discuss staffing with a coordinator or manager if they had a concern. They knew who the senior staff members were and felt comfortable talking to them and could easily phone them up if needed. They could also discuss these matters at review meetings. People expressed satisfaction at having regular staff members visiting. We heard from a couple of people who said knowing who was scheduled to visit in advance and knowing those staff members well, gave them peace of mind and helped them feel relaxed. When recruiting new staff the service carried out all necessary checks and induction for new staff was good. We saw that new staff shadowed more experienced staff. This meant people received support from new staff members who had been made aware of their needs, how they wished to be supported and we saw that this was one way to make sure they got appropriate support. page 3 of 9
We saw Crossroads Scotland had a programme for getting staff through training and there were opportunities to undertake a qualification in social care (Scottish Vocational Qualifications). Training and learning improves a staffs' knowledge and awareness of their responsibilities. It assists them in providing people with better support. We found the staff we spoke to were motivated and professional. People told us they found their staff members friendly and competent. We saw that co-ordinators and the manager would praise staff for supporting and caring for people well and would pass on compliments about staff that they received. Staff told us they felt supported by their line supervisors and manager. We found that the manager and the regional director were aware of more measures that the service could take to support and develop the staff team. This was positive and in talking to the management we saw they were prioritising what steps to take first. We discussed with them gaps we found in the training records and said we thought more steps should be taken around training. Each year we would expect an examination of training records to take place and for the management to carefully plan required staff training and also to identify any new training that would further develop the staff teams' skills and confidence. We made a recommendation about training (see Recommendation 1). Requirements Number of requirements: 0 Recommendations Number of recommendations: 1 1. Staff members should be up to date with all necessary training. This should be monitored and checked regularly and each year the service provider should undertake an assessment of staff training needs and set out a training plan to meet these. Scottish Social Services Council code of practice for employers 3.2. National Care Standards Care at Home. Standard 4: Management and Staffing Grade: 4 - good Quality of management and leadership Findings from the inspection People and their relatives told us that communication was good with the current management team. They would feel comfortable bringing things up with them. We saw how good communication helps people get better support. We also received and saw evidence of positive communication between the manager and coordinators and other key social care and health professionals locally. This all aids good service provision and enables people to be more satisfied and happier with their care and support. Whilst there had been some concerns about the delivery and organising of the service this had improved in page 4 of 9
recent months. We saw that a plan for improvement was being carried out and that the manager prioritised very well. It was good to see matters of poorer performance being taken seriously and the service taking steps to address these. We found the manager had an overview of day to day matters in the service. The staff team told us that generally they saw the manager and co-ordinators as supportive. It's important that the manager and senior staff are in touch with the day to day service provision and are seen as approachable and supportive. It means they can make appropriate decisions and be responsive. We found that various activities were done by the management such as monitoring checks and feedback surveys that assisted with making sure the service provision was meeting people's needs and they were happy with the service. We examined the accident and incident records at the service and found the management followed up any matters of concern. Overall, it was clear to us that the management took their responsibilities seriously and strove to provide a high standard of care and support. We had a general discussion with the service manager and regional director about steps the service provider could take to assist the progress that had been made in recent months to continue. We also discussed notifications services should submit to the Care Inspectorate about certain incidents and accidents. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Grade: 4 - good What the service has done to meet any requirements we made at or since the last inspection Previous requirements Requirement 1 The service must make sure that people's care and support is provided at the times to best meet their needs and wishes and as arranged in their personal support plans. The Social Care and Social Work Improvement Scotland (Requirement for Care Services) Regulations 2011 (SSI 2011/210 - regulation 4(1)(a), Welfare of Users - this requires providers to make proper provision for the health and welfare of service users. National Care Standards Care at Home. Standard 7: Keeping Well - Healthcare page 5 of 9
Timescale for meeting this requirement: from receipt of this report. This requirement was made on 12 April 2016. Action taken on previous requirement The service provider submitted an action plan to us on 29 April 2016 stating the actions it was taking to meet this requirement. At this inspection we found there were still instances during 2016 when people had not received there support at the agreed times. This had improved in recent months and we saw that staff rota planning was being carefully monitored by the manager as well as the coordinators. We decided that this requirement had been met but it was outside the timescales we agreed with the service provider at the previous inspection. Met - outwith timescales What the service has done to meet any recommendations we made at or since the last inspection Previous recommendations Recommendation 1 The service should make sure that people's review meetings are up to date. This will make sure that people's current care and support needs have been fully discussed and that the support provided by the service is meeting the person's needs and wishes. National Care Standards Care at Home. Standard 3: Your Personal Plan and Standard 11: Expressing your Views We found the service provider had made suitable arrangements to undertake people's review meeting and make sure their support plans were up to date and the service was meeting their wishes. This recommendation was met. Recommendation 2 The service should make sure that it manages medication in an accountable way. This includes making sure staff members have all the necessary guidance information for following best practice when they administer medication and suitable records are kept. National Care Standards Care at Home. Standard 8: Keeping Well - Medication We discussed this area with the manager and the regional director. We saw that whilst further improvements could be made, progress had been made and the service provider had identified actions it was to take. We were page 6 of 9
confident this would happen. At this current inspection we made a recommendation regarding staff training and in discussion with the manager we stated that all necessary medication training for staff should be up to date. Recommendation 3 The service should establish more ways to involve service users and carers/family members in assessing and improving staffing. Service users and carers/family members should have some involvement in staff recruitment and selection. National Care Standards Care at Home. Standard 11: Expressing Your Views We saw actions taken in this area and that the new manager was committed to enabling service user and carer/ family member involvement. We were confident there would be more examples of involvement in the coming year. Recommendation 4 All staff should have regular supervision. Scottish Social Services Council code of practice for employers 2.2. National Care Standards Care at Home. Standard 4: Management and Staffing We found that not all staff had regular supervision over the last year. We saw reasons why this was the case and a main one was disruption to the management team and a change of manager during 2016. For 2017 we saw recent supervision had taken place and that there was a plan in place for staff members supervision for the rest of 2017 with dates being set. We discussed the importance of the manager monitoring this to ensure it happens. Recommendation 5 All staff should have the opportunity to attend team meetings. Scottish Social Services Council code of practice for employers 1.4. National Care Standards Care at Home. Standard 4: Management and Staffing We found that team meetings had not taken place on a regular basis. Again we saw that a plan had been made for 2017. We discussed the importance of the team meetings for staff and the manager went over how they'd be at suitable times for most staff to be able to attend. page 7 of 9
Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. Enforcement No enforcement action has been taken against this care service since the last inspection. Inspection and grading history Date Type Gradings 2 Mar 2016 Unannounced Care and support 3 - Adequate Environment Not assessed Staffing 3 - Adequate Management and leadership 3 - Adequate page 8 of 9
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 9 of 9