Leonard Cheshire Services (Scotland) - Glasgow Housing Support Service 22-24 Fulwood Avenue Knightswood Glasgow G13 4AB Telephone: 0141 954 5900 Type of inspection: Unannounced Inspection completed on: 20 September 2016 Service provided by: Leonard Cheshire Disability Service provider number: SP2003001547 Care service number: CS2004075575
About the service Leonard Cheshire (Scotland) - Glasgow provides a combined Care at Home and Housing Support Service to 19 adults with learning disabilities and physical disabilities living in their own homes. It operates 24 hours a day. The provider is Leonard Cheshire, an organisation that has support services throughout Britain, with its Headquarters in London. The service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate in 2011. There are four service sites around Glasgow, two in Parkhead, which is in the East of the city, one in Castlemilk in the South and one in Partick, which is in the North. The majority of supported individuals usually live with one or two other people. At the time of inspection, there were 19 people receiving a service. The service's information brochure describes the values of the organisation as: integrity, excellence, pioneering, valuing the individual. Its mission statement is "to work with disabled people throughout the world, regardless of their colour, race or creed by providing the environment necessary for each individual's physical, mental and spiritual wellbeing". What people told us During the course of the inspection we met 10 of the 19 people using the service in their own homes and observed interactions between staff and supported individuals. We also met a family carer and spoke with another three family carers by phone. We sent out 20 care standards questionnaire prior to the inspection and 13 of these were completed and sent back to us from family carers or from someone helping the supported person to complete the questionnaire. Overall feedback about the service and support provided was positive. People told us they felt involved in their support and knew who they could talk to if they were unhappy about anything. Relatives told us that they felt communication with the service was very good, they could raise any issues with the senior staff and described a flexible and reliable service delivered by competent and caring support workers. Comments included, "I like the staff, I like everything" "There was no service brochure, but it was a smooth move in" "Can get up when I want and go to bed when I want" "Staff treat me well" "I can choose what I want to do" "Feel safe" "Staff are good with my medical appointments" "Always someone to talk with" "I am happy here" "Keep you informed about things...problems are sorted out right away" page 2 of 7
"They give him choices...they know him very well...low turnover of staff at the moment" "I visit unannounced, no criticisms" "His behaviour is better, not agitated as much" "They pick up on health signs" "He loves going back to his home" "Welcoming". Self assessment The Care Inspectorate received a completed self-assessment from the provider. The provider identified what it thought the service did well and gave examples of improvements across some areas. We were generally happy with the relevant information included as it contained a range of information which reflected what we found during our inspection. We were pleased to note that the self assessment included evidence of outcomes for the people who use the service. There was scope to provide more of this type of evidence and show how stakeholders had taken part in the self assessment process. From this inspection we graded this service as: Quality of care and support Quality of staffing Quality of management and leadership not assessed What the service does well Supported individuals and family carers spoken with described a service which listened to their views. The service continued to develop opportunities for people to have a say in various aspects of service delivery. For example, an Open Day initiative involved them in the recruitment of new staff. Action plans were developed from local and national satisfaction surveys in response to stakeholder feedback, reflecting a service focused on continuous improvement. Staff, supported individuals and family carers spoken with felt confident that any issues would be addressed appropriately by "approachable" managers. This was welcomed for safeguarding purposes. Support and health plans were detailed, person centred and outcome focused. We noted appropriate partnerships with health professionals and others aimed at improving outcomes for people. For instance, a thriving volunteer befriending scheme enriched supported individuals' lives by improving opportunities for social inclusion and wellbeing. page 3 of 7
Staff impressed as motivated and caring, and held accountable by regular supervision, training and audit systems to ensure appropriate standards were maintained. We were pleased to note the positive feedback from family carers regarding the differences staff had made to the lives of their relative. This was summed up by one person who commented, "...my sister's care has been of a consistently good standard...every effort is made to give her a varied lifestyle and staff use their imagination and initiative in doing this." What the service could do better We noted some discrepancies in support plan paperwork, which could potentially result in inconsistency of practice and service provision. These included missed signatures, monthly reports not up to date, some health appointments not recorded in health plans and insufficient guidance around matters such as oral care, behaviour management and healthy eating. Daily diary entries could also be more evaluative to identify how the person had responded to activities to inform support plans (See Recommendation 1). Involving people in the supervision and appraisal of staff and encouraging family carers to become more involved in participation methods remained areas for improvement. Sampled records suggested that not all staff teams were holding regular enough team meetings to ensure service business was appropriately discussed and staff maintained a shared understanding of their support task. This could improve, and likewise, staff teams would benefit from more regular discussion around good practice underpinning their work, such as found at the Care Inspectorate Hub and Scottish Services Knowledge Scotland (SSSKS) websites (See Recommendation 2). The manager was in agreement with us that a service specific welcome pack of information was needed as the current service information leaflet referred to Leonard Cheshire services across the UK. Generally, observations of staff practice showed warm and caring interactions with supported individuals. However, at the Partick Service, we noted long periods of non engagement, a focus on tasks rather than the person and assistance provided for eating and drink which was contrary to the individuals' identified support plans and good practice. The manager assured us that these recurring practice issues would be addressed with staff. We advised the manager that a number of staff at the Partick Service reported that current sleepover arrangements made them feel unsafe so that she could explore this matter further with the staff team. Requirements Number of requirements: 0 Recommendations Number of recommendations: 2 1. The manager should ensure that audits of care plans are robust enough to ensure that all information is adequate, complete and current. National Care Standards (NCS) for Care at Home, Standard 4: Management and staffing arrangements page 4 of 7
2. Staff forums should include current best practice as part of ongoing agendas in order to enhance knowledge and share influences on practice. NCS, for Care at Home, Standard 4: Management and staffing arrangements Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. Inspection and grading history Date Type Gradings 7 Oct 2015 Unannounced Care and support 5 - Very good Management and leadership 5 - Very good 14 Aug 2014 Unannounced Care and support 5 - Very good Management and leadership 5 - Very good 31 Jul 2013 Announced (short notice) Care and support 5 - Very good Management and leadership 5 - Very good 17 Jul 2012 Announced (short notice) Care and support Management and leadership 13 Jun 2011 Announced (short notice) Care and support 3 - Adequate Management and leadership 3 - Adequate page 5 of 7
Date Type Gradings 12 Jul 2010 Announced Care and support 2 - Weak 3 - Adequate Management and leadership 3 - Adequate 17 Nov 2009 Announced Care and support 2 - Weak 2 - Weak Management and leadership 2 - Weak 13 Feb 2009 Announced Care and support 3 - Adequate Management and leadership 3 - Adequate 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