Ballantrae Rural Initiative Care in the Community Ltd Support Service
12 Main Street Ballantrae Girvan KA26 0NB
Telephone: 01465 831380
Type of inspection: Announced (short notice)
Completed on: 19 July 2019
Service provided by: Service provider number: Ballantrae Rural Initiative Care in the SP2004004419 Community Ltd
Service no: CS2004073930 Inspection report
About the service
The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at www.careinspectorate.com
This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April 2011.
Ballantrae Rural Initiative Care in the Community Ltd (BRICC) is registered to provide a service to adults with support needs living in their own homes. With support being carried out by one staff team.
Since the last inspection a variation had been submitted to remove previous condition 4 and their registration certificate had been updated accordingly.
A voluntary board of trustees provides the service. The BRICC office is located within the centre of the village of Ballantrae in South Ayrshire. Services are available on a private basis, via direct payment and by contractual arrangement with South Ayrshire Council.
The service covers Maidens, Girvan, Ballantrae, Dailly, Barr and the outlying communities.
The aims of the service are to support the care to suit the needs of each person, for the elderly, frail or people in need by providing a reliable, flexible, professional service so they can maintain their independence and live in their own homes for as long as possible.
During the inspection there were 118 people using the service from the ages 46 years old of to 96 years old with packages ranging from 15 Minutes per day to four hours per day,
What people told us
During the inspection we received feedback from 38 service users and relatives who all agreed they were very happy with the quality of care and support the service gave them. People were very happy that their needs were being met and were highly complimentary of the staff who they told us were approachable, friendly and caring and knew them well.
Service users and relatives were given rotas in advance and knew who to expect (apart from initial visits, see areas for improvement). They told us staff turned up within timescales agreed and would stay for the full support times. People knew about office staff and how to contact them if their needs changed.
We received the following comments:
"I feel the service can't improve. The carers do all they can for me".
"My relatives carers are great, especially her main carer".
"It's the attention to the little things they do that make all the difference".
"The service is excellent and I count myself very lucky".
Inspection report for Ballantrae Rural Initiative Care in the Community Ltd page 2 of 10 Inspection report
"The service is brilliant. I have the same carers and they come on time".
"The service is brilliant. Carers adjust times to support me as and when needed".
"One of my carers is almost one of the family".
"This service has exceptional staff".
Self assessment
The service had not been asked to complete a self-assessment in advance of the inspection. We looked at their improvement plan and quality assurance paperwork. These demonstrated their priorities for development and how they were monitoring the quality of the provision within the service.
From this inspection we graded this service as:
Quality of care and support 5 - Very Good Quality of staffing 5 - Very Good Quality of management and leadership not assessed
What the service does well
Service users experienced a very good standard of care and support at a relaxed pace with dignity and respect from staff, who believed in their potential and recognised they were experts in their own experiences needs and wishes. Staff attended to various care needs in partnership with service users and relatives to ensure things were done in a way they were used to. As a result of this, service users felt accepted, valued, included and involved.
Empowering, positive and fun relationships were formed between service users relatives and staff who spoke to individuals in a way that was familiar, courteous and respectful, with their care needs being the main focus of their attention.
Individuals were getting the most out of life because the staff supporting them had a professional, caring, fun and enabling attitude and service users looked forward to their visits. People were encouraged and supported to make informed life style choices affecting their health and wellbeing and maintain and develop their independence, interests and activities, and managing relationships with families and friends.
Individuals received support to attend various appointments and social events (which they would otherwise miss) out with support, by staff who had a good awareness of the impact of continuing to attend meaningful events and activities for individuals. This meant that people were free from isolation and remained active members within their close knit and supportive community.
Changes were made to individuals care packages and support times in response to changes in individuals needs and circumstances giving individuals a better quality of life at times beneficial to them. Care and support was consistent and stable because staff worked very well together and shadowed each other to meet new service users before support.
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The service manager was aware that individuals could not always be met on initial support visits due to tight timescales to start their packages and was considering how this could be prevented.
People had confidence in staff who were trained competent and skilled and followed their professional codes of conduct caring for individuals sensitively following best practice especially when moving and handling and attending to food hygiene. They felt comfortable safe and in control as a result of this. Personal care was carried out in a dignified way with privacy and personal preferences respected.
People using the service were protected from harm by staff who had a clear understanding of their responsibilities and were sensitive, alert and responsive to any signs of changes and deterioration in individual's health and well being. Various ailments and illnesses were timeously addressed as a result of this.
The service manager maintained good professional working relationships with other members of the multi disciplinary team such as, social workers local authority and General Practitioners (GP). Holding regular meetings to ensure service users experienced consistency and continuity and during unexpected events and emergencies.
The service promoted a positive culture through their participation policy, which valued the contribution of people supported, in assessing and improving the quality of the service provided through: annual surveys, news letters, daily discussions during support and feedback during staff induction. People were informed about changes within the service as a result of these.
Staff continued to undergo the Protection of Vulnerable Groups (PVG) checks and continued to be registered or applying to be registered with the appropriate professional bodies such as; Nursing and Midwifery Council (NMC) or Scottish Social Services Council (SSSC). This made sure they were competent and safe to work alone with service users in their own homes.
What the service could do better
Service information was variable within people's folders. The service information booklets and the service website needed reviewed to ensure that service users had up-to-date information needed to help them decide about using the care service and how it complies with the Health and Social Care Standards. Area for improvement 1
People knew how to raise a concern or make a complaint about their care and support, however, these were not always fully recorded, reviewed and evaluated to ensure they were satisfactorily addressed. Timescales for completion of formal investigations needed updated. Area for improvement 2
Care plans reflected individuals needs wishes and choices, however, they lacked some detailed information recording previous life histories and how individuals needs would be clearly met. They contained summarised information which did not always reflect the care being delivered Risk assessments contained limited information regarding risks identified and how they should be safely addressed reviewed and monitored.
There was limited reference to best practice regarding moving and handling equipment and administering of medication following locality procedures including appropriate paperwork to be completed, reviewed and evaluated.
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Although routine reviews of personal plans were taking place, there was no clear evidence to show routine six monthly reviews for everyone. Meeting minutes were not provided and there were no clear records of discussions taking place and actions agreed for review and evaluation. Area for improvement 3
Although accidents and incidents were acted upon to ensure service users remained safe and protected these were not always recorded reviewed and evaluated or reported to the Care Inspectorate as part of the service quality assurance processes. Policies and procedures needed reviewed to ensure they included up-to-date information legislation and best practice. Area for improvement 4
Care staff were undergoing various aspects of best practice skilled levels of dementia training focusing on understanding the rights of people living with dementia. As a result of this, service users were being recognised and accepted for who they were and were treated with dignity and respect.
The service manager was considering how training could be completed for all staff to ensure relevant areas of the Promoting Excellence framework (developed by Scottish Social Services Council and NHS, which care services have been expected to follow) was accessed. Area for improvement 5
Requirements Number of requirements: 0
Recommendations Number of recommendations: 5
1. The service manager should ensure that service users have all the information needed to help them decide about using the care service at home. All service users should have access to a service information pack which remains up-to-date and relevant, including reference to Health and Social Care Standards and information about the service participation policy and how their feedback will impact on future service delivery. These should be completed in a format or language that is right for all individuals to understand. The service manager should consider how stakeholders and staff can be included in feedback about service delivery.
Health and Social Care Standards, My support my life; 1: I experience high quality care and support that is right for me. 1.17 I can choose from a wide range of services and providers as possible, which have been planned, commissioned and procured to meet my needs. 1.18 I have time and necessary assistance to understand the planned care, support, therapy or intervention I will receive, including any costs, before deciding what is right for me. 4: I have confidence in the organisation providing my care and support. 4.19 I benefit from a culture of continuous improvement, with the organisation having robust and transparent quality assurance processes.
2. The service manager should ensure that all concerns and complaints are satisfactorily and timeously addressed, reviewed and evaluated following the service complaints procedures.
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Health and Social Care Standards, My support my life; 1: I experience high quality care and support that is right for me. 4: I have confidence in the organisation providing my care and support. 4.19 I benefit from a culture of continuous improvement, with the organisation having robust and transparent quality assurance processes. 4.20: I know how, and can be helped, to make a complaint or raise a concern about my care and support. 4.21: If I have a concern or a complaint, this will be discussed with me and acted on without negative consequences for me.
3. The service manager should ensure that all care plan documentation is fully completed and reviewed detailing up-to-date information regarding how individual needs and wishes will be met with reference to best practice guidance in areas such as, moving and handling, and administering medication. Risk assessments should be clearly identified and addressed with routine review and evaluation. They should be signed and dated following best practice.
Health and Social Care Standards, My support my life; 1: I experience high quality care and support that is right for me. 1.12 I am fully involved in assessing my emotional, psychological, social and physical needs at an early stage, regularly and when my needs change. 1.15 My personal plan sometimes called my care plan) is right for me because it sets out how my needs and wishes will be met, as well as my wishes and choices. 3: I have confidence in the people who support and care for me. 3.4 I am confident that the right people are fully informed about my past, including my health and care experience, and any impact this has on me. 4: I have confidence in the organisation providing my care and support. 4.19 I benefit from a culture of continuous improvement, with the organisation having robust and transparent quality assurance processes.
4. The service manager should ensure that policies and procedures are routinely reviewed and updated to include current legislation and best practice. This should include a detailed and comprehensive accident and incidents policy which is fully understood and followed by all staff.
Health and Social Care Standards, My support My life; 4: I have confidence in the organisation providing my care and support Wellbeing. 4..27 I experience high quality care and support because people have the necessary information and resources.
5. The service manager should ensure that staff complete the dementia training outlined in the Promoting Excellence Framework developed by Scottish Social Services Council and NHS Scotland as part of the Scottish Government's Dementia Strategy.
Health and Social Care Standards, My support my life; 3 I have confidence in the people who support and care for me. 3.14 I have confidence in people because they are trained, competent and skilled, and are able to reflect on their practice and follow their professional and organizational codes. 4: I have confidence in the organisation providing my care and support. 4.19 I benefit from a culture of continuous improvement, with the organisation having robust and transparent quality assurance processes.
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We signposted the service manager to the following: www.ssks.org.uk Social Services Knowledge Scotland/Dementia Promoting Excellence.
Complaints
There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com.
What the service has done to meet any requirements we made at or since the last inspection
Previous requirements
There are no outstanding requirements.
What the service has done to meet any recommendations we made at or since the last inspection
Previous recommendations
There are no outstanding recommendations.
Inspection and grading history
Date Type Gradings 1 Aug 2018 Unannounced Care and support 5 - Very good Environment Not assessed Staffing Not assessed Management and leadership 5 - Very good
30 May 2017 Unannounced Care and support 5 - Very good
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Date Type Gradings Environment Not assessed Staffing Not assessed Management and leadership 5 - Very good
16 Aug 2016 Unannounced Care and support 6 - Excellent Environment Not assessed Staffing 6 - Excellent Management and leadership Not assessed
20 Aug 2015 Unannounced Care and support 6 - Excellent Environment Not assessed Staffing 6 - Excellent Management and leadership 5 - Very good
16 Jun 2014 Unannounced Care and support 5 - Very good Environment Not assessed Staffing 5 - Very good Management and leadership 5 - Very good
17 May 2013 Unannounced Care and support 4 - Good Environment Not assessed Staffing 5 - Very good Management and leadership 4 - Good
5 Jul 2012 Unannounced Care and support 5 - Very good Environment Not assessed Staffing 4 - Good Management and leadership 5 - Very good
1 Dec 2010 Announced Care and support 4 - Good Environment Not assessed Staffing 3 - Adequate Management and leadership 4 - Good
10 Feb 2010 Announced Care and support 4 - Good Environment Not assessed Staffing 3 - Adequate Management and leadership 3 - Adequate
19 Feb 2009 Announced Care and support 4 - Good
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Date Type Gradings Environment Not assessed Staffing 4 - Good Management and leadership 3 - Adequate
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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.
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Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas.
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