Hamilton/Blantyre/Larkhall Home Care Service Housing Support Service
Social Work Resources Brandon Gate 1 Leechlee Road Hamilton ML3 0XB
Telephone: 0303 123 1008
Type of inspection: Unannounced Inspection completed on: 29 July 2016
Service provided by: Service provider number: South Lanarkshire Council SP2003003481
Care service number: CS2004073570 Inspection report
About the service
Hamilton/Blantyre/Larkhall Homecare Service is delivered to people who live in these areas of South Lanarkshire. The provider for this registered service is South Lanarkshire Council.
The home support service is available to older people, younger adults and children and families who have had a needs assessment completed.
The care and support service is managed by a team of Community Support Co-ordinators and delivered by a trained and motivated dispersed Home Care Support Workers delivering personal care, extended personal care, meals and shopping.
Service users are also supported by the Integrated Community Support Team located at a local hospital and the providers own out of hours service Community Alarm which operates twenty-four hours a day three hundred and sixty-five days per year.
The introduction to the service user's guide says: "The Home Care Service offers personal, social, emotional and practical support to service users and their families. It aims to ensure that people are maintained and supported in their own home for as long as possible".
What people told us
We sent out Care Inspectorate questionnaires before the inspection and had thirteen returned prior to writing this report. The responders ticked the question that overall satisfaction was strongly agree or agree although the written comments varied on experience and satisfaction of the service delivery.
"I am satisfied with care I receive, although I would like if the carers had more time"
"I think those who walk could do with a bit more time to get from A to B"
"One day when I required personal care I found a carer to stand and gloat. I hope this never happens again"
"The support staff do an excellent job. However in the short time I have had care there have been constant changes of staff and changes to arrival times. More regular staff would be more helpful to me and to the staff, we could establish a routine"
We spoke service users and their partners or carers at the Participation Meeting who were overall very happy with the service and spoke highly of the home carers.
"My relative receives excellent care"
"My parents are both extremely happy with the support and care provided by their regular carers and can't thank them enough for the care and attention provided. The only improvement they feel could be made is perhaps the provision of a little more time to perform their care".
"I requested for someone to come in and shower my relative and there has been a lengthy time lapse and we have still not heard from anyone. I find this unacceptable due to my elativesr age".
Inspection report for Hamilton/Blantyre/Larkhall Home Care Service page 2 of 12 Inspection report
Self assessment
We received a fully completed self assessment document from the service provider who graded themselves across all the statements good and very good. 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 are consulted to give their views and opinions about the support they receive; quality of service and how they think it could be improved.
The views of employees are also sought by the provider.
From this inspection we graded this service as:
Quality of care and support 4 - Good Quality of staffing 4 - Good Quality of management and leadership 4 - Good
Quality of care and support
Findings from the inspection The ethos of home support service is to deliver a person centred care service that enables the individual to retain their daily living skills and remain in their own home for as long as is physically possible and safe to do so. In Hamilton, Blantyre and Larkhall there are four hundred part-time home care workers providing care and support to over one thousand one hundred service users.
All parties are involved in the development of the individuals support plan through the assessment process and review of the support plan every six months or more frequently when required. People who use the service are provided with a copy of their care plan and a customer Welcome Pack which provides contact details including phone numbers and email addresses.
The Provider has a number of policies and procedures including the Complaints Policy and Procedure which is made available to all users of the care service. The service had evidence of comments, Compliments and Complaints recorded as well as thank you cards.
All persons who use the service are invited to join the Participation group and attend twice yearly meetings or quarterly surgery type events as well as completing a Satisfaction Survey or Questionnaire. The outcome of the in house survey is collated and circulated, permits comments to be recorded and indicate the level of overall satisfaction an individual has regarding their own day-to-day support and activities and evaluate the services and that of the staff.
The dispersed home care workforce is managed by the Community Support Co-ordinators for each of the geographical areas. The Co-ordinators supervise their Home Carers quality of care delivered, competency to implement the training they have received, complete the six month reviews of the care plans, organise and communicate the service delivery. The service is supported by administrators located at the office base.
Inspection report for Hamilton/Blantyre/Larkhall Home Care Service page 3 of 12 Inspection report
The assessment process, through interview either at a home visit or referral from hospital services provide the information which is developed into the support plans relating to the individuals social and health care needs to retain skills of daily living. We sampled a number of individuals support plan details held on the Social Work Information System and the hard copies held in the office.
People who use the support service also have access to other South Lanarkshire Services including the out of hours service accessible by the individual using the ALERT alarm, normally worn as a pendant around the neck or on a wrist band.
A recent addition to the service is the Integrated Community Support Team "ICST Team" which provides overnight support to a number of people who use the service whose assessed needs meet the criteria for this specific section of the support service.
South Lanarkshire Council and NHS Lanarkshire are working in partnership to evaluate the new medicines management system for people who live at home. There is a clear delineation of levels of assistance assessed, identified and provided. Medication record sheets are in place where and when required.
Staff receive training from the provider before they are deemed competent to administer medication; keeping accurate records and ensuring the storage of the individuals prescriptions are safe, secure and at appropriate temperature. Service users use the primary health care team in the community and staff have details how to access said.
Staff also received various specialised training to meet the assessed needs of the individual, including Nutrition and Infection Control, to protect the nutrition and hydration requirements of the individual.
Home care staff make use of receipt books supplied by the provider to retain clear records of a financial nature on behalf of the service user.
Since the last inspection there have been refinements of the internal systems with siting operational staff in the local hospitals to improve the discharge plan. Occupational therapists are easily accessible through "Supporting Your Independence" to assist with goal setting and variation to the package of care.
Requirements Number of requirements: 0
Recommendations Number of recommendations: 0
Grade: 4 - good
Quality of staffing
Findings from the inspection The provider has a recruitment policy and procedure in place. The care service has a rolling programme for the recruitment of home care workers and the interview process.
Inspection report for Hamilton/Blantyre/Larkhall Home Care Service page 4 of 12 Inspection report
New employees are interviewed by a panel who score the individual against a set criteria. Prior to an offer of employment the provider completes the Safer Recruitment process which is inclusive of references and Protection of Vulnerable Groups check. The successful applicant then participates in the Home Care Induction programme over a designated period and shadows an experienced member of staff prior to working alone with their own allocated caseload. South Lanarkshire Council employees receive a handbook, receipt book, specialised and communication tools and personal protective clothing.
The provider had evidence of training calendar and there was the facility to print off an overview spreadsheet for the full staff group of courses run and attended. Each member of staff has their own training record held on the information technology system and these are used at times of supervision and personal development meetings. Records are in place showing name of attendees at the training topic, date and venue and who delivered the course. The attendees are requested to complete an evaluation form to express their learning achievements regarding content.
2016 has seen a number of specialised training courses, having been made available to staff via the Learning and Development Section of the organisation, such as Palliative Care, Continence Care, Enhanced Level Dementia Workshop, Adult Support and Protection and other courses have focussed on the home care scheduling and core caring skills for home carers.
Staff have recognised qualifications Scottish ocationalV Qualifications at level 2, 3 and 4 and are already or are in preparation to register with Scottish Social Services Council.
We discussed with management that the staff all should have a copy and understand their Code of Conduct and when registered it is the start of a journey and requires them to complete specified hours of continuous learning to ensure they retain their registration.
We attended a "Patch" meeting held by the Co-ordinator with a number of the home care workers in the Blantyre area. Staff are also supported in their roles and responsibilities by planned supervision and personal development meetings with their Co-ordinator. The Co-ordinators indicated their manager had an "open door policy" and easily available to speak to as well as planned supervision meetings.
We received ten completed staff Care Inspectorate questionnaires prior to writing this report. Feedback from home support workers were that:
"the training given at the beginning of my employment was very good also the training is on going throughout the years always improving knowledge and skills".
"My colleagues are very helpful and keep me up to date" but to improve "could be made aware of any mental health issues or physical conditions of an individual could have which may help when attending" and if "there should be two workers at any one time".
"Care and support are always given in the interest of the service users, making sure everything meets the service users needs, although there will always be room for improvement concerning both service users and staff".
Requirements Number of requirements: 0
Inspection report for Hamilton/Blantyre/Larkhall Home Care Service page 5 of 12 Inspection report
Recommendations Number of recommendations: 0
Grade: 4 - good
Quality of management and leadership
Findings from the inspection Since the last inspection the integration process has taken place and South Lanarkshire Health and Social Care Partnership is in place and the draft strategic commissioning plan for the next three years has been developed.
The provider produces publications and information leaflets and these are accessible to the general public and service users at all the front-facing offices across South Lanarkshire. The provider also has policies procedures for the safety and welfare of their employees including risk assessments and lone working protection.
The Provider has a commitment to quality assurance for this local authority service through:
- Policies and procedures available in electronic and hard-copy - On call system twenty-four hours per day, three hundred and sixty-five days per year - Information technology provided statistics and reports.
The care plans sampled reflected that risk assessment tools are completed on every occasion for specific areas and actions to be taken to reduce hazards. The senior management of the service have various methods of identifying and ensuring that the care plans are reviewed six monthly or more frequently where required to meet the legislative requirement. There was a lack of detail that all interested parties are invited to attend or contribute to the care plan review process
The people who use the services are invited to express their views with regards to quality of care and support, staff and management via provider's inhouse surveys and participation meetings.
The staff are invited to attend Practioner Forum Groups and Home Care Consultation surveys, team briefings and meetings, management meetings and inter-agency dialogue. All meetings have an agenda, which staff state they can add to when required, minutes generated and an outcome action plan put in place.
Communication is also enhanced through the Home Care Service Newsletter, Core Brief and the Integration News Bulletin to keep all employees updated with the direction of travel of the organisation.
A quote from a member of staff during the inspection process "lots of change in the last year for the better".
This is a large service and we experienced that the present structure of the service was from the bottom up and this was an ongoing process to ensure efficiency and effectiveness of service delivery and positive outcomes for people who use the service. Future developments are planned for the improvement to the phone communication used by employees in the field.
Inspection report for Hamilton/Blantyre/Larkhall Home Care Service page 6 of 12 Inspection report
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 provider must ensure all service user have a meaningful and effective care plan which has been produced in conjunction with the service user. This is to comply with: The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011-Personal plans. 5 - (3) A provider must, after consultation with each service user and where it appears to the provider to be appropriate, any representative of the service user, within twenty-eight days on which the service user first eceivedr the service prepare a written plan which sets out how the service user's health, welfare and safety needs are to be met.
Timescale: All service users to have a care plan within four months of receipt of this report.
This requirement was made on 9 February 2015.
Action taken on previous requirement As in requirement 2 this is met and is an ongoing part of the service review by management.
Met - outwith timescales
Requirement 2
The provider must ensure care plans detail service user's health, welfare and safety needs.
This is to comply with:
SSI regulations 2011-Welfare of service users 4-(1) a provider must make proper provision for the health, welfare and safety of service users.
All care plans to have: - Risk assessments and moving and assisting assessments - Moving and assisting guidance for staff
Inspection report for Hamilton/Blantyre/Larkhall Home Care Service page 7 of 12 Inspection report
- Clear and consistent information and guidance on tasks to be carried out by staff - Consistent recording of information by home carers.
Timescale: To be completed by end of March 2016.
This requirement was made on 7 October 2015.
Action taken on previous requirement SWIS IT system and hard copies of care plans, available in the individuals home, have when required to meet the individuals assessed needs the following documents as part of the personal care plan:
- Risk assessments and moving and assisting assessments - Moving and assisting guidance for staff - Clear and consistent information and guidance on tasks to be carried out by staff - Consistent recording of information by home carers.
The staff complete care service reviews of the care plans to ensure they reflect the needs of the service user.
Met - outwith timescales
What the service has done to meet any recommendations we made at or since the last inspection
Previous recommendations
Recommendation 1
Service users should be offered choices about how their service is delivered. National Care Standards, Housing Support Services, Standard 4, Housing support planning.
This recommendation was made on 9 February 2015.
Action taken on previous recommendation Through "Support Your Independence" and "About Me" give staff the information on what the individual wishes & how their care is to be delivered however the provider is aware that the delivery of care could be more person centres as it presently continues to be time and task orientated.
This recommendation is met.
Recommendation 2
The service should continue with their programme to hold six monthly reviews with all service users.
National Care Standards, Housing Support Services, Standard 4, Housing Support Planning.
Inspection report for Hamilton/Blantyre/Larkhall Home Care Service page 8 of 12 Inspection report
This recommendation was made on 7 October 2015.
Action taken on previous recommendation Evidence of assessment and review coordinators who are allocated workload by Team Leader and their progress and impact are screened through supervision.
The frequency of reviews will be part of future inspections because at this time the service were unable to show an at glance overview through audit process that everyone has had two reviews since the last inspection.
This recommendation is met.
Recommendation 3
Staff should have palliative care training.
National Care Standards, Housing Support Service, Standard 3, Management and Staffing Arrangements.
This recommendation was made on 7 October 2015.
Action taken on previous recommendation Palliative Care training has taken place and supported by the Specialist Palliative Nursing Team within NHS Lanarkshire.
This recommendation is met.
Recommendation 4
The roll out of dementia training should continue for all staff.
National Care Standards, Housing Support Service, Standard 3, Management and Staffing Arrangements.
This recommendation was made on 7 October 2015.
Action taken on previous recommendation Dementia training has taken place and continuing to roll out, supported by the Operational Manager with responsibility for training.
This recommendation is met.
Complaints
Please see Care Inspectorate website (www.careinspectorate.com) for details of complaints about the service which have been upheld.
Inspection report for Hamilton/Blantyre/Larkhall Home Care Service page 9 of 12 Inspection report
Enforcement
No enforcement action has been taken against this care service since the last inspection.
Inspection and grading history
Date Type Gradings 24 Aug 2015 Unannounced Care and support 2 - Weak Environment Not assessed Staffing 4 - Good Management and leadership 3 - Adequate
9 Feb 2015 Unannounced Care and support 2 - Weak Environment Not assessed Staffing 3 - Adequate Management and leadership 3 - Adequate
28 Mar 2014 Unannounced Care and support 3 - Adequate Environment Not assessed Staffing 5 - Very good Management and leadership 3 - Adequate
29 Mar 2013 Announced (short notice) Care and support 4 - Good Environment Not assessed Staffing 5 - Very good Management and leadership 5 - Very good
23 Feb 2012 Unannounced Care and support 4 - Good Environment Not assessed Staffing 5 - Very good Management and leadership 5 - Very good
17 Dec 2010 Announced Care and support 5 - Very good Environment Not assessed Staffing Not assessed Management and leadership 5 - Very good
11 Nov 2009 Announced Care and support 4 - Good Environment Not assessed
Inspection report for Hamilton/Blantyre/Larkhall Home Care Service page 10 of 12 Inspection report
Date Type Gradings Staffing 4 - Good Management and leadership 4 - Good
4 Feb 2009 Announced Care and support 5 - Very good Environment Not assessed Staffing 5 - Very good Management and leadership 4 - Good
Inspection report for Hamilton/Blantyre/Larkhall Home Care Service page 11 of 12 Inspection report
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