Fernlea, The Wishart Anderson (Support Service) Support Service Fernlea The Wishart Anderson Centre Marrister Whalsay ZE2 9AE Inspected by: Allan Barker (Care Commission Officer) Type of inspection: Announced Inspection completed on: 13 October 2005 1/9 Service Number Service name CS2005097965 Fernlea, The Wishart Anderson (Support Service) Service address Fernlea The Wishart Anderson Centre Marrister Whalsay ZE2 9AE dummy Provider Number Provider Name SP2003002063 Shetland Islands Council dummy Inspected By Inspection Type Allan Barker Announced Care Commission Officer dummy Inspection Completed Period since last inspection 13 October 2005 11 Months dummy Local Office Address Room 205 / 222 Charlotte House Commercial Road Lerwick Shetland ZE1 0HF dummy 2/9 Introduction Fernlea, The Wishart Anderson Care Centre, was a purpose built residential centre with an adjoining day care facility. The service, situated in Marrister on Whalsay, overlooked the picturesque Linga Sound. The service was registered to provide a support service to a maximum of eight adults on a daily basis. The service presently operated two days a week. The support service had a separate service entrance and own staffing compliment. The accommodation consisted of various rooms including, bathroom facilities, a lounge and activity area, kitchen /dining room and two offices. The areas were decorated with photographs and artwork and was of a homely-like appearance. The care service, previously operated by Shetland Welfare Trust had recently been transferred over to Shetland Islands Council, social care department. Basis of Report This report was based on consideration of the service's compliance with the regulations associated with the Regulation of Care (Scotland) Act 2001, as well as taking account any requirements, recommendations, or areas of development identified from the inspection of 23 November 2004. The inspection focussed on the sections of The Regulation Care (requirements as to Care Services) (Scotland) Regulations 2002, Statutory Instrument 114, and took account of the National Care Standards for Support Services. Standard 1. Informing and Deciding. Standard 2. Management and Staffing Arrangements. Standard 4. Support Arrangements. Standard 6. First Meetings. Standard 10. Feeling Safe and Secure. Action taken on requirements in last Inspection Report Not applicable Comments on Self-Evaluation The self-evaluation was not returned but was discussed during the inspection visit. View of Service Users The Care Commission Officer spoke with five Service Users during the inspection visit.Comments were very positive and reflected the general theme. ' I just love coming here', ' it makes my week', ' the staff are splendid' and ' the food is just lovely' were comments made throughout the day. Service Users spoke highly of the support and help from staff. View of Carers The Care Commission Officer spoke with three staff including the manager. 3/9 Staff spoke positively and enthusiastically about the service and service delivery. The staff said their team was very small, everyone worked well together and they enjoyed their work. Staff had regular supervision and accessed training opportunities. 4/9 Regulations / Principles Regulation 5: SSI 114 Regulation 5 (2) Personal Plans Strengths Five care plans were examined during the inspection visit. There had been an overall general improvement with most of the documentation. Most review minutes highlighted monitoring, evaluation and detailed outcomes. Documentation was current and up to date. Most reviews were held on a regular basis. Records and care plans examined highlighted involvement with health care professionals and other services. Service Users said that the support from community services especially the district nurse and therapist service was very good. Service Users who were on special diets had details of such diets or nutritional supplements documented within their care plans. The provider kept appropriate records in accordance with the conditions of registrations. Areas for Development Care plans could be further developed and enhanced to note unmet need. It was noted during the inspection visit that some reviews were behind schedule. National Care Standards National Care Standard Number 1: Support Services - Informing and Deciding Strengths Information about the service was available to Service Users in a format that was easy to understand. The manager stated that a new Service Users contract would be out over the forthcoming months and brought in as a rolling process. An information leaflet was available which highlighted the service, activities and choices. Supplementary material was available usually from staff which covered rights, responsibilities and contracts. The most recent Care Commission inspection report was available for inspection and could be viewed at any time. Trial periods were available for prospective Services Users accessing the service. Home visits took place before commencing a trial period and where relevant the provider liaised with other agencies and services. A review was usually held within a four to six week period of starting the service. All Service Users had a named keyworker. Policies and procedures were available for inspection at any time. 5/9 Personal belongings could be stored in a secure area if required. The provider had appropriate insurance cover in place. The policy was examined during the inspection visit. Areas for Development Information leaflets were dated and could be updated and enhanced. National Care Standard Number 2: Support Services - Management and Staffing Arrangements Strengths Service Users spoke very highly about the service and the support from staff. Service Users said staff were ' splendid ' and always helpful'. Staff said, as a small team everyone worked well together and enjoyed their work. Staff said that supervision was held on a regular basis and if additional support was needed the manager was always available.Staff said they had opportunities to access training. The skill mix of staff was sufficient to meet the needs of the service and service delivery. Staff accessed regular training which was specific to the service. Staff said there was a good working relationship with staff in the residential unit. Staff from each service often worked with each other between the two services or helped out. The Care Commission Officer observed practice throughout the inspection visit which was supportive to Service Users and enabled and respected choice. Staff were confident in their approach, which reflected up- to- date best practice and stated they were continuously striving to improve practice. Staff commented that the choice was very much that of the Service Users, who often suggested ideas for activities and outings. Service Users said were able to suggest ideas for activities and outings. Staff had an activity planner in operation which helped with the planning and organisation of group activities and outings. The provider ensured best practice was observed for the recruitment and selection process for staff. All staff underwent Disclosure Scotland checks. The provider had comprehensive policies and procedures in place which covered legal requirements applicable to the type of care service and the conditions of registration and included; administration of medication, fire safety, risk management, health and safety and the recording of accidents, incidents and complaints. Many of the Shetland Welfare Trust policies and procedures were in operation along with Shetland Islands Council policies and procedures. Joint procedures would be in operation over the forthcoming year. 6/9 Policies and procedures were reviewed on a regular basis. Many of the health and safety records were examined during the inspection visit. Areas for Development At present there was not a Service User activity planner in operation. Staff usually informed Service Users what was happening on the day. National Care Standard Number 4: Support Services - Support Arrangements Strengths The service was able to respond to referrals and emergency requests in a timeous manner. Service Users had a named keyworker to help and support them. Care plans were usually drawn up within a 72 hour period of commencing the service which highlighted aims, goals, interests and choices. Care plans were drawn up in conjunction with the Service User or their representative by the keyworker. Where relevant other agencies also assisted including social services. Reviews were held within four weeks of starting the service. The provider promoted an open and close working relationship with Service User's, their family or relevant others. Personal care plans detailed regular reviews and monitored and evaluated the care service being delivered. Specialist equipment was available if required. Assessments often involved other agencies or individuals. Service User's communication needs, in general were adequately supported. Contracts for Service Users were being implemented or updated as a rolling process. Areas for Development National Care Standard Number 6: Support Services - First Meetings Strengths All prospective Service Users had the opportunity to visit the service before making their mind up and were able to have a trial period. All Service Users had a named keyworker to support them. Single shared assessments and home visits involved the provider, staff, social services and relevant others where required. 7/9 A personal care plan was usually drawn up between the Service User and keyworker