Mid - Argyll, Kintyre, Islay and Jura Home Care Service Housing Support Service Old Quay Head Campbeltown PA28 6ED Telephone: 01546 605500 Type of inspection: Announced (short notice) Completed on: 5 March 2020 Service provided by: Service provider number: Argyll and Bute Council SP2003003373 Service no: CS2004079966 Inspection report About the service Mid- Argyll, Kintyre, Islay and Jura Home Care Service is provided by Argyll and Bute Council and was registered by the Care Inspectorate in April 2011. The home care service offers personal, social, emotional and practical support to people experiencing care. Its aims are: - to provide a high quality care service that helps people remain in their own home - to provide practical support to relatives and friends caring for people in the community - to enable people to lead as independent a life as possible within their own community - to provide a service that takes account of people's preferences, wishes, personal circumstances, cultural and religious beliefs - to provide services in an anti-discriminatory way. At this inspection, we visited or spoke to people from all localities the service supported. What people told us During the time of our inspection the service supported 135 service users across all parts of the service. We spoke to 18 service users and family members and received 21 completed questionnaires. Most people were happy with their support. They felt the quality of staff and management was good and they received good information about the service. Where people felt there were more improvements to be made, we discussed their points with managers in a confidential way. Examples of what people told us were: - 'My father appreciates the excellent service provided and the staff always show great care and compassion'. - 'The support provided has been of great help'. - 'I am delighted with everything and am very happy with the all the carers I have had'. - 'For the last few years we are overall happy with care team and management'. - 'I also value the psychological contact with the carers three times a day'. - 'All my carers are pleasant and very efficient. They do a great job'. - 'We are impressed by the cheery and friendly presence of the carers and the supportive attitudes shown'. - 'The carers are very competent and caring, nothing is ever a bother to them. They are a pleasure to have coming into the house'. Inspection report for Mid - Argyll, Kintyre, Islay and Jura Home Care Service page 2 of 9 Inspection report - 'I cannot speak highly enough about the quality of the service I receive. It is of the highest quality, not just professionally, but also personally. My two assigned carers give me the confidence and ability to acef each day, safe in the knowledge that I can cope with whatever transpires'. - 'Mum smiles. She is non-verbal due to her dementia, so we know she likes her care staff. All very good, caring and do a really good job'. - 'Everything they do for me is good. They are constantly checking that I'm ok'. Self assessment The service had not been asked to complete a self assessment in advance of the inspection. We looked at their own improvement plan and quality assurance paperwork. These demonstrated their priorities for development and how they were monitoring the quality of provision within the service. From this inspection we graded this service as: Quality of care and support 4 - Good Quality of staffing not assessed Quality of management and leadership 4 - Good What the service does well Feedback received from service users and families was mostly very good. People told us that staff treated them with warmth, kindness and respect. Service users felt that they had positive relationships with the staff who supported them, and that this helped them to achieve positive outcomes. A family carer told us: 'My mum sees the carers as her friends. She looks forward to them coming and enjoys their company'. In most service areas people were happy with the consistency of support they experienced. They also felt that the service was reliable and communicated well with them. This provided service users with a sense of safety and comfort and helped them to build positive relationships with staff. People felt that staff were competent, skilled and knowledgeable. Service users and families gave us several positive examples of how staff used their professional skills to provide for people with complex conditions, including for people living with dementia. Overall staff were positive about their access to training, but some staff felt that more training for some specific healthcare conditions, including dementia, would benefit them (see also: What the service could do better). Where necessary the service communicated and worked well with other health professionals. In most service areas staff did not manage or administer people's medication. Where they did, this was managed safely and robustly. Managers demonstrated their detailed knowledge of the service's strengths and areas that needed to be improved. This included the formulation of clear key quality indicators that linked to quality assurance processes for all key areas of the service. Structured observations of practice formed an important part of the quality assurance system. We found that the robustness and scope of the quality assurance processes Inspection report for Mid - Argyll, Kintyre, Islay and Jura Home Care Service page 3 of 9 Inspection report had improved since our last inspection. This provided managers with the detailed and meaningful information they needed to maintain an effective service development plan. It is important that service users and their families have confidence in the way the service is managed. Most people we spoke to were satisfied with the accessibility of managers and senior staff. People found that they could approach the service if they had concerns and felt that managers were able to find positive solutions. What the service could do better People felt respected and listened to and most people experienced that the service sorted out any problems that arose. However, some people felt that managers were remote or not known to them. We discussed this with managers and encouraged them to continue to work on this to ensure that all service users and families are aware of the service's management structure and managers' names. People on Jura were less happy with the service provision than people in the other areas the service operated in. This mainly related to gaps in staffing, which led to inconsistent or disappointing experiences for some service users. We discussed those concerns with managers who were open and transparent about the situation and their own assessment of it. Managers confirmed that the service provision on Jura was a clear priority for them and that improvement action was on-going. Some service users and families on Jura confirmed that they saw improvements being made in the weeks leading up to our inspection. We were encouraged by the services sense of urgency to solve the staffing situation on Jura and felt reassured by the existing action plans and early signs of improvement. We decided to continue a previous area for improvement that asked for all staff who provided care for people living with dementia to have sufficient and consistent access to Promoting Excellence dementia care training. This was because some staff told they felt that training for some specific healthcare conditions, including dementia, would benefit them. Managers also confirmed that theoll-out r of this training had not yet been as wide and consistent as they planned to achieve. Although medication management and administration were managed safely in the part of the service where this applied, we encouraged managers to implement a clearer system of regular competency checks and observations of practice. This would further increase the quality and safety of medication practice and provide regular feedback and learning opportunities for staff. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 Inspection report for Mid - Argyll, Kintyre, Islay and Jura Home Care Service page 4 of 9 Inspection report 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 Recommendation 1 The service should meaningfully involve people and encourage them to express their views on any aspect of the service at any time. National Care Standards Housing Support Services: Standard 8 - Expressing your views. National Care Standards Care at Home: Standard 11 - Expressing your views. This recommendation was made on 22 March 2018. Action taken on previous recommendation The service continued to find it difficult to organise greater service user and family involvement. Feedback overall showed that people knew how to get in touch with managers. We discussed various options for trying to increase information flow and participation and managers were open to include this in their on- going action plan. This recommendation will not continue Recommendation 2 The service should ensure that people experiencing care contribute to monitoring the quality of the support the service offers and developing plans for the service. Inspection report for Mid - Argyll, Kintyre, Islay and Jura Home Care Service page 5 of 9 Inspection report National Care Standards Housing Support Services: Standard 8 - Expressing your views. National Care Standards Care at Home: Standard 11 - Expressing your views. This recommendation was made on 22 March 2018. Action taken on previous recommendation The service had a clear format for following up complaints and concerns and there was good evidence of regular contacts between care organisers and people using the service or their families.