Antonine Day Centre Support Service Without Care at Home Darroch Way Seafar G67 1QA Telephone: 01236 856060

Inspected by: Arlene Woods Type of inspection: Unannounced Inspection completed on: 28 February 2012 Inspection report continued

Contents

Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 9 4 Other information 17 5 Summary of grades 18 6 Inspection and grading history 18

Service provided by: Council

Service provider number: SP2003000237

Care service number: CS2003001199

Contact details for the inspector who inspected this service: Arlene Woods Telephone 01294 323920 Email [email protected]

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Summary

This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection.

Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service.

We gave the service these grades Quality of Care and Support 4 Good Quality of Environment N/A Quality of Staffing 4 Good Quality of Management and Leadership N/A

What the service does well The service supports older people to participate in activities within a day-care setting. It assesses service users' healthcare and social needs and level of independence. It also helps them to access other services, for example housing support and care at home or opticians.

The support plans were person centred and being reviewed monthly. There was a well qualified staff team.

What the service could do better The service should consider different ways to involve service users and their carers in improving the quality of the service.

What the service has done since the last inspection The service had been developing integrated health and social care support plans. These contained information on how to support people to participate in social activities while assessing and addressing any healthcare needs.

Conclusion This service is appreciated by those who use it. It is building up its service user group and is still developing its connections with other services. It involves people in

Antonine Day Centre, page 3 of 19 Inspection report continued activities they enjoy in a pleasant environment. They support people in a respectful and dignified way.

Who did this inspection Arlene Woods

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1 About the service we inspected

The Antonine Centre Day Care is managed by North Lanarkshire Council. The service was formally located in the Seafar area of Cumbernauld, however at the time of this inspection it was operating from its temporary home in the Westfield Day Centre in Kilsyth. The service will be based here until a new purpose built unit is built on the original site in Seafar.

The service used local taxis to transport people to and from .

The service currently operates between 09:00 hours and 17:00 hours, Monday to Sunday 52 weeks of the year. The service caters for a maximum of forty two older people each day although is currently working with a maximum of twenty three people each day due to its lack of a permanent base.. On the day of the inspection there were six people using the service.

The service aims "to provide social opportunities and assist service users maintain their independence in the community".

The service was formerly registered with the Scottish Commission for the Regulation of Care (the 'Care Commission'). The Care Commission merged on 1 April 2011 with the Social Work Inspection Agency and the section of HMIE responsible for inspecting services to protect children, to form the new scrutiny body SCSWIS'

Based on the findings of this inspection this service has been awarded the following grades:

Quality of Care and Support - Grade 4 - Good Quality of Environment - N/A Quality of Staffing - Grade 4 - Good Quality of Management and Leadership - N/A

This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection.

Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website www.careinspectorate.com or by calling us on 0845 600 9527 or visiting one of our offices.

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2 How we inspected this service

The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care.

What we did during the inspection In this service we carried out a medium intensity inspection. We wrote this report after an unannounced inspection by Arlene Woods, which took place between 10 am and 4.30pm on 16/02/12.

As requested by us, the care service sent us an annual return. The serviced also sent us a self assessment form.

We issued 20 Questionnaires to friends, relatives or carers of people who used the service. 10 Questionnaires were returned before the inspection. All of the questionnaires returned agreed or strongly agreed that people were treated with dignity and that individual support needs were met.

In this inspection we gathered evidence from various sources, including: * Evidence from the service's most recent self assessment * Personal plans of people who use the service * Training records * Health and safety records * Accident and incident records * Complaints records * Questionnaires that had been requested, filled in and returned to the care service from people who use the service, their relatives or advocates, and staff members * Discussions with various people, including: * the manager * care staff * the people who use the service * relatives and carers of the people who use the service * observing how staff work * examining equipment and the environment (for example, is the service clean, is it set out well, is it easy to access by people who use wheelchairs?)

Antonine Day Centre, page 6 of 19 Inspection report continued Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements.

Details of what we found are in Section 3: The inspection

Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement.

Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org

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The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic

Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. Social Care and Social Work Improvement received a fully completed self assessment document from the service provider. We were satisfied with the way the service provider had completed this and with the relevant information they had given us for each headings that we grade them under.

Taking the views of people using the care service into account The activities are good and we get singers in". "I like it hear but would prefer to be back in Cumbernauld". "the food is good and the girls are lovely" "I don't like the travelling but its only for a short time".

Taking carers' views into account There were no carers available at this inspection.

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3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found.

Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 4 - Good

Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths There was a written participation strategy in place. The service was developing this to more clearly inform service users and their carers of the different ways they could give their opinions on the quality of the service they received. This would include six monthly reviews, meetings, questionnaires, the complaints procedure and a suggestion box. It will also include the way that people will be informed of actions the service had taken in response to issues raised. We felt that when this was fully introduced it would clearly inform service users how they could influence the development and performance of their service in the future.

The service held regular reviews of support plans with service users and their carers. Most support plans were signed by service users or their carers. The reviews gave people a regular forum to raise issues and comment on aspects of their support.

Service users meetings were being held monthly, the agenda was set by the staff and records identified who attended and issues raised.

There was a Complaints procedure which was displayed. It followed the most up to date guidelines and referred people to the Care Inspectorate. The service had recorded one complaint and there was evidence that appropriate action had been taken to address the issue. This was good practice.

There was a comments and suggestion box in the main reception area. It was not used well but gave people the opportunity to make comments anonymously.

There was a key worker system in place. Staff knew their service users very well and the service users were very happy with the staff and the way they were supported.

Antonine Day Centre, page 9 of 19 Inspection report continued There was a three monthly newsletter in place. This was a social document with information on upcoming activities, birthdays, and some healthcare information.

There was advocacy information available to service users. This was to help them access independent support to express there views when they had difficulty doing this. Areas for improvement Service users were not having their support plan reviewed a minimum of 6 monthly. We feel that this denied them the opportunities to comment on the effectiveness of their care and whether they wished to continue to use the service. This is a new legal directive for this service (April 2011) and did not effect the grade at this inspection. (Requirement 1)

The monthly service users meetings were not taking place regularly. The content was noted to be the service informing service users of changes with their service provision rather than obtaining service users opinions on the support they received. The service should use its existing opportunities for service users to comment on the various aspects of quality of the service. (Recommendation1)

The service should complete the development of its written participation strategy.

The service should develop a method to feedback the actions taken as a result of the questionnaires, meetings and complaints to service users and carers. We felt that this could be done routinely by using the 3 monthly newsletter

Grade awarded for this statement: 4 - Good Number of requirements: 1 Number of recommendations: 1

Requirements 1. The service must ensure that all care reviews are held a minimum of once in 6 months. This is in order to comply with SSI2011/5 - personal plans.

Timescale 8 weeks from receipt of this report

Recommendations 1. The service should routinely use the systems currently in place to obtain service users' opinions on the quality of the service they receive. Standard 12: Expressing your views

Statement 4

Antonine Day Centre, page 10 of 19 Inspection report continued We use a range of communication methods to ensure we meet the needs of service users. Service strengths The people who used this service had varying communication difficulties. These included hearing difficulties, being unable to speak due to having suffered a stroke and confusion in those people diagnosed with dementia.

On admission all service users were assessed by their allocated keyworker. The service users and their carers were involved in the development of their individual support plans which recorded their care and support needs. This included service users' communication needs. Support plans held instructions on how to communicate effectively with the service user. These included speaking clearly, loudly or face to face, giving time to respond and using different tools and technologies. This could help all staff to more effectively interact with the service users.

There were picture cards available to show service users the choices available to them and the service had recently purchased talking mats, where a picture is pointed to indicate what the person wishes to say. These tools could be used by a variety of service users to gain their opinions and reduce their frustration in not being understood clearly. Some staff had received training on using these tools.

Individual diaries were used after consultation with service users and carers to share accurate information with the appropriate people. This could help all those involved in supporting the service users have a better understanding of the each others input and decision making on behalf of the service users. This could lead to a more "joined up" system of support.

There was a loop system in place within three group work rooms and a portable loop system was available for use in other rooms. This system improved the performance of individual hearing aids. This could improve the involvement in discussions and activities by those who used hearing aids.

All information including service users welcome pack, could be provided in audio, braille, large print and through an interpreter. This could improve effective communication with various service users.

As this in an integrated service between social work and health professionals there were ways to make referrals to the sensory impairment team for support. This should make getting appointments quicker and easier. Areas for improvement The support plans were being developed at the time of the inspection. It was noted that not all support plans had been signed as agreed by the service user or their carer. The manager had developed a strategy to address this.

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The support plans should include who should be involved in support plan reviews and when the reviews should take place.

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0

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Quality Theme 2: Quality of Environment - NOT ASSESSED

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Quality Theme 3: Quality of Staffing Grade awarded for this theme: 4 - Good

Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths The opportunities for commenting on the staff group were as reported under Quality statement 1:1

At service users meetings there was evidence that they had been asked if there were any issues with staff. Service users were recorded as stating there were no problems. The service users we talked to were very happy with the staff who supported them. Areas for improvement These are listed under Quality statement 1:1

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0

Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths There was an annual staff development plan in place which covered mandatory and service user specific training for example dementia. This was devised from development opportunities offered by North Lanarkshire Council and those identified at supervision by both the staff member and their supervisor.

A high level of staff had been awarded their Scottish Vocational Qualification (SVQ) 3 qualifications in care. Staff confirmed that they had received sufficient training to support their service users. We saw records of staff training which supported this.

The service had a system in place to monitor the attendance of staff at mandatory (legally required) training for example fire and moving and handling. This should ensure staff maintain the skills to keep the service users safe.

There was staff supervision policy in place which stated that this would take place six

Antonine Day Centre, page 14 of 19 Inspection report continued weekly. The service had a system in place to monitor that it was complying with this. Staff interviewed, felt that this was a positive activity and were confident in aisingr service management and training issues at these meetings. We noted that the content of staff supervision was appropriate to the post held.

Staff were familiar with the National Care Standards and the SSSC (Scottish Social Services Council) codes of practice. Areas for improvement The service should continue with the current good practice being demonstrated.

The service should continue to identify training needs of its staff and deliver appropriate training throughout the year. This would help the staff support the service users using the most up to date knowledge and skills.

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0

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Quality Theme 4: Quality of Management and Leadership - NOT ASSESSED

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4 Other information

Complaints No complaints have been upheld, or partially upheld, since the last inspection.

Enforcements We have taken no enforcement action against this care service since the last inspection.

Additional Information

Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1).

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5 Summary of grades

Quality of Care and Support - 4 - Good

Statement 1 4 - Good

Statement 4 4 - Good

Quality of Environment - Not Assessed

Quality of Staffing - 4 - Good

Statement 1 4 - Good

Statement 3 4 - Good

Quality of Management and Leadership - Not Assessed

6 Inspection and grading history

Date Type Gradings

18 Nov 2010 Announced Care and support 5 - Very Good Environment 4 - Good Staffing Not Assessed Management and Leadership Not Assessed

1 Sep 2009 Announced Care and support 5 - Very Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good

17 Mar 2009 Announced Care and support 5 - Very Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good

All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission.

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To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on 0845 600 9527.

This inspection report is published by the Care Inspectorate. You can get more copies of this report and others by downloading it from our website: www.careinspectorate.com or by telephoning 0845 600 9527.

Translations and alternative formats This inspection report is available in other languages and formats on request.

Telephone: 0845 600 9527 Email: [email protected] Web: www.careinspectorate.com

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