Sheltered Housing - /Shotts Housing Support Service 236 Main Street Wishaw ML2 7ND Telephone: 01698 302945

Inspected by: Barbara Montgomery Type of inspection: Announced (Short Notice) Inspection completed on: 31 October 2013 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 10 4 Other information 21 5 Summary of grades 22 6 Inspection and grading history 22

Service provided by: North Council

Service provider number: SP2003000237

Care service number: CS2004068985

Contact details for the inspector who inspected this service: Barbara Montgomery Telephone 01698 897800 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 Staffing 4 Good Quality of Management and Leadership 4 Good

What the service does well Tenants were involved in the planning and delivery of their support.

Every tenant had a comprehensive support plan and sheltered housing staff understood their tenants needs and circumstances well. The service had a range of effective ways to check on people's wellbeing and respond to problems.

Almost all staff had the social care qualification they needed to register with the SSSC.

What the service could do better We have made a recommendation about ways in which the Council could improve consultation with tenants.

Joint working with social work and home support needs to further improve.

Dementia training should be offered to housing staff from local offices and other personnel who visit sheltered developments.

To better evidence monitoring of the service, audits need to be more structured.

Sheltered Housing - Wishaw/Shotts, page 3 of 23 Inspection report continued What the service has done since the last inspection We did not make any requirements or recommendations in the last report. To comply with changes in the regulations support needs reviews took place every 6 months.

Conclusion The service had effective ways to check on people's wellbeing, assist them with their problems and respond to emergencies. It also offered people a good quality of life with plenty of opportunities for socialisation. Tenants we heard from spoke very highly of the service and of the staff. We have made some recommendations about consultation, a need for improved joint working with housing and social work, dementia training and more structured service monitoring. For grades to improve further these areas need to be addressed.

Who did this inspection Barbara Montgomery

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1 About the service we inspected

The Wishaw and Shotts sheltered housing service is run by Council. This service aims to meet the needs of people over 60 whose present accommodation is unsuitable but who can live independently with support. There are six developments in Wishaw, Shotts, and surrounding areas. Most developments have communal lounges for the use of tenants which can be used for a range of events including lunch clubs in some complexes. Twelve sheltered housing officers managed by a local housing manager and backed up by the Councils Community Alarm Service provided support to 190 people. Before 1 April 2011 this housing support service was registered with the Care Commission. On this date the new scrutiny body, The Care inspectorate took over the work of the Care Commission, including the registration of care services. This means that from 1 April 2011 this service continued its registration under the new body. This service is also subject to regulation by The Scottish Housing Regulator.

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 Staffing - Grade 4 - Good Quality of Management and Leadership - Grade 4 - Good

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 This inspection, which took place in October 2013 was carried out by one Inspector. We sent 60 questionnaires to a sample of tenants from all developments and 36 people sent back completed forms. We sent staff questionnaires to the 12 sheltered housing officers and got back 9 completed forms. We had a meeting with managers, visited a development where we met and talked to some tenants, carried out telephone interview with 6 sheltered housing staff and looked at a range of literature, policies and records.

Note: some people who returned our questionnaires thought they were being asked about their homecare service but because some of the returns were anonymous we were unable to determine how many this may apply to.

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

Sheltered Housing - Wishaw/Shotts, page 6 of 23 Inspection report continued 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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What the service has done to meet any recommendations we made at our last inspection We did not make any requirements or recommendations in the last report.

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. Completed in full noting strengths and some areas for improvement

Taking the views of people using the care service into account Views of people using the service and their relatives

Out of the 36 people who completed or were supported to complete and return a questionnaire 25 strongly agreed and 10 agreed that overall they were happy with the quality of care and support this service gave them. (Noone disagreed and one person ticked not applicable). Overall comments included :

* I am very happy here * I like living in the complex * I like the support the service gives me * I love living in sheltered housing the staff know me well and do a great job * I have great support from living here. I am a happy person since moving here; support is excellent any time I need them * our warden is always there when you need her, always there to help in any way she can * staff are really marvellous, everyone is well looked after and cared for regardless of time of day or night - I' m very happy here * the sheltered housing officers do a great job

Sheltered Housing - Wishaw/Shotts, page 8 of 23 Inspection report continued * it was the best move I have ever made the staff are very good and always there for us making it a very pleasant place to stay * I am really happy in my house , feel safe and know there is always help there for me when I need it and can call on staff at any time I need it * I am 98 years old and very well looked after * I feel safe and confident in complex * I live alone and feel very safe * I am happy with my life in sheltered housing; it has a lot going on for everyone I feel secure and I have no complaints; the wardens are very good and helpful * I am looked after good and the staff are very helpful

Taking carers' views into account

Please see under views of people using the service.

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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 We found that this service's performance was good in the areas covered by this statement. We concluded this after we heard from tenants and relatives, spoke to managers and looked at the following: minutes from tenants meeting, report from tenant led inspection, survey results, newsletters and tenants support plans and reviews.

Participation Strategy North Lanarkshire Council offered tenants a range of ways in which to express their views and be involved in the planning and delivery of services. Managers told us they placed a strong emphasis on encouraging people to voice their concerns as soon as possible so that any problems could be resolved informally with minimal delay. Thirty one out of 36 tenants who filled in a arC e Inspectorate Questionnaire agreed that the Council asked for their opinions about how it can improve.

Meetings and Events and Surveys These included tenants committee meetings, neighbours associations, tenants groups and recently a successful forum at which tenants from all developments were represented. There were plans to make this an annual event. Tenants also took part in tenant led inspections of their complexes when they could comment on the premises and repairs. Regular newsletters kept tenants informed about things in their own development or neighbourhood and the Council always informed tenants when there were any significant changes to the service.

Participation in Support Planning and Reviews Sheltered housing officers completed support plans along with tenants following a

Sheltered Housing - Wishaw/Shotts, page 10 of 23 Inspection report continued detailed discussion with them and involved them in reviewing and updating their plan. Tenants were asked to sign their agreement to the plan and offered a copy, though we were told very few people ever wanted one.

Complaints Thirty out of 36 people who filled in a arC e Inspectorate Questionnaire said they knew about the Council's complaints procedure and knew they could complain to the Care Inspectorate. Areas for improvement Meetings and Events and Surveys The Council should consider the introduction of more ways to consult service users such as a programme of annual meetings in each development with an agenda to which all tenants and their relatives could contribute. This is an idea that tenants could be consulted about. Also there was limited use of surveys as a method of consultation. Tenants who attended the recent forum had been asked to complete a survey about the forum.This would have been a good opportunity to invite tenants views about the service overall. The Council should also consider the introduction of annual satisfaction surveys that all tenant have the opportunity to complete. (see recommendation 1 )

Participation in Support Planning and Reviews A useful addition to the six monthly review format would be a question about satisfaction with key aspects of the service and suggestions for improvement. (see recommendation 1 )

Complaints Two people disagreed with the statement about being asked for their opinions about how the service could be improved and two ticked 'not applicable' Six people who filled in a arC e Inspectorate Questionnaire said they did not know about complaints procedure . Six monthly reviews are an opportunity for staff to reinforce awareness of these procedures with everyone. (see recommendation 1 )

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1

Recommendations 1. Participation (i) The Council should consider the introduction of more ways to consult sheltered tenants and get their views and suggestions such as a programme of annual meetings in each development and the introduction of annual satisfaction surveys that all tenants have the opportunity to complete.

Sheltered Housing - Wishaw/Shotts, page 11 of 23 Inspection report continued (ii) Include a question about satisfaction with key aspects of the service and suggestions for improvement in the six monthly review format along with a question about awareness of complaints procedures. (National Care Standards Housing Support Standard 8: Expressing Your Views)

Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths We found the performance of this service was very good in the areas covered by this statement. We have given the service this grade because the day-to-day service delivered by staff was very good. Areas for improvement we have identified equirr e action on the part of other departments within the council as well as sheltered housing. We concluded this after we heard from tenants and relatives; spoke to managers and sheltered housing staff and looked at a sample of tenants support plans.

Support Plans

Support plans we looked at were comprehensive and contained good information about people's support needs and agreed arrangements for welfare checks ie calls and /or visits. Essential information was also shared with the Community Alarm Service so that staff there and responders were well informed. Sheltered housing staff also summarised essential information about tenants needs for relief staff. 33 out of 36 people who returned a Care Inspectorate questionnaire agreed they had a personal plan or support plan which contained information about their support needs and preferences. (Two people ticked don't know or not applicable).

Reviews

To comply with regulations support needs reviews were taking place every 6 months or sooner if there was, for instance, a sudden deterioration in health or significant change in circumstances. 34 out of the 36 people who filled in a arC e Inspectorate Questionnaire agreed that the service checked with them regularly that it was meeting their needs. (One person ticked disagree and one ticked not applicable)

Support and wellbeing checks

The service had a range of effective ways to ways to check on people's wellbeing and respond to concerns. Sheltered housing staff who were available on site every day including weekends and public holidays called or visited tenants who had requested a wellbeing check as part of their support plan either every day or less frequently depending on what had been agreed. In addition to the agreed checks staff made visits over and above what was agreed in the support plan if they were concerned about a tenant.

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24 Hour Emergency Call System

The Council provided efficient and effective emergency call arrangements. When a tenant or anyone else used the emergency call system in their home during the day days sheltered housing staff responded. At all other times (evenings and overnight) the response came from the Council's Community Alarm Service. Sheltered housing staff we asked said there was a reliable exchange of information between them and the Community Alarm Service each day. They said that tenants were comfortable about using the alarm service though there were still instances of tenants who had had a problem but chosen not to use the emergency call system. Thirty two out of 36 people who filled in a arC e Inspectorate Questionnaire agreed that staff have enough time to carry out the support and care. (3 disagreed and 1 ticked not applicable - some people we heard from may have thought we were asking about homecare).

Joint Working (Health, Social Work, Homecare, Housing and other agencies)

Effective joint working helped to promote tenants health and wellbeing. Sheltered housing staff liaised with other agencies or made a referral to arrange appropriate services to meet tenant's needs such as a need for a homecare or other service. Some sheltered housing staff we asked described good communication with home support workers who were in and out of their complexes every day. There were instances of sheltered housing officers being informed about homecare packages and asked to contribute to or attend social work reviews.

Socialisation and Healthy Lifestyle SHOs encouraged and supported a wide range of social activities and events with tenants groups in some developments and communal lounges open during the evening and weekends. Lunch clubs and breakfast clubs also took place in some complexes. Areas for improvement Areas for improvement we have identified equirr e action on the part of other departments within the council as well as sheltered housing.

Support Needs Assessments

Sheltered housing officers were not involved in the support needs assessment process prior to allocation of a sheltered property and housing colleagues did not routinely share information about eg known medical conditions with sheltered staff. Sheltered staff in turn had to rely on the accuracy of the information new tenants shared with them when they moved in. Situations can arise where sheltered housing staff have limited information about a tenant with eg a history of violence, substance abuse or serious mental health issues. Similarly staff may be unaware of someones medical history and eg., prescribed medication or pace maker and so could lack vital

Sheltered Housing - Wishaw/Shotts, page 13 of 23 Inspection report continued information in the event of a medical emergency.This was noted as an area for improvement in the last inspection report in 2010. (see recommendation 1)

Joint Working (Health, Social Work, Homecare) While there were instances of sheltered housing officers being informed of the start of or change to a homecare package this was not routine practice. Similarly while there were instances of sheltered housing officers being asked to contribute to or attend social work reviews this was not routine practice. (see recommendation 2). We heard of other instances of poor communication with home support such as not always being informed by visiting home carers when tenants were unwell. Managers tried to address these issues as and when they cropped up. Sheltered housing staff we talked to were familiar with and read Homecare diaries/log books but not everyone felt comfortable about making entries in these. (see recommendation 2)

We think that there needs to be frank and open discussion at a senior level to ensure a consistent approach across the Council to the sharing of information that is in the interests of the health and well being of service users.

Socialisation and Healthy Lifestyle

Not all complexes had a communal lounge. The development we visited which had a busy social calendar lacked a good size communal sitting room due to it being a converted mainstream property. We also heard of another development where local council premises close by were going to be used. There were an increasing number of service users in some complexes with poor mobility who used a wheelchair and needed support to be able to go to social events in the communal lounges. We were told that the Council had clarified that staff erw e insured to do this and were going to be offered moving and handling training updates. Please also see Quality Statement 3.3.

Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 2

Recommendations 1. Support Needs Information relevant and vital to service users health and wellbeing obtained prior ro allocation of a sheltered property should be available to Sheltered housing Staff (National Care Standards Housing Support Services Standard 4: Housing Support Planning.) 2. Joint Working Sheltered Housing and Home Support /Social Work need to agree to and adhere to a consistent approach to the sharing of information that is relevant and vital to

Sheltered Housing - Wishaw/Shotts, page 14 of 23 Inspection report continued service users health and wellbeing . (National Care Standards Housing Support Services Standard 4: Housing Support Planning.)

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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 Please see comments at Quality Statement 1.1. Areas for improvement Please see comments and recommendations at 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 We found the performance of this service was good in the areas covered by this statement. We concluded this after we heard from tenants and relatives; spoke to managers and sheltered housing officers and looked at training and supervision records, 'Learning and Development Pathway' document, procedures for supervision and team meeting minutes.

Training & Development

Sheltered housing officers training and development needs got assessed through annual personal development reviews. Almost all sheltered housing staff we heard from confirmed having an induction when they started their job. (For those who ticked no this may be related to the length of service). The Council had a staff training programme and sheltered housing staff could attend relevant courses and had access to e-learning. Managers advised that all staff had done the required dementia training as set out in the Promoting Excellence knowledge and skills framework. Most staff who sent back a Care Inspectorate questionnaire agreed that they had been

Sheltered Housing - Wishaw/Shotts, page 16 of 23 Inspection report continued provided with opportunities to access training in the last 12 months, agreed that the training had helped them with their job and said they had no unmet training needs directly related to their job. Managers advised that all Sheltered Housing Officers now had or were working towards the minimum required qualification for registration with the SSSC unless they were due for retirement. Thirty five out of the 36 tenants and relatives who completed Care Inspectorate surveys agreed that staff had the skills and experience to meet their needs and agreed that staff treated them with respect. (one person ticked not applicable) Support and Supervision

Team meetings for sheltered housing staff took place every 6- 8 weeks. Most staff who sent back Care Inspectorate questionnaires confirmed opportunities to meet with other staff and considered they had the necessary materials and equipment for their job and most felt safe at work. Areas for improvement Areas for Improvement Training & Development

It is important that Housing personnel from local offices who come into contact with people with dementia should also be offered the dementia training as set out in the Promoting Excellence knowledge and skills framework. This should also be extended to other personnel who visit sheltered developments. (see recommendation 1) Some sheltered housing staff we heard from said they needed moving and handling and first aid updates and would welcome computer training due to increased use of IT at work. We noted that moving and handling updates were planned for all staff in January 2014. It was hoped that this will assist staff who are asked to support an increasing number of wheelchair users who need help to attend social events in some developments. The content of some Performance Development Review Meeting minutes we looked at was very scant. We were told that this was because some staff had been in post for a long time and development needs and opportunities were more limited.

Support and Supervision

While most staff agreed that they had regular supervision meeting with their manager we noted that out with Performance Development Review Meetings managers did not have regular planned one to one meetings with staff. However, managers said they were in regular, sometimes daily contact with staff and visited developments often. (Please see Quality Statement 4.4 recommendation 1) While sheltered housing staff who sent back Care Inspectorate questionnaires confirmed opportunities to meet with other staff some would welcome more opportunities at these meetings to discuss some of the difficult situations they encounter in their day-to-day work.

Sheltered Housing - Wishaw/Shotts, page 17 of 23 Inspection report continued Most but not every sheltered housing officer who sent back a Care Inspectorate questionnaire agreed that they felt safe at work. This was related to concerns about personal safety when managing situations involving eg a tenant with a history of violence or having insufficient information about eg a tenants mental health. (Please see comments and recommendations at Quality Statement 1.3)

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1

Recommendations 1. Training Personnel from local housing offices should also be offered dementia awareness training. This should also be extended to other personnel who visit sheltered developments. (National Care Standards Housing Support Standard 3: Management and Staffing Arrangements)

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Quality Theme 4: Quality of Management and Leadership 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 management and leadership of the service. Service strengths Please see comments at Quality Statement 1.1. Areas for improvement Please see comments and recommendations at Quality Statement 1.1.

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

Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide Service strengths We found the performance of this service was good in the areas covered by this statement. We decided this after we spoke to managers and staff. The Council had some effective ways to check the quality of its services. These include feedback from tenants either informally or via the Council's complaints procedures.

Personnel files and records related to training, recruitment and personal development plans were subject to scrutiny by the Councils Continuous Improvement Group.

Managers who were in regular contact with all staff and all developments were well placed to monitor the service and address any problems as well as scrutinise records. Areas for improvement As far as we could ascertain the Council's Continuous Improvement Group did not do any formal audits of service delivery or records in Sheltered Developments. Staff we asked had no recollection of this kind of visit and no records were available. Also, while managers visited complexes regularly these visits were not recorded and no

Sheltered Housing - Wishaw/Shotts, page 19 of 23 Inspection report continued written action plans were available. We have made a recommendation about being able to better evidence effective monitoring of the service. (see recommendation 1)

The service also did not invite stakeholders/partner agencies such as social work or home support to complete any satisfaction surveys. (see recommendation 1)

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1

Recommendations 1. Quality Assurance

To better evidence monitoring of the service:

(i) Monitoring visits by local managers or by the Councils Continuous Improvement Group should be part of a planned audit programme and follow a set format with written action plans.

(ii) The Council should also invite stakeholders/partner agencies to complete satisfaction surveys about this service.

(National Care Standards Housing Support Service Standard 3: Management and Staffing Arrangements)

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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 We noted that the Council had not notified the arC e Inspectorate of the managers absence for more than 28 days or of who was acting manager in her absence. We also drew the providers attention to changes in the regulations as regards notifications and matters that all services were now required to notify the Care Inspectorate.

The Council was offering this service to some younger adults and needs to apply for a variation to this services conditions of registration to extend the category to include younger adults.

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 the Care Inspectorate re-grading a Quality Statement within the Quality of Management and Leadership Theme (or for childminders, Quality of Staffing Theme) as unsatisfactory (1). This will result in the Quality Theme 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 3 5 - Very Good

Quality of Staffing - 4 - Good

Statement 1 4 - Good

Statement 3 4 - Good

Quality of Management and Leadership - 4 - Good

Statement 1 4 - Good

Statement 4 4 - Good

6 Inspection and grading history

Date Type Gradings

19 Aug 2010 Announced Care and support 4 - Good Staffing Not Assessed Management and Leadership 4 - Good

7 Sep 2009 Announced Care and support 4 - Good Staffing 4 - Good Management and Leadership 3 - Adequate

27 Aug 2008 Announced Care and support 4 - Good Staffing 3 - Adequate Management and Leadership 3 - Adequate

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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