East End Project Support Service 2 Barlanark Drive Barlanark Glasgow G33 4QB Inspected by: Sarah Gill (Care Commission Officer) Type of inspection: Inspection completed on: 30 August 2005 1/13 Service Number Service name CS2004073430 East End Project Service address 2 Barlanark Drive Barlanark Glasgow G33 4QB dummy Provider Number Provider Name SP2003000264 Quarriers dummy Inspected By Inspection Type Sarah Gill Care Commission Officer dummy Inspection Completed Period since last inspection 30 August 2005 N/A dummy Local Office Address Central West, Paisley. dummy 2/13 Introduction The East End Projects comprises of three projects: Calvay, Robroyston and Braidfauld place. The Calvay project offers support to 9 adults with learning disabilities from the Greater Easterhouse area of Glasgow. Support is provided on a flexible basis with each individual averaging around 15-25 hours of support per week. Each person has their own flat and tenancy agreement with the housing provider. The Robroyston project supports 2 adults with learning disabilities, a 3rd place is currently vacant. The accommodation is within a 3 bedroom detached bungalow set in a quiet cul de sac in the North East of Glasgow. Support is provided on a 24 hour basis including staff sleepovers. Each person has their own tenancy agreement with the housing provider. Braidfauld Place project supports one person with a learning disability. The accommodation is within a small house which has been adapted to meet the needs of the individual. The service is provided on a 24 hour basis, including staff sleepovers. All of the projects aim to offer a range of supports in order to promote an ordinary living experience for the people they support. This is achieved using person centred planning. Basis of Report This report is written on the basis of one Care Commission Officer visiting the projects over a period of two days. During this time 6 service users and 6 staff were consulted. A meeting was held with one relative and questionnaires were returned by two relatives. The relevant records, policies and procedures were examined. The Care Service was measured against the Regulation of Care (Requirements as to Care Services)(Scotland) Regulations 2002. Scottish Statutory Instrument 2002 No.114. In addition six of the National Care Standards were focused on as follows: Standard 1 Informing and Deciding (Care at Home) Standard 2 The Written Agreement (Care at Home) Standard 4 Management and Staffing (Care at Home) Standard 8 Keeping Well - medication (Care at Home) Standard 11 Expressing Your Views (Care at Home) Standard 7 Exercising Your Rights (Housing Support) Action taken on requirements in last Inspection Report This is the first report by the Care Commission. Comments on Self-Evaluation The self evaluation was completed by the Manager, this helped to identify many areas of strength and some areas for development against the five National Care Standards listed above. 3/13 View of Service Users All of the service users consulted expressed positive views about the Calvay Project. These included comments that "the staff are great", "they help you with things but you've still got your freedom", "the chance to build my confidence", "the neighbours treat us with respect and we can be a part of the community", "can't think how you could make it better they've just got it right" View of Carers All three of the relatives of service users who could not express their own views provided feedback. They all stated they were very happy with the service their relatives received and had been given information if they wished to raise a complaint or concern. They all stated that they had been involved in reviews. There were also positive comments made regarding staff, "her carers are wonderful". 4/13 Regulations / Principles Regulation 3: SSI 114 Regulation 3 Statement of Aims and Objectives Strengths A statement of aims was provided with the pre-inspection return. A mission statement was also evident in the draft information pack. There is a service description which details what the service is and how it is to be provided. Areas for Development As previously stated under Standard 1 the aims and objectives statement could be made clearer to define the function and purpose of the service and the aims and objectives as to how this is to be provided. Regulation 4: SSI 114 Regulation 4 (1) Welfare of Users Strengths Each service user has their own G.P. and access to community health facilities. In addition each service user has a Care Manager and contact with the local Community Learning Disabilities Team. Within each project service users are allocated two case coordinators. This assists with building relationships and providing continuity of care. Any health or welfare concern can be addressed either by the staff within the project or referred on to the appropriate agency. Staff have all attended training in strategies for crisis intervention and prevention (SCIP). This assists staff in managing challenging behaviour. There is a Quarriers standard for "promoting positive behaviours". The SCIP training includes physical intervention. Service users who may exhibit challenging or difficult behaviours will have a behaviour support plan. There is an infection control policy and there are suitable procedures in place for the uplift of clinical waste. Areas for Development The term restraint has not been defined for staff and there was a lack of recognition of when restraint may be in use. This could relate in particular to the use of chemical restraint if medication is given for the purposes of stopping or reducing a behaviour. Staff were not aware of the Mental Welfare Commission Guidance "Rights, Risks and Limits to Freedom guidance on the use of restraint." This is an area where the guidance to staff could be made clearer by defining restraint and including the guidance recommendations within the training for staff. 5/13 Regulation 5: SSI 114 Regulation 5 (1) Personal Plans Strengths All personal plans examined were very comprehensive and reflect a person centred approach in each support plan. Areas for Development As previously stated under Standard 2 Written Agreement, if service users are unable to consent to their personal plan their representative should be fully consulted. Regulation 7: SSI 114 Regulation 7 Fitness of Managers Strengths There has been a recent change of Manager. The verification of fitness of Manager has not yet been received. It is expected that this will be supplied without delay. Areas for Development as above. Regulation 9: SSI 114 Regulation 9 Fitness of Employees Strengths Quarriers have robust recruitment policies and procedures which include Disclosure Scotland checks, references and an interview process. Areas for Development Some staff files examined could not verify the appropriate procedures had been carried out. As previously stated under Standard 4 Management and Staffing, this information is held at headquarters and discussion will take place regarding a visit there to sample files. Regulation 13: SSI 114 Regulation 13 Staffing Strengths There is a high level of training amongst the staff group with most staff trained to Higher National Certificate (HNC) in Care or Scottish Vocational Qualification in Care (SVQ) Quarriers have an aim of achieving a high staff percentage with SVQ 3. 6/13 There are no set staffing numbers for each of the projects and the provider can adjust the staffing numbers according to the needs of the service users. Areas for Development There is an ongoing need for staff development and training. Regulation 19: SSI 114 Regulation 19 (1) Records Strengths All of the relevant records were found to be satisfactory. Areas for Development none Regulation 25: SSI 114 Regulation 25 Complaints Strengths Quarriers have a comprehensive systems in place to allow a service users or representative to make a complaint. Areas for Development To ensure that representative's of service users receive a copy of the relevant complaints information. National Care Standards National Care Standard Number 1: Care at Home - Informing and Deciding Strengths An introductory pack is under development. A draft copy was available on the day of the inspection and this provided a good level of information. Due to the amount of text within the pack it is likely that this will be best suited for representatives of service users. It is the aim of the service to develop a format that is suitable for people with learning disabilities and this will include the use of pictures. There is a mission statement that will be included within the pack. A set of aims for the projects was provided with the pre-inspection return. The pack will include information about Quarriers, as the provider of the service and it is intended to also include an introduction from the Manager, this will also be included in the new service brochure. 7/13 The draft pack includes information about managing risk and reporting accidents and incidents. There is excellent information available on how to make a complaint. A format has been produced using pictures. The self evaluation of the service against this standard also recognises that service users can visit the project and attend one of the Tenants meetings if they wish. A yearly operational audit is carried out and copies can be made available. Staff will always be happy to meet and discuss the service with new service users. There is also a service descriptor available. Areas for Development At present there is no introductory pack available for service users and their representatives. The completion of the pack in keeping with this standard will be a recommendation of this report. The aims and objectives statement could be expanded upon and made more specific to each of the projects. Information about relief staff and how shifts would be covered if staff are off sick or absent could be included in the pack.