Inspection Report
Transcription
Inspection Report
Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Blaenau Gwent County Borough Council Supported Living Scheme Abertillery Sports Centre Alma Street Abertillery NP13 1QD Type of Inspection – Baseline Date(s) of inspection – Thursday, 26 March 2015 Date of publication – Tuesday, 28 May 2015 Welsh Government © Crown copyright 2015. You may use and re-use the information featured in this publication (not including logos) free of charge in any format or medium, under the terms of the Open Government License. You can view the Open Government License, on the National Archives website or you can write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: [email protected] You must reproduce our material accurately and not use it in a misleading context. Page 1 Summary About the service Blaenau Gwent Supported Living Service is registered with the Care and Social Services Inspectorate Wales (CSSIW) as a domiciliary agency to provide personal care to older persons, people with physical disabilities, people with sensory loss/impairment, people with mental health problems and people with dementia. The service currently provides personal care in supported living accommodation located in five properties in the Blaenau Gwent area. The service has an office base in Abertillery. The registered provider has a nominated individual who represents the company and the Registered Manager is Joanne Hawkins. What type of inspection was carried out? We (CSSIW) visited the agency’s office on an announced basis followed by a visit to a supported home on the 26 March 2015 to conduct a baseline inspection. To inform our report we considered the following: information held by CSSIW about the service a discussion with the Registered Manager and staff limited discussion with several people using the service an examination of three staff files an examination of supervision and training records an examination of the provider’s quality assurance review and consultative questionnaires to people using the service, family representatives and stakeholders an observation of daily care practices at a supported home in Tredegar. What does the service do well? We found areas of consistent good practice particularly in respect of the monitoring of the quality of care, ensuring that health needs are maintained during stays away from the supported home and specific needs training. We saw evidence in care files, staff files and quality assurance documentation that demonstrates that the provider places emphasis on these areas. What has improved since the last inspection? We found that service delivery plans we saw were regularly reviewed and that deprivation of liberty arrangements are detailed in the care file at the supported home. What needs to be done to improve the service? No non-compliance notices were issued on this occasion. We found that the service were not fully compliant with Regulation 16(4) of the Domiciliary Care Agencies (Wales) Regulations 2004 and National Minimum Standards for Domiciliary Care Agencies (Wales) 21.2 in that all staff meet with their line manager at least once every three months. We were informed that staff meet their line manager every three Page 2 months but its alternate one to one and group supervision. We informed the Registered Manager that the consultation process would be improved if questionnaires for people using the service were available in a more accessible format for those with learning disabilities. Page 3 Quality Of Life People can be assured that they have a voice, are encouraged and supported in making choices and their rights are protected. We considered the agency statement of purpose which declares the philosophy of supporting people’s rights. We spoke with staff who understood their role in safeguarding vulnerable people and people’s rights to privacy, choice, dignity and respect, and we observed daily care practice where people were provided with choices and influence in their daily living such as meals, snacks and drink. We saw staff who were familiar with the communication needs of people and supported them in making choices about where they would like to sit or supported them in communicating with us. Staff were very respectful of their wishes and needs. When we spoke with staff we were informed of the communication needs of one person we saw who used body language, eye contact and touch. We were also made aware that tenants meetings were regularly held in order for people to have a say in aspects of daily living. We saw notes of meetings where holidays were discussed along with decoration, meals and activities. People can be assured that they will be supported in achieving an active and fulfilling lifestyle as possible based on their individual needs and abilities. We saw a care plan which included an ‘activity’ planner and staff, we were informed, would discuss with individuals their wishes. During the inspection visit one person returned from a day centre activity and she discussed with us her recent holiday to the south coast. She was talking to staff about her next holiday activity. In the care files we inspected we saw evidence of a variety of social outings, events and activities which included trips to the theatre, pubs, restaurants and one service user spoke about a visit to the X-Factor auditions which she enjoyed immensely. Generally, people’s physical well-being is maintained and they can have access to specialist and medical support. Because of the complex nature of people’s physical health needs the service maintain constant communication with the health service. In addition, care plans reflect the health needs of people using the service and so enable their needs to be anticipated by the staff. In care files we saw District Nursing Service notes of care they have administered, appointments attended to Local Health Board physiotherapy departments and multidisciplinary meeting recordings in which the Community Learning Disability Team (CLDT) were involved. Also within the care files was evidence that the provider has adopted the local Health Board hospital assessment scheme (Red, Amber and Green) so that, at times of hospital admittance, the service provide a needs assessment to the hospital immediately. This should maintain continuity of care. Further evidence of supporting people to maintain physical wellbeing included a letter, Page 4 written to the health board, by the home manager airing her concerns over a recent hospital stay by a person using the service. The letter had been responded too and offered apologies for a lack of care to the individual. This was an ongoing issue. People can experience warmth attachment and a sense of belonging and they can feel supported in times of anxiety and when they are upset. This is because the service fully understands peoples needs and preferences, and had devised strategies that, on the whole, help to prevent people becoming anxious. We spoke with staff who were very familiar with any behavioural difficulties that may be presented as these were detailed in behaviour plans and risk assessments in the care files we reviewed. We observed staff interact with several people returning to the supported home from their day centre. Staff interactions were calm and personalised, and provided a warm welcome to people returning. We spoke with one of those returning home who was complimentary of the staff and the service provided. Page 5 Quality Of Staffing People using the service can be confident that the personal care they receive is provided by appropriately recruited staff because the provider has robust procedures in place to employ staff. We saw evidence in three staff files that the provider had obtained references, a full employment history, undertaken disclosure and barring service checks (DBS) and several proof of identity. In addition, the files confirmed that staff complete an appropriate and recognised 12 week induction whilst in post. People can be assured that they are able to be supported by staff who have the knowledge and skills to care for their personal and daily living needs. This is because staff are given training in general aspects of care and more specialist training where appropriate. We saw evidence both in the staff files and in the home that people had received training in epilepsy, dementia, and learning disabilities and ‘network’ training provided by health professionals who have given guidance in relation to a specific individual. There was evidence that medication administration training is regularly provided by a nationally recognised provider. A notification had been received by CSSIW in relation to one incident of missed medication and we saw that those staff responsible had been withdrawn from giving medication until they have undergone refresher training. The provider is not fully compliant with providing evidence in respect of Regulation 16(4) of the Domiciliary Care Agencies (Wales) Regulations 2004 and National Minimum Standards 21.2 that all staff meet with their line manager at least once every three months on a one to one basis. We did see in documentation that staff have one to one and group supervision and we spoke to the staff who confirmed this and who said that they could approach their manager at any time for advice and guidance. However, it is necessary that all one to one supervision is recorded to fully comply. As detailed in the quality of life section people can be assured of good interactions with staff and feel able to develop positive and supportive relationships with staff who understand their role. Page 6 Quality Of Leadership and Management People can be assured that all staff managing or delivering a service to them understand the philosophical aims of what the provider aims to deliver and achieve. This is because the written statement of purpose clearly sets out these aims and staff spoken with understood what they are required to deliver and the outcomes they endeavour to achieve. The Service User Guide is written in a format accessible to people using the service. People are able to receive and can feel they get reliable, good quality of care because the provider has systems in place to monitor, review and improve the service provided. We saw that Regulation 23 (review of quality of service provision) was being complied with and that people using the service (and their representatives) were being consulted and that an annual report is made available. However, we would recommend that the consultative questionnaires to people using the service are made in a more accessible format for those with learning disabilities. In addition, we would recommend that any suggestions, from the consultation and quality monitoring process are developed into an action plan for improving the service. Never the less, on the whole people can be confident that they are safe, that the business is well run by a competent and knowledgeable manager and that due care and attention is made to the regulations and national minimum standards. This is because we saw several procedural documents and policies that were familiar to the manager and staff spoken with. We considered the database relevant to complaints, POVA, notifications to CSSIW and staff disciplinary and these were fully completed. Page 7 Quality Of The Environment This theme is not considered in domiciliary care inspections. Page 8 How we inspect and report on services We conduct two types of inspection; baseline and focussed. Both consider the experience of people using services. Baseline inspections assess whether the registration of a service is justified and whether the conditions of registration are appropriate. For most services, we carry out these inspections every three years. Exceptions are registered child minders, out of school care, sessional care, crèches and open access provision, which are every four years. At these inspections we check whether the service has a clear, effective Statement of Purpose and whether the service delivers on the commitments set out in its Statement of Purpose. In assessing whether registration is justified inspectors check that the service can demonstrate a history of compliance with regulations. Focused inspections consider the experience of people using services and we will look at compliance with regulations when poor outcomes for people using services are identified. We carry out these inspections in between baseline inspections. Focussed inspections will always consider the quality of life of people using services and may look at other areas. Baseline and focused inspections may be scheduled or carried out in response to concerns. Inspectors use a variety of methods to gather information during inspections. These may include; Talking with people who use services and their representatives Talking to staff and the manager Looking at documentation Observation of staff interactions with people and of the environment Comments made within questionnaires returned from people who use services, staff and health and social care professionals We inspect and report our findings under ‘Quality Themes’. Those relevant to each type of service are referred to within our inspection reports. Further information about what we do can be found in our leaflet ‘Improving Care and Social Services in Wales’. You can download this from our website, Improving Care and Social Services in Wales or ask us to send you a copy by telephoning your local CSSIW regional office. Page 9 Page 10