Bolton supporting people annual self assessment form

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					                      Bolton Council
                    Supporting People
   Annual Service Self Assessment
              2009/10

Name of Provider:                      Provider
                                       ID
                                       Service
Name of Service:
                                       ID

Address of Service:




Provider Contact:


Date Questionnaire Issued:


Date Questionnaire Returned:


Date of Assessment:




                                                  1
Included in this Self-Assessment Form

 Introduction: .................................................................................................... 3
 Section 1: ......................................................................................................... 4
 Quality ............................................................................................................... 4
 Quality Assessment Framework ........................................................................ 5
 Consultation/Communication............................................................................. 8
       i)Service User Consultation ........................................................................ 8
       ii)Engagement and Consultation with stakeholders, partner agencies
       and with Supporting People ................................................................                      9
 Complaints ...................................................................................................... 12
 Compliments ................................................................................................... 13
 Section 2: ....................................................................................................... 14
 Staffing/organisation ........................................................................................ 14
 Staffing details ................................................................................................. 16
 Service Budget & Annual Accounts ................................................................. 17
 Section 3: ....................................................................................................... 17
 Contract compliance ........................................................................................ 17
 Section 4: ....................................................................................................... 23
 Case Studies ................................................................................................... 23
 Section 5: ....................................................................................................... 24
 Local authority specific .................................................................................... 24
 Referrals .......................................................................................................... 24
 Future developments / discussions ............... Error! Bookmark not defined.25
 Declaration ................................................... Error! Bookmark not defined.25




                                                                                                                   2
             Bolton Supporting People Service - Annual Assessment

Introduction:

This annual service self-assessment will form part of our contract monitoring
process and is intended to reduce bureaucracy. The process will contribute to the
assessment of service quality and will assist in deciding if a more thorough
review of the service quality is necessary. As an integral part of the monitoring
and review process, providers should ensure that the QAF standards are
embedded into the approach to service delivery and organisational culture.

The QAF also identifies methods of evidencing achievements and is a practical
tool for ensuring continuous improvement. It is a means of ensuring that
providers deliver services to high standards and in accordance with contractual
expectations.

Details from the self assessment forms will be fed into the risk assessment which
will help to determine the need for service visits and operational reviews for the
forthcoming year and the number of contract monitoring meetings required for
each service. (See Bolton Contract Management Approach 2009-2010 doc)

Providers are required to self assess all services against the new criteria in the
refreshed QAF and to provide details of the current standards in place.

The purpose of the annual self-assessment is:

          To report on areas of Quality, Performance and Staffing of your
           service, which will be used in conjunction with other areas of contract
           monitoring

          To build on the QAF results of the previous service review undertaken
           by the Supporting People Team, as it provides the framework for
           continuous self-assessment, therefore promoting improved standards,
           identifying good practice and scope to develop those at a lower level.

          To encourage service providers to maintain high standards of service
           delivery and to demonstrate the involvement of service users and
           stakeholders in the service, and its development.

          To demonstrate how providers use feedback to improve service
           provision.

          To allow the Supporting People Team to address quality and
           performance issues across the authority.

Providers are required to submit the form, ensuring that each section is
completed with relevant information regarding the current performance and
quality.




                                                                                     3
   Section 1:
   Quality

1.1 Has there been any changes to service delivery since the   Yes       No
initial service review, e.g. how the service operates?

Please detail any specific changes below giving dates they
occurred




                                                                     4
   Quality Assessment Framework

   For this self-assessment we need providers to decide on the current
   performance rating in line with the refreshed QAF. If you feel your
   performance rating has changed since the last service visit or your last self
   assessment, please give details of appropriate supporting evidence. (Please
   do not provide copies of the evidence as this will be checked on site at future
   visits)

   Quality Assessment Summary Sheet – Service Visit Assessment
   on
   ___________________________


                                    Objectives                                            Score
C1.1   Assessment of needs and risks are carried out for all service users. Processes
       place service users’ views at the centre, are managed by skilled staff and
       involve carers and/or other professionals.

C1.2   Service users have up to date support plans in place. Processes place users’
       views at the centre, are managed by skilled staff and involve carers and/or
       other professionals.

C1.3   The security, health and safety of all individual service users, staff are
       protected.
C1.4   Service users have the right to be protected from abuse and this right is
       safeguarded.

C1.5   There is a commitment to the values of diversity and inclusion and to practice
       of equal opportunity (including accessibility in its widest sense) and the needs
       of black and minority ethnic service users are appropriately met.
C1.6   Users, Carers and other stakeholders are made aware of complaints
       procedures and how to use them.

S1.2   Service users are consulted about the services provided and are offered
       opportunities to be involved in their running

S3.3   The living environment:
              Is suitable for its stated purpose, accessible, safe and well maintained
           Is appropriate to the needs of the residents
       Meets the requirements for independence, privacy and dignity




                                                                                          5
   Quality Self Assessment

                                                           Evidence details given
                                     New Self Assessment
                                                                 Yes / No
C1.1 – Assessment & Support
Planning
Comments




                                                           Evidence details given
                                     New Self Assessment
                                                                 Yes / No
C1.2 – Security, Health and Safety

Comments




                                     New Self Assessment   Evidence details given
                                                                 Yes / No
C1.3 – Safeguarding and
Protection from Abuse
Comments




                                                                        6
                                                             Evidence details given
                                     New Self Assessment
                                                                   Yes / No
C1.4 – Fair access, diversity and
Inclusion
Comments




                                     New Self Assessment     Evidence details given
                                                                   Yes / No
C1.5 – Client Involvement and
Empowerment
Comments




Any further comments relating to the QAF or self assessment, please state below:




                                                                          7
    Consultation/Communication

        i) Service User Consultation

Please indicate by ticking below how you consult with your service users and how
frequently (in the comments box below):

House Meetings   □       Focus Groups   □     One to one sessions   □     Surveys
□
Organisational Newsletters   □   Events   □   Feedback Form   □           Other   □
Comments (please give examples of the subjects/topics discussed or consulted on
regarding how the service operates, e.g. complaints policy)




Do you make minutes/notes of this consultation                Yes       Sometimes         No
available to service users?
Please comment below how service users are
encouraged to participate in meetings/activities e.g. do
clients set the agenda?
Please comment on any barriers to service user
involvement
Comments




                                                                                      8
 Have any changes or improvements been made to service               Yes         No
 delivery following consultation with service users?
 Please give examples

 Examples:




     ii) Engagement and Consultation with stakeholders, partner
          agencies and with Supporting People
Please indicate by ticking below how you consult with your stakeholders and/or
partner agencies and how frequently (in the comments box):

Surveys    □             Forums   □          Events   □         Away Days    □
Focus Groups   □         Questionnaires      □                   Other   □
 Have you carried out consultation exercises with stakeholders       Yes         No
 and/or partner agencies over the last 12 months?
 Please comment below on details of any consultation
 exercises conducted regarding service delivery e.g. eligibility
 criteria. You should also, if available, submit evidence that
 you have acted upon consultation exercises.
 Please comment on any barriers to consultation with
 stakeholders or partner agencies
 Comments




                                                                                 9
Engaging with stakeholders and/or partner agencies               Yes      No
Have you attended events with or facilitated by stakeholders
and/or partner agencies over the last 12 months? This would
include events held with other departments of the council,
other funders etc.
If so please provide details below
Comments




Engaging with the Supporting People Programme                      Yes         No
In order to advise and consult with providers regarding
changes in the delivery of the Supporting People programme a
number of events are organised throughout the year.
Has any member of your organisation attended organised
Supporting People events over the last 12 months?
If representatives from the service have been unable to attend
Supporting People Events in the last 12 months, could you
please indicate how the events could be organised differently
for your representatives to be able to attend.
Comments




                                                                         10
Added Value                                                    Yes        No
In order to assess your organisation, please advise of any
aspect of your service that you consider added value e.g.
volunteers, chairing meetings that benefit the SP programme,
representation on steering groups, non SP funded activities,
etc.

Comments




                                                                     11
      Complaints

      As part of the QAF you are expected to monitor and respond to complaints
      as this is an important part of understanding service user/stakeholder
      needs, as well as a way of improving the quality of your service. Please
      complete the tables below with details of any complaints and compliments
      received within the last 12 months for this service.
      (Resolved means the complainant is satisfied with the outcome)

   Source of        Total number    Total number                                     Total
  complaint/s         of verbal       of written     Brief comments/ Action         number
                     complaints      complaints               taken                resolved
                      received        received
Residents/service
     users



Referring agents




  Neighbours




  Stakeholders
  (please state
relationship with
     service)


 Others, please
    specify




Please give details of any complaints that have not been resolved satisfactorily and
the actions to be taken




                                                                              12
     Compliments


                    Total number   Total number
    Source of         of verbal      of written
  compliment/s      compliments    compliments    Brief details of compliment
                      received       received

Residents/service
     users



Referring agents




  Neighbours




  Stakeholders
  (please state
relationship with
     service)


 Others, please
    specify




Additional comments:




                                                                      13
   Section 2
   Staffing/Volunteers/organisation

2.1 Have you met the required staffing levels at all times, as   Yes        No
specified in the Supporting People contract?

Please clarify your answer in the comment box below.
Comments




2.2 Are all staff (new and existing) properly recruited,         Yes        No
including the taking of references, POVA and enhanced CRB
checks?

Please clarify your answer in the comment box below.
Comments




2.3 Have all volunteers (new and existing) had enhanced          Yes        No
CRB checks?

Please clarify your answer in the comment box below.
Comments




                                                                       14
2.4 Have there been any changes to staffing levels within the      Yes        No
service in the last 12 months. This would also include any
changes to management/board structures.

Please provide details of any changes below.
Comments




2.5 Have you encountered any issues relating to staffing           Yes        No
levels or turnover in the last 12 months? This would include
the use or increased use of locum or agency staff and any
significant issues relating to recruitment or retention of staff
creating capacity problems for you?

Please detail any issues or comments below.

Comments




                                                                         15
     Staffing details

2.6 Please provide details of your current staffing by completing the table below.
Please complete a table for each service

The total weekly hours and total salary including on costs (NI and pension only)
should be given not just the cost related to Supporting People.

                 Calculation of Staff Time and Expense on Support Activities

                               NB All yellow boxes need to be completed.


        Provider                                                                      Provider
         Name                                                                          ID No.

         Service                                                                      Service
          Name                                                                        ID No.


                                           Weekly
                                                         % Time      Total Salary +
        Initials of                       Hours ( all    on SP        On costs (NI
       employee             Title          duties)      Activities    & Pension)
      E.g. MJ         Scheme Manager              35         50%         £25,634
      E.g. BP         Support Worker              20         60%         £14,258




      Completed by:
      Date of completion:
      Provider contact name:




                                                                                                 16
   Service Budget & Annual Accounts

2.7 Please provide detailed budgets for the current and          Yes        No
forthcoming financial year for each individual service.

Comments




2.8 Please provide your latest audited Annual Accounts           Yes        No
    (electronically if possible)

Comments




   Section 3

   Contract compliance

3.1 Accreditation - Are you externally validated by any of the   Yes        No
following frameworks?
    Another participating Local Authority
    CHS Code of Practice
    Community Legal Services
    Foyer Accreditation
    Investors In People
    Care Quality Commission
    Tenant Services Authority (formerly Housing Corporation)

Comments




                                                                       17
3.2 Do you consider that you have provided the service that is   Yes            No
specified within the Supporting People contract?

Please state any comments below.
Comments




3.3 Health and Safety                                  Y/N       Details
Have any of the following occurred in the last
12 months (during or related to the operation
of the service)?

      Injuries relating to clients, staff or public
       including deaths, suicides and
       attempted suicides of service users
      Incidents reportable to Health and
       Safety Executive (HSE) or
       Environmental Health officer (EHO)
      Incidents reportable to Medicines and
       Healthcare Products Regulatory Agency
       (MHRA)
      Are all risk assessments up to date for
       all clients and available to relevant
       staff?

Please provide copies of incidents reports if
not already done so.

Are there any other relevant Health and Safety
issues?

Is Health & Safety covered during staff
induction and are the manager and staff all
appropriately trained in Health & Safety
compliance?




                                                                           18
3.4 Notifiable Incidents                           Y/N   Details
Have any of the following occurred in the last
12 months?

      Police actions relating to clients or
       services.
      Issues that might create bad publicity
       relating to clients or services.
      Known or anticipated inability to
       continue providing part/all of service.
      Enforcement/improvement notices
       served
      Staffing – any long term absence
       (please include cover arrangements)
      Any Adult or child protection issues

Please provide copies of incidents reports if
not already done so.

3.5 Protection of vulnerable adults                Y/N   Details
Are there any adult (or child) protection issues
occurring within the last 12 months, including
POVA or CQC notifications.
If YES please provide details, including
actions taken.

Please confirm that the safeguarding adults’
and child protection policies and procedures
have been reviewed and updated to include
changes in the nature of the operation, new
legislation and good practice within the last
three years.

Is safeguarding adults and child protection
covered during staff induction and are the
manager and staff all appropriately trained in
local safeguarding adults and child protection
procedures?




                                                                   19
3.6 Quality and contract performance               Y/N       Details
Are there any issues arising from provider’s
own quality assurance systems?




                                                   Y/N       Details
3.7 Insurance requirements
                                                         and expiry dates
Are the terms of the contract still met in terms
of insurance requirements?

Please confirm the provider has the following
insurance and provide expiry dates.

      Public liability insurance (min level £5
       million in respect of any one claim)
      Employers liability insurance (min level
       £10 million in respect of any one claim,
       covering all employees)
      Professional indemnity Insurance




3.8 Contract developments                          Y/N       Details

Are there any significant changes to services,
provider or premises, including those
anticipated, that might have an impact on your
SP contract or jointly funded services?




                                                                       20
3.9 Client Record Forms                          Y/N   Details

Are Client Record Forms being regularly
returned electronically for all new service
users?


Are there any issues relating to the return of
Client Record Forms for new service users?

If so please give details and action taken to
remedy this.




3.10 Outcomes Framework                          Y/N   Details

For short term services - are Outcomes forms
being regularly returned for all service users
departing the service

For long term services - are Outcomes forms
being returned for long term services as per
CLG guidance, i.e. 10% sample for sheltered
services and 50% for all other long term
services?

Please note for extra care services we now
require the completion of outcome forms.

Please state the number of forms that have
been submitted for the previous year for both
short and long term services.

Are there any issues relating to the return of
Outcomes Forms for service users?

If so please give details and action taken to
remedy this.




                                                                 21
3.11 Contingency planning                          Y/N   Details

Is there a contingency plan in place in case of
financial hardship for the organisation/
provider?


Is there a contingency plan in place in case the
premises become unsuitable for use?

Is there a contingency plan in place in case of
an outbreak of pandemic flu affecting clients
or staff within your service?




3.12 Advice on housing benefit, Supporting
People & fairer charging assessments               Y/N   Details

In order to maximise service users personal
income does the service offer advice on
Housing Benefit, Supporting People and the
availability of a fairer charging assessment?




                                                                   22
   Section 4

    Case Studies




If you have relevant case studies that can support positive outcomes for service
users, please provide details in the comment box below or attach supporting evidence
to the annual self assessment form.
Comments




                                                                        23
      Section 5

      Local authority specific

      Referrals
      (This section is not applicable for home improvement agencies, community
      alarm services or Telecare)
      Where referrals are made via an Adult Services Allocation Panel please
      indicate this and the Supporting People team will request this information from
      the relevant allocation panel.

      Please include the following referral information about the applications and
      acceptance to your service in the last 12 months period

                   Total Referred                                  Total Referred         Comments /
5.1                                       Total Admitted /
                   or applications                               from Out of Area        issues noted
Source of                                    accepted
                        made
referral/applica
                          Female




                                                 Female




                                                                         Female
tion
                                   B&ME




                                                          B&ME




                                                                                  B&ME
                   Male




                                          Male




                                                                  Male
                                    %




                                                           %




                                                                                   %
Housing

Probation

Social
services
Youth
offending
Team
Health

Education

Internal
Transfer

Self Referral

Other
providers
Other (please
specify)




                                                                                               24
        Future developments / discussions

5.2 Please give details of any recent, current or future discussions with Bolton
Council regarding development of services that are not currently Supporting People
funded
Comments




        Declaration

Completed by (Provider):

Position:

Date:



Received by (Supporting People):

Position:

Date:




                                                                           25

				
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