Cambusnethan Residential Children's House Care Home Service Children and Young People 239 Cambusnethan Street Cambusnethan Wishaw ML2 8BS Telephone:

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1 Cambusnethan Residential Children's House Care Home Service Children and Young People 239 Cambusnethan Street Cambusnethan Wishaw ML2 8BS Telephone: /8 Inspected by: Howard Armstrong Janie Fraser Type of inspection: Unannounced Inspection completed on: 8 January 2013

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 12 4 Other information 26 5 Summary of grades 27 6 Inspection and grading history 27 Service provided by: North Lanarkshire Council Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Howard Armstrong Telephone enquiries@careinspectorate.com Cambusnethan Residential Children's House, page 2 of 29

3 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 3 Adequate Quality of Environment N/A Quality of Staffing 4 Good Quality of Management and Leadership 4 Good What the service does well Cambusnethan Residential Children's House continues to provide very good support to a wide range of young people with different needs. Staff are motivated and enthusiastic. The young people that we spoke to told us that they felt safe living there. They thought that staff supported them well, and that they were given choice about the way the house was run. What the service could do better The service needs to improve the quality of its care plans, staff supervision and medication recordings. Staff need to provide more evidence of the informal work that they do with young people in relation to choice and decision making. They need to continue to develop a range of ways of getting feedback from young people, families, and other people involved with the service. What the service has done since the last inspection Managers and staff have worked hard on several of the recommendations that we made at the last inspection. They have greatly improved the accurate recording of incidents and of staff training sessions. Also, they have developed useful checklists to help with recording care plans, reviews and risk assessments. Cambusnethan Residential Children's House, page 3 of 29

4 Conclusion Inspection report continued There was a very good atmosphere in the house. Young people told us that they feel safe and well supported by staff. We observed sound relationships between staff and young people. The staff team was motivated and enthusiastic, although it needs further support to re-form fully. Who did this inspection Howard Armstrong Janie Fraser Cambusnethan Residential Children's House, page 4 of 29

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Prior to 1 April 2011, this function was carried out by the Care Commission. Information in relation to all care services is available on our website at: This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve its service, we may make a recommendation or requirement. - A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service but where failure to do so will not directly result in enforcement. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reforms (Scotland) Act 2010 and Regulations or Orders made under the Act, or a condition of registration. Where there are breaches of the Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Inspectorate. Cambusnethan Residential Children's House is provided and managed by North Lanarkshire Council. It is based in a purpose built single storey building in Wishaw, near to local amenities. It is normally registered to provide a care home service to a maximum of 6 children between the ages of 8 and 18 years. From 1 December 2012 until 1 February 2013 it can provide a care service to a maximum of 7 children between the ages of 8 and 18 years. This number includes one child from Buchanan Street Children's House. The current staffing schedule, dated 13 July 2009, will be increased by one staff member on each day and evening shift. The unit has six bedrooms, each of which has en-suite facilities, and one further bedroom in use at present. There is a large open plan sitting room/dining area, an education/activity/computer room, a meeting room and an additional open plan sitting area. Cambusnethan Residential Children's House, page 5 of 29

6 At the time of inspection there were six young people accommodated in the service. One of these young people was staying temporarily with relatives. During the course of the inspection visit there were seven care staff present (due to shift handover period), two cooks, and one domestic member of staff. The service aims state that they commit to a child centred approach and strive to promote the best interests of the young people. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 3 - Adequate Quality of Environment - N/A 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 or by calling us on or visiting one of our offices. Cambusnethan Residential Children's House, page 6 of 29

7 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 report was written following an unannounced inspection visit on 08 January 2013 between 12:00 noon and 6:15pm. We gave feedback to the provider and manager at the end of the inspection. The inspection was carried out by Care Inspectorate Inspectors Howie Armstrong and Janie Fraser. This was a follow up to the inspection of 05 July Both reports should be considered together. Evidence was gathered from a variety of areas including: * The most recent annual return and self assessment document * Discussion with the children and young people * Evidence of feedback from young people, families and referring social workers. * Discussion with Residential Childcare Workers, Depute Manager, Manager and Provider (Service Manager). * Observation of a staff shift handover meeting * Examination of records including: care plans, personal outcome plans, incidents and restraint recordings, Individual Crisis Management Plans (ICMPs), medication records, minutes of young people's meetings, staff training records, minutes of staff meetings and senior staff meetings. We heard the views of three young people and a parent. We had lunch with care staff and domestic workers. 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 Cambusnethan Residential Children's House, page 7 of 29

8 Inspection Focus Areas (IFAs) Inspection report continued 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 Cambusnethan Residential Children's House, page 8 of 29

9 What the service has done to meet any recommendations we made at our last inspection We made eight recommendations at the last inspection: Recommendation 1. Staff should consider using a range of ways to encourage young people's participation, feedback and ideas for improvement. They should record suggestions and action taken whenever possible, and feedback the results to the young people. National Care Standards, Care Homes for Children and Young People, Standard 9 - Making choices. We felt that the service still needed to record additional evidence of its participation and consultation activities. We have carried the recommendation into this report. See Quality Statement 1.1. Recommendation 2. Steps should be taken to ensure that matters raised by young people are reported back to the staff group as a whole and that matters arising from previous young people's meetings are followed up. National Care Standards, Care Homes for Children and Young People, Standard Making choices. We found good informal evidence that issues raised by young people were being listened to and acted on by staff. We have carried the recommendation into this report so that we can track the service's use of formal recording of these issues. See Quality Statement 1.1. Recommendation 3. The service should actively seek to meaningfully involve the children and young people in assessing the quality of care and support, environment, staffing and management and leadership. The children and young people have a right to receive, and be supported to complete, the Care Standard Questionnaires provided by SCSWIS (Care Inspectorate). National Care Standards Care Homes for Children and Young People Standard 8 - Exercising Your Rights. The service now made sure that children and young people were able to complete Care Standard Questionnaires. We have carried the recommendation into this report so that we can track the setting up of the planned Youth Form, and the effectiveness of the new independent advocacy arrangements. See Quality Statement 1.1. Cambusnethan Residential Children's House, page 9 of 29

10 Recommendation 4. The service should review its filing procedures to make sure that records - both electronic and paper, were accurate and up-to-date. National Care Standards, Care Homes for Children and Young People, Standard Management and staffing. We found significant improvements, especially in the recording of incidents and the effective use of checklists. Work was needed in other areas so we have carried the recommendation into this report. See Quality Statement 1.3. Recommendation 5. The service should make sure that it can evidence that all relevant people, and particularly young people, have agreed and signed care plans and reviews of care plans. National Care Standards, Care Homes for Children and Young People, Standard 4 - Support arrangements We continued to find inconsistencies in this area so we have carried the recommendation into this report. See Quality Statement 1.3. Recommendation 6. The service should make sure that the reason for medicine being prescribed to a young person was always recorded. National Care Standards, Care Homes for Children and Young People, Standard Keeping well - medication. In the records that we sampled we found an example where we could not find any record of why a medicine had been prescribed. The recommendation had not been met and is carried forward into this report. See Quality Statement 1.3. Recommendation 7. The service should review its supervision arrangements to make sure that all staff receive regular supervision. Reasons for supervision sessions not taking place should be recorded, and the manager should monitor the regularity of supervision. National Care Standards, Standard Management and staffing. This recommendation had been met. Cambusnethan Residential Children's House, page 10 of 29

11 Recommendation 8. Quality auditing systems should fully involve the children and young people and all those with an interest in the service. Young people should in particular be supported to use any internal and external systems for evaluating the service if they wish to do so. National Care Standards Care Homes for Children and Young People Standard 18 - Concerns, Comments and Complaints. This recommendation has still to be implemented fully and is carried forward into this report. See Quality Statement 4.2. 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. The Care Inspectorate 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 heading that we grade them under. The service provider identified what they thought they did well, some areas for development and any changes they had planned. Taking the views of people using the care service into account We spent time talking with three young people. They gave us very good feedback about the support that they got from staff. They all felt safe in the house and said that staff handled difficult situations well. Taking carers' views into account We talked with a parent who told us that he was very pleased with the way that his child was supported. He thought that his child's needs were being met well. Cambusnethan Residential Children's House, page 11 of 29

12 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: 3 - Adequate 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 This section includes evidence from Quality Theme 1, Quality Statements 1.1 and 1.3. We found that the service was operating well in the areas covered by this statement. We reviewed the evidence of participation that the service gave us. We found good informal evidence that children, young people and families were involved in commenting on and improving the quality of care and support in the service. We have awarded the same grade as we gave at the previous inspection. Staff told us that young people had been involved in the recruitment interviews for senior members of staff here, as well as at another residential house in Cumbernauld. We met with three young people throughout the day. They were generally happy with the care that the staff were giving. They all felt safe and secure and that they were given choice in relation to the way the unit was run. The parent that we talked with told us that he felt that he got a say in how the unit supported his child. He was pleased with the way that the service supported his child and family. Cambusnethan Residential Children's House, page 12 of 29

13 Areas for improvement The service told us that they had very good examples of the involvement of young people in improving the service. These examples mainly were in the individual records of 'focused work' with young people. However, the service needed to collate these examples, and identify patterns, action taken and the feedback given to children, young people, parents and carers. We do recognise that a lot of the participation work in a service like this will be informal at times. However, it is important to keep records of at least some of the improvements that children and young people have suggested. This could be at an individual or group level. It is important, then, to use a range of participation and recording methods to suit differing circumstances. For example, in the seven months from June to December 2012 there had only been one young people's meeting (in October). We understand that there will be periods when young people's meetings do not take place, for example due to holiday periods, unsettled times in the house, or young people simply not wanting to meet as a group. However, staff still have a responsibility to seek young people's views, whether positive or negative, so that they can continuously improve the quality of the service. Staff need to record this so that they can demonstrate the good work that they are doing. We have carried forward recommendations 1, 2 and 3 from the previous inspection so that we can continue to monitor this. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 3 Recommendations 1. Staff should consider using a range of ways to encourage young people's participation, feedback and ideas for improvement. They should record suggestions and action taken whenever possible, and feedback the results to the young people. National Care Standards, Care Homes for Children and Young People, Standard 9 - Making choices. 2. Steps should be taken to ensure that matters raised by young people are reported back to the staff group as a whole and that matters arising from previous young people's meetings are followed up. National Care Standards, Care Homes for Children and Young People, Standard Making choices. Cambusnethan Residential Children's House, page 13 of 29

14 3. The service should actively seek to meaningfully involve the children and young people in assessing the quality of care and support, environment, staffing and management and leadership. The children and young people have a right to receive, and be supported to complete, the Care Standard Questionnaires provided by SCSWIS, (Care Inspectorate). National Care Standards Care Homes for Children and Young People Standard 8 - Exercising Your Rights. Cambusnethan Residential Children's House, page 14 of 29

15 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths We found that the service was operating adequately in the areas covered by this statement. We decided this after sampling care plans and related documents including restraint and incident recordings. Also, we examined the paper and electronic medication recording systems. We talked with three young people about their care plans. Managers and staff had worked very hard to improve the way that records were filed, kept and signed off. We saw this particularly in relation to incident recordings. A new system had been put in place so that staff on shift completed a detailed incident report. This was filed together with any follow-up work like 'life-space' recordings. The information was then put into the electronic recording system which kept a running total of the number of incidents. Also, staff now used a number of new checklists to make sure that key tasks had been carried out. For example, there was one to record updates to Individual Crisis Management Plans (ICMPs) and care plans. We heard from managers that staff had been working very hard to improve care plans. We saw that much work had been done on the process of producing the plans. We confirmed that care plans were generally kept up to date. All three young people that we interviewed said that they participated in their care plans. However, we found that the approach that was taken by staff varied from one young person to the next. See areas for improvement. The depute manager had continued to have an oversight of medication issues. She had retained the electronic recording system in addition to the paper one, in the hope that it acted as a 'double-check' on the records that had to be kept. Areas for improvement Inspection report continued We found some inconsistencies in keeping records accurate and up to date, so we have carried forward a recommendation from the previous inspection. See recommendation 1. We found similar inconsistencies in making sure that care plans were agreed and signed off, so have carried over the recommendation from the previous inspection. See recommendation 2. Although young people told us that they were involved in care planning, they said that some key workers stayed with them throughout the process. Other staff simply gave them the care plan to read once it had been updated. The manager and depute told us that young people sit with their key worker and use a' pro-forma' together to update care plans. When we informed them that this was not consistent with what the young people said they disagreed. Cambusnethan Residential Children's House, page 15 of 29

16 All three young people expressed a lack of interest to us about their care plan. They saw it only as a necessary process, rather than something they owned which helped them with their journey through care. The service needs to look at ways of making care planning more interesting and child friendly, so the young people feel it is their plan rather than something that is done to them. We sampled 50% of the care plans in the house. We noted the following issues in all three care plans and ICMPs: * Information was copied across from previous care plans and used in current ones, with updated information added. * The SHANARRI well being indicators were not being used appropriately. They should have tied in with the focused work and information in the daily logs and therefore reflected the knowledge the staff had about the young people. This information should have been analysed using the well-being indicators to help formulate the care plans. For example, we noted in one young person's file that there were safety issues. It was clear from the file that staff had been building relationships to promote self esteem and confidence, but no link was made between this work and how it could assist the young person with their safety issues. (See the previous report for information on the Scottish Government GIRFEC system and its SHANARRI well-being indicators). * Individual Crisis Plans were also being copied and pasted. This did not reflect the work that the staff were actually doing to manage individual behaviour within the unit. * If outcomes had been achieved since previous care plans, this was not reflected anywhere and there was no discussion if this was maintained. * If outcomes were not achieved there was no evidence recorded of how this would be addressed. For example, one young person had expressed an interest in music. After speaking to the young person we knew this had been supported but there was no discussion in the care plan about how this impacted on his well being. We realise that the service is at a relatively early stage in implementing these new ways of reflecting the range of young people's needs and aspirations in their care plans. The service manager recognises the need for additional support for staff, and we have offered to 'signpost' some materials and resources that may be helpful. Cambusnethan Residential Children's House, page 16 of 29

17 We sampled administration of medicine records, both paper-based and electronic. We found that there were errors and omissions in both systems. For example, there were gaps in the electronic administration records, so we could not tell if a medicine had actually been given or not. Also, there was at least one error in recording the amount of medicine remaining. In one of the paper records we could not find any mention at all of why a medicine had been prescribed. We recognise that the recording of administration of medicines can be complex and time-consuming for staff. We question the need for two recording systems. More reliable and accurate outcomes might be achieved by concentrating on a single system. We know from discussion with the service manager that medication issues in general are being taken forward with the Council's specialist advisers, and we welcome this. We have carried forward the recommendation from the last inspection about recording the reasons for medicines being prescribed (recommendation 3). We have made a new recommendation, asking the service to review its use of two recording systems. See recommendation 4. Grade awarded for this statement: 3 - Adequate Number of requirements: 0 Number of recommendations: 0 Recommendations 1. The service should review its filing procedures to make sure that records - both electronic and paper, were accurate and up-to-date. National Care Standards, Care Homes for Children and Young People, Standard Management and staffing. 2. The service should make sure that it can evidence that all relevant people, and particularly young people, have agreed and signed care plans and reviews of care plans. National Care Standards, Care Homes for Children and Young People, Standard 4 - Support arrangements 3. The service should make sure that the reason for medicine being prescribed to a young person was always recorded. National Care Standards, Care Homes for Children and Young People, Standard Keeping well - medication. Cambusnethan Residential Children's House, page 17 of 29

18 4. The service should review its systems for recording the administration of medicines. Specifically, it should seek advice on continuing to maintain two separate recording systems. National Care Standards, Care Homes for Children and Young People, Standard Keeping well - medication. Cambusnethan Residential Children's House, page 18 of 29

19 Quality Theme 2: Quality of Environment - NOT ASSESSED Cambusnethan Residential Children's House, page 19 of 29

20 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 This section includes evidence from Quality Theme 3, Quality Statements 3.1 and 3.3. We found that the service was operating well in the areas covered by this statement. See Quality Theme 1, Quality Statement 1.1 for information about participation and involvement that also applies to this statement. We have given this statement the same grade as Quality Statement 1.1. Areas for improvement See quality statement 1.1 for areas for improvement that also apply here. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Cambusnethan Residential Children's House, page 20 of 29

21 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Inspection report continued We found that the service was operating well in the areas covered by this statement. We examined staff supervision records. The service had made considerable progress since the last inspection in the accuracy of recording supervision sessions that had been held. Managers had set up a supervision tracking sheet to do this. Also, the service was now keeping accurate records of staff training that included an historical record of the previous three years. This meant that managers could identify current training needs more easily, for example the need for updated training in specific areas. North Lanarkshire Council had a Personal Review and Development plan (PRD) in place that provided training, development and support for staff. We observed a staff shift handover meeting. Each young person's needs were confirmed thorough a review of their achievements and issues over the past few days. Also, the team discussed and agreed action on specific issues for young people. All members of staff were engaged and actively participating in these discussions. We reviewed the minutes of recent staff meetings. These confirmed discussions we had with managers about their support for staff to improve medication recording systems, young people's meetings, and notes of 'focus work' with young people. We found that there was a very good atmosphere in the house. The staff team was motivated and enthusiastic, despite the difficulties they had experienced over recent times. They had developed solid and supportive relationships with young people. The young people we spoke to confirmed this, and that they got on well with staff. The parent that we interviewed told us that staff in the house were all very supportive to his child and to him. For example, before going into Cambusnethan his child had stopped going to school. but staff had encouraged him to get back into education via a college placement. He told us that his child's hobbies were encouraged and supported in the house. The parent knew how to complain if there was anything relating to his care that he was unhappy with. He said that this had never been an issue because the quality of his child's care was good. Two of the young people we talked with told us that the unit can sometimes be disrupted by the behaviour of other young people. However, they said that staff managed these behaviour challenges very well. One young person expressed genuine admiration for the ability of staff to stay calm when challenged. Cambusnethan Residential Children's House, page 21 of 29

22 Areas for improvement We noted discussion in team meeting minutes about some key issues, for example that young people's meetings could be informal and should always be minuted. However, some of these decisions still had to be put into practice. Managers needed to be clear about responsibilities, required actions and monitoring systems to support such decisions. We discussed at feedback the difficulties that this staff team has experienced over the past two years, and the fact that currently it is operating with five fewer permanent staff than normal. The final planned changes to staffing have been made, but there have been unexpected events that have imposed further change and difficulty on the team. The service manager was clear that the team needs support and time to reform itself, and gave a commitment to provide this. We comment on this further in Quality Statement 4.2. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Cambusnethan Residential Children's House, page 22 of 29

23 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 This section includes evidence from Quality Theme 4, Quality Statements 4.1 and 4.2. We found that the service was operating well in the areas covered by this statement. See Quality Theme 1, Quality Statement 1.1 for information about participation and involvement that also applies to this statement. We have given this statement the same grade as Quality Statement 1.1. Areas for improvement See Quality Statement 1.1 for areas for improvement that also apply here. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Cambusnethan Residential Children's House, page 23 of 29

24 Statement 2 We involve our workforce in determining the direction and future objectives of the service. Service strengths Inspection report continued We found that the service was operating well in the areas covered by this statement. Staff were able to influence the future direction of the service through team meetings, supervision and authority-wide working groups (but see areas for improvement). The manager highlighted the important role the new depute had played, for example in involving and supporting staff to improve recording practices and care planning. Children and young people had continued to benefit from staff who were well supported by their managers, and focused on meeting their needs. Young people confirmed this in their discussions with us. It was clear that managers were working hard to support and develop the team in sometimes difficult circumstances. Young people confirmed that staff worked very hard to support them. The service had begun to develop 'evidence boxes' that gave staff the opportunity to highlight good practice that supported the national standards. Areas for improvement We found that the content of staff supervision records lacked structure and content. There was no clear agenda, for example the use of subheadings would be helpful. The focus of supervision seemed to be on staff morale and team dynamics. Although this was a valuable aspect of supervision, there also needed to be discussion about professional development and current knowledge. The needs of the young people was not a standing item on supervision agendas, nor was teamwork. Supervision records were not always dated and signed by both the supervisor and supervisee. See recommendation 1. We would like to see further progress in the area for development we highlighted in the last report. This was about using structured methods to get staff views about the aims and direction of the service. We suggested that this might be done through specific slots at team meetings, or by using staff questionnaires. We acknowledge that managers have told us that staff will be involved in producing future development plans for the service. We did not find robust evidence about quality assurance systems fully involving children and young people. There is an outstanding recommendation about this that we have carried over into this report. See recommendation 2. Cambusnethan Residential Children's House, page 24 of 29

25 We found that some of the service's questionnaires, for example the one for social workers, used too many 'closed' questions. (Questions that could only be answered by 'yes' or 'no'). This limited the type and extent of feedback that could be gathered. It would be good practice to make sure that formal questionnaires always included 'open' options. See recommendation 3. We mentioned in Quality Statement 3.3 the need for this service to have a period of stability so that it could re-form. The service manager gave a commitment to provide the necessary support. Also, the Council has planned a new Continuing Professional Development strategy (CPD) which will have positive impact on training and support opportunities for staff. We will review this area at the next inspection. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 3 Recommendations Inspection report continued 1. Managers should make sure that staff supervision sessions include discussion of issues that directly benefit young people, such as their needs and aspirations. The service should consider using standard supervision agendas to support focused discussion of key issues. Staff and supervisors should sign off supervision recordings to confirm agreement with the content. National Care Standards Care Homes for Children and Young People Standard Management and staffing. 2. Quality auditing systems should fully involve the children and young people and all those with an interest in the service. Young people should in particular be supported to use any internal and external systems for evaluating the service if they wish to do so. National Care Standards Care Homes for Children and Young People Standard 18 - Concerns, Comments and Complaints. 3. The service should review and revise its questionnaires to make sure that they gave stakeholders sufficient opportunity to comment on issues in detail. National Care Standards Care Homes for Children and Young People Standard Management and staffing. Cambusnethan Residential Children's House, page 25 of 29

26 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 The service gave us an appropriate action plan on 28 August 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). Cambusnethan Residential Children's House, page 26 of 29

27 5 Summary of grades Quality of Care and Support Adequate Statement 1 Statement Good 3 - Adequate Quality of Environment - Not Assessed Quality of Staffing Good Statement 1 Statement Good 4 - Good Quality of Management and Leadership Good Statement 1 Statement Good 4 - Good 6 Inspection and grading history Date Type Gradings 5 Jul 2012 Unannounced Care and support 3 - Adequate Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good 23 May 2011 Unannounced Care and support 3 - Adequate Environment Not Assessed Staffing 3 - Adequate Management and Leadership 2 - Weak 20 Jan 2011 Unannounced Care and support 3 - Adequate Environment Not Assessed Staffing 2 - Weak Management and Leadership Not Assessed 20 Sep 2010 Announced Care and support 4 - Good Environment 4 - Good Cambusnethan Residential Children's House, page 27 of 29

28 Staffing Management and Leadership 4 - Good 4 - Good 8 Dec 2009 Announced Care and support 3 - Adequate Environment 4 - Good Staffing 4 - Good Management and Leadership 3 - Adequate 7 Sep 2009 Announced Care and support 3 - Adequate Environment 3 - Adequate Staffing 3 - Adequate Management and Leadership 3 - Adequate 24 Mar 2009 Unannounced Care and support 3 - Adequate Environment 2 - Weak Staffing 3 - Adequate Management and Leadership 2 - Weak 29 Oct 2008 Announced Care and support 2 - Weak Environment 2 - Weak Staffing 2 - Weak Management and Leadership 2 - Weak All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Cambusnethan Residential Children's House, page 28 of 29

29 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 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: or by telephoning Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: enquiries@careinspectorate.com Web: Cambusnethan Residential Children's House, page 29 of 29