Bardykes Road Care Home Service Children and Young People Short Term Unit Bardykes Road Blantyre Glasgow G72 9UJ Telephone:

Transcription

1 Bardykes Road Care Home Service Children and Young People Short Term Unit Bardykes Road Blantyre Glasgow G72 9UJ Telephone: Inspected by: Alan Paterson undefined Type of inspection: Unannounced Inspection completed on: 6 February 2013

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 8 4 Other information 19 5 Summary of grades 20 6 Inspection and grading history 20 Service provided by: South Lanarkshire Council Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Alan Paterson Telephone enquiries@careinspectorate.com Bardykes Road, page 2 of 22

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 4 Good Quality of Environment 4 Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well The service provides a modern well appointed and homelike location for the Children and Young People who use the service. The staff are very supportive of the Young People (YP) and we received positive comments on the staff from the questionnaires that were returned to us What the service could do better The service, at inspection, was supporting a group of Young People who were presenting needs which were difficult for the service to meet. The service would benefit from a strategy which clearly identified what the classification of 'short term' unit meant. What the service has done since the last inspection The service has had a temporary manager since the last inspection who has had significant experience in working with Looked After and Accommodated children and Young People (LAAC) and has brought new ideas and perspectives to the service. This has led to an increase in staff confidence. Bardykes Road, page 3 of 22

4 Conclusion Bardykes Road is a small, homelike residential service for Looked After and Accommodated Children. (LAAC) which fosters good relationships between staff and Young People (YP) who present challenges to the service. Who did this inspection Alan Paterson undefined Bardykes Road, page 4 of 22

5 1 About the service we inspected Bardykes Road Children's Care Home is owned and managed by South Lanarkshire Council. The service was registered with the Care Commission in April 2002 to provide short term residential care for children and young people accommodated by the Local Authority. The premises are custom built and can accommodate up to eight children and young people. There were 8 young people living in the service at the time of this inspection. The aim of the service is to provide short term care for young people, with a "positive, nurturing, warm, caring, predictable environment". 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 Environment - Grade 4 - Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very 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. Bardykes Road, page 5 of 22

6 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 In the course of the inspection we talked with the manager, staff and YP, examined service documentation and personal files, observed practice and toured the building. 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 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 Bardykes Road, page 6 of 22

7 What the service has done to meet any requirements we made at our last inspection The requirement undefined What the service did to meet the requirement The requirement is: 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. We received a fully completed self assessment. Taking the views of people using the care service into account Taking carers' views into account Bardykes Road, page 7 of 22

8 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 concluded that the service was very good this aspect of the inspection. We concluded this after inspection of the service documentation, questionnaires sent on behalf of the care inspectorate, discussion with staff, young people residing in the service and the service management. The provider, South Lanarkshire Council Social Work Resources (SLC) operates a wide ranging and effective participation policy which mandates that all stakeholders contribute to the development of its services. This takes place over formal consultation events, support of advocacy groups and in the policies and procedures which the services have to follow. There is also a quality unit which is dedicated to making sure that the participation policy is followed in practice. Service users are consulted in the formation of their personal plans at the commencement of their placement with the service.this is accomplished over time in conjunction with their coordinator (identified person/keyworker) and their carers (including foster carers) as appropriate. This offers the young person support and opportunity to participate fully in the planning of their care. Personal files were available for inspection and those sampled were good. The service uses Getting it Right for Every Child (GIRFEC) outcomes in daily, weekly and monthly recording. YP talked to and through responding to questionnaires supported the service's view that they were supported to contribute to the planning and evaluation of their care. Each service user has regular Looked after and accommodated children (LAAC) reviews. The service users participate in putting together the report for the Bardykes Road, page 8 of 22

9 review, they are supported to attend and contribute to the review meeting by their coordinator or if they wish an external advocate and are supported to access and understand the outcomes of the review. Additional review meetings are held if required due to individual circumstances. We noted that the service had discontinued service user meetings. In discussion with the manager and common to the providers other services we found that this had happened due to the evaluation of the meetings being that they did little to support the service users participate in the development of the service. They had tended to be poorly attended and that stronger personalities had prevented them representing the service users fairly. We found that the service had put in place and emphasised individual supports to replace them. The manager had worked with staff and YP to use mealtimes to raise and discuss issues which was a natural and homelike activity which promoted the ethos of family life. This evidenced that the service was evaluating and where appropriate improving its efforts to ensure that young people participated in the development of their care. The service has regular contact with 'Who Cares Scotland' an independent advocacy service for looked after children and Young people. Who Cares Scotland has a worker allocated to the service on whom the service users can call upon to advise and represent them on issues regarding their care. Some service users use 'Speak Out', an independent self advocacy group, to assist them in making their views clear. The service also liaises closely with: the local social workers for the children. During the inspection the service was assisting a social worker hold a case discussion with carers, the service and the family. local education resources where the service users attend school. This enables the service to support the service users to remain in education. local health resources where the service liaises with the local and specialised resources to support the service users. This includes direct health services and information. The service users families wherever possible were engaged by the service in participating in planning the service. Areas for improvement The samples of personal plans we looked at showed that the service was moving from a one file model to one which split the old style of file into an active file and an archive file. We found the latter to be easier to read, make sense of and audit whether it contained sufficient information and detail. This should be completed for the other files. Bardykes Road, page 9 of 22

10 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The service should continue to develop its personal plan format and convert all of the YPs files to the new format. National Care Standards (NCS) 4 Care Homes for Children and Young People - Support Arrangements Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths We concluded that the service was good in this area of the inspection. We noted that the service users health needs were noted in their personal plan and discussed at reviews when appropriate. All of the service users were registered with the local health centre and dentist and had had health screening as appropriate. The service had links with CAYP (children and young people) which is a mental health and wellbeing resource which can directly support the young people or by providing information to the service enable the service staff to support the young person with issues they are experiencing. We saw case examples of the results of referrals of YPs psychological services. The service supported the YP pursue hobbies and interests. One YP was supported to attend drama and singing groups. The service operated an initiative which supported the older YPs to take responsibility to cook for themselves on agreed nights of the week. This was a good learning experience for when the YP moved on from the service. YPS were given additional money, support to shop and assistance to make meals. The service employed the providers policy and procedures regarding medication storage, dispensing and management. This ensured that the service users received any medication they required safely. Bardykes Road, page 10 of 22

11 Areas for improvement We noted that the YPs residing in the service were presenting numerous challenges to the service. We inspected the crisis management plans which the service uses and contain the procedures that staff will follow to manage the difficult behaviour. These include the physical management of behaviour although, in discussion the manager told us that not all staff could physically manage the YP. The service has followed the provider's policy and procedures for managing the YPs behaviour and has good management strategies in place. However, we would have expected some a quicker more robust response to these issues. (requirement 1) In addition we were unable to determine why the service was designated a 'short term' unit. Grade awarded for this statement: 4 - Good Number of requirements: 1 Number of recommendations: 0 Requirements 1. The provider must re-evaluate its assessment and placement procedures and practices regarding YP involved in criminal behaviour with the aim of addressing the negative impacts on those sharing the service. Social Care and Social Work Improvement Scotland Regulations 2011, regulations 210 Section 4 Bardykes Road, page 11 of 22

12 Quality Theme 2: Quality of Environment 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 environment within the service. Service strengths see comments as statement 1.1 in context of environment Areas for improvement see above Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 2 We make sure that the environment is safe and service users are protected. Service strengths We concluded that the service is good in ensuring that the service is safe and the young people are protected. We concluded this after discussion with service users, staff and management and examination of service documentation. The service has a controlled locking system which prevents unauthorised access to the service. The service has an absconding procedure in place in liaison with the local police. This ensures that the response to a service user absconding is appropriate and based on the assessment of risk the young person is at. The service employs a behaviour management method called TCI (therapeutic crisis intervention) this is a system of responses aimed at managing difficult behaviour ranging from diversion and diffusion through to physical management. All staff are Bardykes Road, page 12 of 22

13 trained in this and receive annual updates. This enabled the service to safely support the young people. The service has policies and procedures in place to hold and administer medication safely to the service users. The service employs risk assessment to identify and plan to minimise risks for each individual service user. These are held in the service users personal plans. This ensures that the risks the service users is at are identified and plans put in place to manage those risks. All staff are trained in child protection procedures and receive regular updates. This equips the staff to identify risks to the service users and respond appropriately. The service regularly undergoes external scrutiny for fire safety. This ensures that the procedures and safety practices are checked and audited by appropriately qualified and experienced agencies. Maintenance is carried out by the providers agency and repairs are carried out quickly. The service maintains a log of repairs recording when they are reported and when they are carried out. There is an internal procedure for reporting shortcomings. This has ensured that the fabric of the service location is in good condition. We observed staff making dinner for the YP. They showed good appreciation of food hygiene when doing so. We noted that temperatures of foods were taken and recorded. Areas for improvement We had concerns over the risks that were present in the service through the behaviour of some of the YP. The service was responding appropriately. We saw evidence that the correct procedures were being followed including crisis plans and risk assessments. (see requirement 1 section 1.3) Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Bardykes Road, page 13 of 22

14 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very 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 statements regarding participation in section 1.1 in the context of staffing Areas for improvement see above Grade awarded for this statement: 5 - Very 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 concluded the service was very good in maintaining a professional, trained and motivated staff group. We concluded this after discussion with staff and management and examination of service documentation. The provider employs and administers safe recruitment practices including; Competitive interview against published standards The gathering of references before job offer Protection of Vulnerable Group checks completed before commencement of employment All new staff undergo a period of induction including shadowing and mandatory training The above ensures that staff have the appropriate skills and background to work with the service users. Bardykes Road, page 14 of 22

15 All of the service staff have achieved appropriate levels of qualification to enable them to register with the Scottish Social Services Council for their posts. The service manager maintains a record of staff training and when the training needs to be updated. This is supported by the external training department. A record is also held in the staff member's development file. Staff interviewed were very positive about working in the service and had had a considerable number of years experience. Service users interviewed expressed that they liked the staff and that they felt they could be relied upon to support them. Staff receive regular professional supervision and staff meetings are held regularly. Areas for improvement We concluded that the service was very good in this aspect of the service but noted that the needs of the service users and practice guidelines working with this service group are constantly developing. The service need to continue to develop its staff group in the manner it has been doing. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Bardykes Road, page 15 of 22

16 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very 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 the statements made in section 1.1 in the context of management and leadership. Areas for improvement see above Grade awarded for this statement: 5 - Very 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 felt that the service was very good at using quality assurance systems involving all stakeholders. We concluded this after discussion with management, staff and service users and examination of service audit documents. The provider, South Lanarkshire Council, mandates how the service approaches quality management as part of to the overall provision of services for looked after and accommodated children and young people. This means that the service also operates as a part of a group of services to achieve the council's aims. That the service uses the same recording formats and audit tools are examples of the influence of this. This, as it is a very good system, has been audited by Social Work Inspection Scotland and enables all stakeholders to participate well and have their participation recorded, acknowledged and acted upon. The service regularly uses questionnaires to gather stakeholders views of the service. Although the returns are often low in numbers the service values the information they Bardykes Road, page 16 of 22

17 gather and uses the information as part of the audit process. This is augmented by the gathering and recording of stakeholders views as part of the review process. The provider requires the service to provide quality assurance information in the form of monthly and bi-annual reports. These are completed by the management team. This ensures that the provider is kept up to date on developing issues. The audit procedures build in quality information gathering at important stages in service activities. Examples of these are the contribution of service users and other stakeholders to the LAAC ( looked after and accommodated children and young people) review reports and the collection of comments from the service users and stakeholders after the review. The management of each service in the South Lanarkshire Council provision audit the performances of each others services providing a report which enables the service manager to identify and address the issues identified. This process has been formalised into an initiative called 'managing for quality' this has resulted in the sharing of good practice between the providers services. The management teams of the providers services also come together under an external manager to follow up on quality issues and discuss provider wide initiatives. This ensure best practice is achieved. Service users are supported to raise issues regarding their service. This is done through discussion with coordinators (key workers), can be formally taken up with the attached Who Cares Scotland Worker ( Who Cares Scotland is an independent advocacy service for looked after and accommodated children). Service users told us that they were aware of the complaints procedures to the council and to the care inspectorate. This evidences that the provider's quality requirements and evaluation of its service has included the service users. Personal Plans are audited by the service management team on a regular basis and shortcomings identified and reported to the responsible person for action. The shortcomings are formally noted and action plans identified. Evidence of auditing and action plans were available for inspection. Areas for improvement The service should focus effort on the outcomes for people in transition from the service to evaluate the effectiveness of through care support. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Bardykes Road, page 17 of 22

18 Bardykes Road, page 18 of 22

19 4 Other information Complaints Yes but complaint not upheld Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information 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). Bardykes Road, page 19 of 22

20 5 Summary of grades Quality of Care and Support Good Statement 1 Statement Very Good 4 - Good Quality of Environment Good Statement 1 Statement Very Good 4 - Good Quality of Staffing Very Good Statement 1 Statement Very Good 5 - Very Good Quality of Management and Leadership Very Good Statement 1 Statement Very Good 5 - Very Good 6 Inspection and grading history Date Type Gradings 4 Nov 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed 18 Jun 2010 Announced Care and support 4 - Good Environment 4 - Good Staffing Not Assessed Management and Leadership 4 - Good 11 Jan 2010 Unannounced Care and support 4 - Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good Bardykes Road, page 20 of 22

21 1 Jul 2009 Announced Care and support 4 - Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good 10 Mar 2009 Announced Care and support 3 - Adequate Environment 4 - Good Staffing 4 - Good Management and Leadership 3 - Adequate 19 Aug 2008 Announced Care and support 3 - Adequate Environment 4 - Good Staffing 4 - Good 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. Bardykes Road, page 21 of 22

22 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: Bardykes Road, page 22 of 22