Buchanan Street Residential Children's House Care Home Service Children and Young People 33 Buchanan Street Coatbridge ML5 1BA Telephone:

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1 Buchanan Street Residential Children's House Care Home Service Children and Young People 33 Buchanan Street Coatbridge ML5 1BA Telephone: Inspected by: Lynne Thow Type of inspection: Unannounced Inspection completed on: 28 June 2011

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 10 4 Other information 20 5 Summary of grades 21 6 Inspection and grading history 21 Service provided by: North Lanarkshire Council Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Lynne Thow Telephone Lo-call: enquiries@scswis.com Buchanan Street Residential Children's House, page 2 of 23

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 0 N/A Quality of Staffing 4 Good Quality of Management and Leadership 4 Good What the service does well Buchanan Street provides a good quality of care by a caring and supportive staff team. We saw evidence of staff and children enjoying appropriate therapeutic relationships. The manager provides strong leadership. The staff team are skilled at assessment. They have a good knowledge of other services relevant to the children and capably work in partnership with them, including with educational resources. There was a homely, welcoming, caring and calm atmosphere on the day of this unannounced inspection. What the service could do better The service continues to identify areas for improvement and the staff group were working hard to achieve ongoing improvement. The systems to involve the children and young people in decisions about the way the service is run need to be further developed. The manager is continuing to explore the best means of fully involving the young people in all aspects of their care and showing evidence of this commitment. The notification of reportable incidents to Social Care and Social Work Improvement Scotland was discussed with the manager. All relevant notifications must be forwarded to SCSWIS to allow for an adequate assessment of the risk level of the service and to assess how well the service is managing incidents. Buchanan Street Residential Children's House, page 3 of 23

4 The manager stated his commitment to addressing issues raised by us and as a result of individual discussion with the young people and the returned Care Standard Questionnaires. What the service has done since the last inspection Buchanan Street provides care and support to children and young people with a wide range of care and support needs. They have been successful in fostering a caring culture and although there are challenges to maintaining it, the staff and management have created an atmosphere within the home which helps the young people feel at home and safe in their environment. Conclusion When we inspected this service the service had a High RSA (Regulatory Support Assessment) score. As a result of the findings on this inspection we have reviewed this and based on current evidence the service has a medium risk rating. The service provides a child centred approach to care and support. Staff were caring in their approach, know the young people well and communicate well as a team. Staff are given good levels of support and direction by seniors and the manager and demonstrated a good knowledge of safe care issues. There is a need for more regular staff and young people's meetings, further and routine engagement will all stakeholders. All staff must have current training in child protection. Buchanan Street works in a committed way to provide good outcomes for the children and young people resident. Children present overall as happy and relaxed in their environment and as having good relationships with staff. This service is very well managed and the staff group are knowledgeable in current good practice. Who did this inspection Lynne Thow Buchanan Street Residential Children's House, page 4 of 23

5 1 About the service we inspected Before 1 April 2011 this service was registered with the Care Commission. On this date the new scrutiny body, Social Care and Social Work Improvement Scotland (SCSWIS), took over the work of the Care Commission, including the registration of care services.this means that from 1 April this service continues its registration under the new body, SCSWIS. Buchanan Street Children's Unit is a service provided by North Lanarkshire Council. It is based in a quiet residential area of Coatbridge. It is a single storey building with five single bedrooms, sitting room and small study room. It has an enclosed garden area. It aims to meet the individual needs of young people in a safe and inclusive environment. It is committed to working in partnership with families and professional agencies. On the day of inspection five young people were accommodated. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade Quality of Environment - N/A Quality of Staffing - Grade Quality of Management and Leadership - Grade 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. Buchanan Street Residential Children's House, page 5 of 23

6 2 How we inspected this service The level of inspection we carried out In this service we carried out a high intensity inspection. We carry out these inspections where we have assessed the service may need a more intense inspection. What we did during the inspection This unannounced inspection was concluded on 28 June An Inspector was in the service from 11.00am to 7.00pm and had an evening meal with the young people and staff. Feedback was provided to the manager and the operational manager at the end of the day. During the inspection process evidence was gathered from a number of sources including: - Evidence from the service's most recent self assessment and the annual return - Observations, including the environment - Discussions with the five young people - Case Standard Questionnaires - Discussion with staff and the Manager - Attendance at staff changeover - Examination of records including : Case tracking of 3 individual young people Individual crisis management plans, risk assessments and care plans. Complaints Incidents Young people and staff meetings Communication Log Communication with Social Workers Log of absconding. 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 Buchanan Street Residential Children's House, page 6 of 23

7 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 Buchanan Street Residential Children's House, page 7 of 23

8 What the service has done to meet any recommendations we made at our last inspection We made 2 recommendations at the time of the last inspection: 1. The service should involve placing social workers in the development of personal plans and crisis management plans to ensure collaboration and a shared understanding are achieved and best practice is maintained. National Care Standards Care Homes for Children & Young People Standard 4: Support arrangements. The service sought the input of all Social Workers and received an improved response. The manager is aware that this area presents regular challenges and is attempting to address this. The recommendation is considered met. 2. The service should ensure that young people continue to be consulted and informed regarding any developments and/or changes to the refurbishment plans. National Care Standards Care Homes for Children & Young People Standard 5: Your Environment Although there is good practice in this area informally, there is a need formal systems to evidence participation more fully. This recommendation is repeated. 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. A fully completed self-assessment document was submitted by the service. This gave information for each of the Quality Themes and Statements. The service identified its strengths and areas for future development and gave some evidence of service user involvement. This was completed to a high standard. Buchanan Street Residential Children's House, page 8 of 23

9 Taking the views of people using the care service into account The Inspector shared an evening meal with the young people and spoke with some of the young people individually. The majority of the young people described receiving a good standard of care and support at Buchanan Street and gave examples of staff being very caring and thoughtful in their approach. Two young people raised separate concerns with the Inspector and these were satisfactorily explored with the manager. In one case action was taken immediately and in the other the manager and operational manager stated their commitment to addressing the area of concern with the young person. Both these young people also described having many positive aspects to living in the care home and described enjoying good relationships with many individual staff. Taking carers' views into account There were no parents or carers present during this unannounced inspection. We saw feedback from relatives within review minutes and in participation and involvement systems. Feedback was on the whole positive with relatives involved in the care planning and review processes where possible. Buchanan Street Residential Children's House, page 9 of 23

10 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 Overall grade awarded for this theme: 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 There was some evidence of young people and their carers, when appropriate, being provided with opportunities to become involved in assessing the service. These included: - Young people's meetings. - Key worker time. - Planning meetings. - Outings - Care Standard Questionnaires - The Provider's Forum. Comments on the quality of care and support were also welcomed at regular reviews of the care plan. We saw evidence of the children and young people being actively involved in their individual crisis management plans and signing their involvement. Many of the young people were comfortable discussing issues about their care and support with their key workers and described enjoying supportive and meaningful relationships with staff. Comments from the young people included: "Staff are supporting me, (staff member) is nice. I love her, she's dead kind." Of the five young people who completed Care Standard Questionnaires, all replied to the statement 'Overall I am happy with the quality of care I get' two strongly agreed and two agreed. Areas for improvement Although we saw evidence of good participation in some areas, there were some areas that could improve. There is a need for current feedback from more external Buchanan Street Residential Children's House, page 10 of 23

11 stakeholders and to ensure all of the young people resident feel fully able to raise any concerns with either staff or the manager. Comments from the children and young people included: "Not all of them treat you with respect, it depends who is on." "It would be good to have more activities, especially at the weekends" One young person stated in the Care Standard Questionnaire that they strongly disagreed that the quality of care was satisfactory. The points of concern raised related to not being fully enough involved in decisions about their care or about new staff. A recommendation was made at the time of the last inspection that the service should involve placing social workers more in the development of personal plans and crisis management plans. Some progress had been made in this area and this recommendation is met. A further recommendation was made that the children and young people are consulted and informed regarding any developments and/or changes to the refurbishment plans. There continues to be a need for more robust evidence of participation in this area. The recommendation made previously is repeated until there is evidence of regular young people's meeting and action taken as a result of their feedback. The manager is currently reviewing participation processes in line with the provider's commitment to participation. He stated his ongoing commitment to offering the young people regular meetings and stated his intention to review this area to ensure there are sufficient meetings and opportunities for the children and young people to comment on the quality of the service. This should include the level of satisfaction the young people feel about the condition of their individual bedrooms as well as the property in general. Further consideration was being given as to how staff meetings link with young people's meetings also. This alongside more regular young people's meetings and involving the young people more in assessing the quality of care and staffing will improve the outcomes for the young people in their care. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 1 Inspection report continued Buchanan Street Residential Children's House, page 11 of 23

12 Recommendations 1. The service should ensure that young people are consulted and informed in all areas relevant to their care and support and regarding any developments and/or changes to the refurbishment plans. National Care Standards Care Homes for Children & Young People Standard 5: Your Environment Statement 3 We ensure that service user's health and wellbeing needs are met. Service strengths We saw examples of staff implementing the principles of the "Go Outdoors" report and of the principles of GIRFEC (getting if right for every child). The young people were being encouraged to be involved in a variety of activity and staff spoke positively of recent "Body Matters" training on activity and diet. One young person commented: "I enjoy going out nice outings, staff are nice and friendly and my family can visit me when I want." The service was enjoying a more settled period and there was a homely, welcoming and calm atmosphere in the house. Staff were working hard to assist the young people to maintain important relationships in their lives. The young people we spoke with confirmed they were on the whole able to discuss their personal health concerns with staff both formally and informally. There were many examples of staff seeking out relevant consultations for the young people. We spoke with young people who described being encouraged in their education and being supported to plan for the future. Staff were experienced and knowledgeable about accessing information and support for the young people. Where young people were not in education the service was working hard to support and direct them well in line with their assessed needs. LAAC reviews were taking place where health issues were being fully explored. Health promotion advice and information was also being made available to the young people. We saw examples in the young people's individual files where health advice had been accessed and action taken to improve the outcomes for the young person. We observed interaction between staff and young people and spoke with staff about their role. Throughout it was evident that staff are continuing to put relevant emphasis on the well being of the young people and on them feeling safe and secure. All five young people stated in their care standard questionnaires that they felt safe from abuse and bullying within the service. When we looked at files we noted that in one case recordings did not make fully clear the strategy in place for supporting a young person to re-engage with school or the Buchanan Street Residential Children's House, page 12 of 23

13 current education of the young person whilst they were not attending school. The service have now reviewed this young person's care and taken steps to improve both these areas. Staff were seeking external advice appropriately. There was involvement with The Child and Adolescent Mental Health Service (CAMHs) and the 'Who Cares' Worker. Good links and referrals were in evidence with external providers of Health Services and services that promote mental and physical health. Young people were observed to be relaxed with the staff on duty during this unannounced inspection and spoke freely about the activities they were involved in within the house and within their local community. Areas for improvement The service identified in their annual return that not all staff are trained in child protection. When we explored this with staff on duty, we found that there had been a considerable time lapsed since at least one member of staff had received child protection training. We explored with the service manager our concern that staffing levels were at times impacting on training and vice versa. We were not however unduly concerned by the staffing levels at Buchanan Street in relation to the outcomes for the children and young people. All staff must however be up to date with child protection training. We will assess this area again at the time of the next inspection. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. A review should be carried out of staff training in child protection. Where there has been a lapse in the training or refresher training, this should be addressed without delay. National Care Standards for Children and Young People - Standard 4 Feeling Safe and Secure and 6 and 7. Buchanan Street Residential Children's House, page 13 of 23

14 Quality Theme 2: Quality of Environment - NOT ASSESSED Buchanan Street Residential Children's House, page 14 of 23

15 Quality Theme 3: Quality of Staffing Grade awarded for this theme: Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths See Quality Statement 1.1 for further evidence in relation to carer and user participation. The service uses various means to obtain the views of the children and young people regarding the quality of staffing. These included one to one discussions, LAAC reviews and young people's meetings, including the provider's Young People's Forum. The manager has a strong positive presence in the service and there was evidence that young people on the whole feel well supported by staff. We found staff to be working well in informally hearing the views of the young people on the quality of staffing as part of the quality of care. A particular strength of this service is the extent of respectful and supportive relationships staff have developed with the young people. This was encouraging many of the young people to feel valued and to openly express their opinions. We saw evidence of good relationships between individual staff and young people during our visit. Staff knew the children and young people well and were skilled at working effectively with them. Although feedback from the young people raised some concerns in the area of quality of staffing, the feedback we received about the skills and values of many of the staff was very positive. The young people described staff as wanting to listen to their views and working hard to make space to do so. The children and young people also have access to the Local Authority's complaints procedure. Areas for improvement See areas for development in quality statement 1.1 Staff described receiving a good quality of management and leadership and we saw aspects of very good communication in the team. This could be improved with more regular staff meetings and participation processes which include regular staff questionnaires and evidence any action taken as a result of feedback. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 1 Buchanan Street Residential Children's House, page 15 of 23

16 Recommendations 1. The service should record and evidence positive outcomes for young people in response to their involvement in participation and consultation. National Care Standards Care Homes for Children and Young People Standard 6, 8, 9 and 11. Statement 4 We ensure that everyone working in the service has an ethos of respect towards service users and each other. Service strengths Staff spoke about the children and young people with respect and knowledge of their individual strengths and support needs. Staff were knowledgeable about the importance of secure attachments in relationships for young people and were working hard to create resilience through trusting and supportive relationships. A particular strength of this staff team is their commitment to assisting the children and young people to develop positive and healthy relationships with family and others. It was very encouraging to see the continuing commitment of the staff team to a young person who had moved on from the service. We found from discussions with staff and records that staff are encouraged in their task and given feedback on their performance as part of the team and during supervision. It was evident that staff are functioning well as a team and that the manager has been successful in fostering a sense of involvement and appreciation of staff. The manager and staff group demonstrated a strong commitment to achieving the best possible outcomes for the individual young people in their care. Comments on the quality of staff made by young people included: "I have a strong relationship with lots of staff. Friendship with staff is good." The provider has significant plans to vary the registration of the service and to improve and develop it further. This will provide a significantly improved standard of environment for the young people, including a more private area for the children and young people to have visits with family. Areas for improvement Although there are significant strengths in this staff team in this area, some of the comments we received from Care Standard Questionnaires and in discussion with the young people related to respect. Comments included: "Some staff are supportive, some aren't, that's the way it goes." Buchanan Street Residential Children's House, page 16 of 23

17 We discussed with the Manager and Operations manager two specific concerns highlighted to us. We have asked the service to feedback to us on how the concerns raised have been resolved. We were confident in their response and that the strengths of the service and skills of the staff team will ensure these areas are resolved for the young people concerned. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Buchanan Street Residential Children's House, page 17 of 23

18 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 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 See findings in quality statements 1.1 and 3.1 for further evidence in relation to the children and young people being actively involved in assessing and improving the service. It was evident from our observations and discussions with the young people and with staff that they felt very well supported by the manager. They described the manager as being approachable and routinely involved in the day to day life of the service and care planning of the young people. Following the last inspection and a recommendation, the service made contact with individual placing Social Workers. This had resulted in some degree of improvement in collaborative working. The manager acknowledged however that this area could improve. We will look at how the service has made progress in this area at the time of the next inspection. Areas for improvement When we spoke with some of the young people in their bedrooms some concern was expressed to us about the condition of carpeting and decoration. We observed these concerns to be valid and noted one young person's bedroom was not personalised and gave no sense of the young persons' individual interests. We discussed this with the manager who stated he would address these areas. Improvements to participation processes, including regularly hearing the views of a wide range of stakeholders and an increased frequency of young people's meetings will ensure the children and young people are routinely involved in both relevant day to day decisions and the more strategic direction of the service. Grade awarded for this statement: 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 Buchanan Street Residential Children's House, page 18 of 23

19 Service strengths There was regular involvement of the manager in the care planning processes for the young people and further involvement of the external manager on a regular basis. Senior meetings were being used to explore the quality of the service being delivered and in an attempt to ensure consistency of care and be of support to staff, staff meetings were being held at a time where night staff could attend where possible. There were a variety of effective quality assurance systems in place, not least the fostering of positive, caring and respectful relationships between staff and the children and young people. This is a particular strength of Buchanan Street. Areas for improvement Although staff described being very well supported by senior staff and the manager, we had some concerns about the availability of staff for training due to staffing levels. We discussed this with the manager and his line manager and will explore this area further at the time of the next inspection. The notification of reportable incidents to Social Care and Social Work Improvement Scotland was discussed with the manager who committed to ensuring SCSWIS is provided with details of all notifiable incidents. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Buchanan Street Residential Children's House, page 19 of 23

20 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 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). Buchanan Street Residential Children's House, page 20 of 23

21 5 Summary of grades Quality of Care and Support - Statement 1 Statement 3 Quality of Environment - Not Assessed Quality of Staffing - Statement 1 Statement Very Good Quality of Management and Leadership - Statement 1 Statement Very Good 6 Inspection and grading history Date Type Gradings 13 Dec 2010 Unannounced Care and support Environment Staffing Not Assessed Management and Leadership Not Assessed 25 Aug 2010 Announced Care and support Environment Staffing Not Assessed Management and Leadership Not Assessed 1 Dec 2009 Unannounced Care and support 3 - Adequate Environment Not Assessed Staffing Management and Leadership Not Assessed 7 Sep 2009 Announced Care and support 3 - Adequate Environment Buchanan Street Residential Children's House, page 21 of 23

22 Staffing Management and Leadership 3 - Adequate 25 Mar 2009 Unannounced Care and support 5 - Very Good Environment Staffing Management and Leadership 16 Sep 2008 Announced Care and support 5 - Very Good Environment Staffing Management and Leadership All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Buchanan Street Residential Children's House, page 22 of 23

23 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 SCSWIS. 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@scswis.com Web: Buchanan Street Residential Children's House, page 23 of 23

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