Simpson Playhouse Day Care of Children 18 Cameron Street Stonehaven AB39 2HS Telephone:

Transcription

1 Simpson Playhouse Day Care of Children 18 Cameron Street Stonehaven AB39 2HS Telephone: Inspected by: Frances Smith Type of inspection: Unannounced Inspection completed on: 13 August 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 30 5 Summary of grades 31 6 Inspection and grading history 31 Service provided by: Simpson's Playhouse Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Frances Smith Telephone enquiries@careinspectorate.com Simpson Playhouse, page 2 of 33

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 2 Weak Quality of Environment 4 Good Quality of Staffing 4 Good Quality of Management and Leadership 3 Adequate What the service does well The manager and staff team provide a welcoming, friendly and caring environment for children and their families. Staff have developed good relationships with children and families. Good use is made of the local community. What the service could do better Better systems and practices must be developed for medication and infection control. The service should continue to develop systems for monitoring, evaluating and improving the performance of staff, the day to day quality of provision and individual children's experiences. What the service has done since the last inspection The service has continued to encourage parents/carers to become involved in the life of the nursery. Risk assessments and care plans had been updated. Staff have continued to attend a range of training. Conclusion Parents are pleased with the service provided and children appear happy at the nursery. The manager and staff are keen to develop and improve the service further. Simpson Playhouse, page 3 of 33

4 Who did this inspection Frances Smith Simpson Playhouse, page 4 of 33

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Information about 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, 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. Recommendations are based on the National Care Standards, relevant codes of practice and recognised good practice. - A Requirement is a statement which sets out what is required of a care service to comply with the Public Services Reform (Scotland) Act 2010 and Regulations or Orders made under the Act or a condition of registration. Where there are breaches of Regulations, Orders or Conditions, a Requirement must be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. The nursery is registered to provide a care service for a maximum of 51 children aged 0 and 12 years, with a maximum of 15 children aged under 3 years. The nursery provides a small number of out of school places. The nursery is based in the small coastal town of Stonehaven in Aberdeenshire. The nursery aims include: 'Continue to provide a healthy, safe, friendly caring environment in which the children are secure and happy and work in partnership with parents. We will support and give opportunities for children to reach the highest levels they can in personal development'. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 2 - Weak Quality of Environment - Grade 4 - Good Quality of Staffing - Grade 4 - Good Quality of Management and Leadership - Grade 3 - Adequate Simpson Playhouse, page 5 of 33

6 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. Simpson Playhouse, page 6 of 33

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 which was carried out by inspector Frances Smith. The inspection took place between 9.10 am and 3.40 pm on 12 August 2013 and between 9.50 am and 2.30 pm on 13 August Feedback was given to the manager following the inspection. As part of the inspection we took account of the completed annual return and self assessment that we asked the provider to complete and submit to us. Fifteen Care Standards Questionnaires were issued to parents and carers of children who used the service. Five completed questionnaires were returned to us before the inspection and during the inspection process. During this inspection we gathered evidence from various sources, including the relevant policies and procedures, records and other documents, including: Registration certificate Insurance certificate Aims and values of the service Parents' welcome information Planning Mind maps Nursery improvement plans Children's profiles Parent notice boards Newsletters Care Standards Questionnaires Cleaning and maintenance records Accidents and incidents Medication system Care plans Risk assessments Photographs. Simpson Playhouse, page 7 of 33

8 Discussion with various people, who included: Manager Staff team Parents Children. - Observation of interaction between staff and the children in each of the playrooms - Observation of practice in the nursery - Observation of toys, activities and resources available - Examination of the environment indoors and outside. 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 Simpson Playhouse, page 8 of 33

9 What the service has done to meet any recommendations we made at our last inspection 1. It is recommended that creative ways be considered and put in place to provide parents and children with improved opportunities to access and influence the quality of care and support, the environment, staffing and leadership and management provided by the centre. This could include regular questionnaires or a focused question of the month for parents. A simple children's questionnaire could be implemented to further support and strengthen communication with children. Voting systems for the school age children would give immediate feedback on their thoughts about certain matters. National Care Standards Early Education and Childcare up to the age of 16, Standard 13: Improving the Service. At this inspection we found that the manager and staff had taken measures to further involve parents/carers in the life of the nursery. These included contributing to the development of the garden area, helping develop a website and attending a learn and share session. This Recommendation was met. 2. The manager and staff should introduce support/care plans for children with medical needs and additional support needs. These should be developed in full consultation with parents, carers and any others involved in the care of the child. National Care Standards Early Education and Childcare up to the age of 16, Standard 4 - Engaging with children; Standard 5 - Quality of experience; and Standard 6 - Support and Development. At this inspection we found that care plans had been produced but had not been shared with all staff, therefore this Recommendation is considered not to have been fully met. Further information in relation to this can be found under Quality Theme 1, Statement 3. 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 Simpson Playhouse, page 9 of 33

10 Comments on Self Assessment Inspection report continued 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 self assessment form was submitted by the nursery prior to this inspection. It gave us relevant information for each of the Quality Themes and Statements. The nursery identified the strengths of the service and areas for further development. Taking the views of people using the care service into account Children were happy and settled, and were familiar with their surroundings. During the inspection the inspector spoke to and interacted with a number of the children, who were happy to chat about what they were doing. The spoke about having enjoyed a walk to the beach: "We found a little crab and then we thought we lost it". "We saw a dog too". "We saw stones and a little fish and a shell with a hole in". "We got to take some pictures" "We took magnifying glasses to look at crabs". We also spoke to a number of children who said that they liked coming to the afterschool club. They told us: "Sometimes we get to choose what to do. We play games and play outside". "It's been fun in the holidays" Others spoke about what they liked best about the food and said: "I like the soup best". "I like the macaroni". Taking carers' views into account Fifteen Care Standards Questionnaires were sent to the service to be distributed to parents. Five were returned to the Care Inspectorate prior to the inspection taking place. All five parents 'strongly agreed' that they were happy with the quality of care provided by the nursery. Specific comments which we fed back to the manager included: "The manager Joanne is always there if I have any questions. She is so helpful. The staff are very friendly and always make us feel welcome. They offer a great menu and my child prefers their homemade meat balls to my own!". Simpson Playhouse, page 10 of 33

11 "Staff are very knowledgeable about my child and I feel confident to speak to staff about concerns I may have". "Excellent menu. Both my children love going". "My child and I are so very happy with all aspects of the nursery. It is well managed and has areal family vibe. I always get asked my opinions and love reading the feedback. It is just such a very good, caring nursery". Parents spoken with in the course of the inspection stated that they were very happy with the service provided. They commented positively about the very good communication and the approachability of the staff team. Their comments included: "Child loves nursery. Really good staff, attentive and knowledgable. My child is well looked after". "Child loving nursery. Staff approachable and take time to listen. There is a profile with photos which we can take home". Simpson Playhouse, page 11 of 33

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: 2 - Weak 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 saw that the service provided good opportunities for children and parents/carers to give feedback and make suggestions for improving the service. At this inspection we looked at information available for parents, opportunities for parents to give their views, and how children's views were sought and used in the nursery. We saw that the manager and staff team were continuing to improve and develop parent participation, and demonstrated an understanding of the importance of working with families to ensure together that the children's needs were identified and met. We saw that the interactions between staff and parents were informative, with staff providing clear detail about their child's day in nursery. Parents told us that the manager and staff always took time to listen to them, and said: "The girls are really nice,approachable and take time to listen. They provide us with information daily and we get s with plans for each day". We found that there was a range of methods to provide information about the nursery and to encourage parents/carers to become involved in the life of the nursery. These included: >welcome information >nursery newsletters >notice boards throughout the nursery >suggestion box >suggestion posters Simpson Playhouse, page 12 of 33

13 >suggestion trees >evaluation questionnaires >profiles where children had an opportunity to share their learning with their parents >together time >mind maps >floor books. Newsletters were now issued to parents electronically. These provided parents/carers with information about staff changes, staff training and transition arrangements. We also saw that parents had been asked to attend a learn and share night, to contribute to the menus, to assist in designing a website and to add to their children's profiles. The manager told us that a parent has volunteered to help develop the nursery website. We saw that the nursery provided display boards around the building with information about plans for children's learning. These gave parents/carers very good opportunities to make further suggestions and be involved in planning for their child's care. We saw that parents had commented on the effectiveness of the wall displays in the baby room. Specific comments: "Very good. It's great to be able see what the kids have been doing that day/week and the different ways/methods they can learn". The manager told us that parents/carers had been asked to attend parents' evenings, one of which focused on effective transitions. They had also been invited to a learn and share session. The manager told us that these sessions had been positive and worthwhile. Feedback from all evaluations we looked at was very positive. We saw that there were opportunities for the children to share their views with staff. We also saw that staff caring for the youngest children had made a start to plan for activities taking account of children's interests. We looked at how staff in the 3-5 room planned for children's learning. We saw that they listened to children's views and had started to use these views and suggestions to plan their learning. We also saw that the nursery was celebrating children's achievements, for example: "(Child's name) was good at sharing with her friends". "(Child's name) can write his name". "(Child's name) can now swim by herself". "(Child's name) can now ride his bike". Inspection report continued The manager told us and we saw that the children had been asked for ideas for new play materials and items of interest. We saw that items requested were in place, and the children were asked what they thought of the new things they got and said: Simpson Playhouse, page 13 of 33

14 "We got a cool new house for our stick insect". "(Child's name) likes our new book on stick insects". "(Child's name) likes the ladybird house". "(Child's name) likes the big bug jar". We noted that each child had a profile which documented what the children had been doing at nursery. From the sample we looked at, we saw there were some entries which recorded the children's achievements. We found that the staff were also keeping written and pictorial notes of the children's time in nursery. We acknowledged that the manager and staff team had continued to encourage parents and carers to contribute to the development of the service. We saw that the profiles for the children were accessible to the children and their parents. We saw that parents had been encouraged to contribute to these profiles and parents told us they could look at the folders at any time. All five parents who responded to the Care Standards Questionnaires indicated that they strongly agreed that they were happy with the quality of care provided by the nursery, and felt that they had been involved in developing the nursery. Areas for improvement We noted that parents' responses were positive when asked to evaluate the parents' night and the learn and share session. One parent thought there were too few cars in the garage for children to play with. We have asked the manager to audit the responses to these events and take action to address areas identified for improvement. We noted that the learning journeys had recorded some details about children's achievements. We found that a good number of the entries were not purposeful, for example, '(child's name) was able to cut round a heart shape", (child's name) said the glue feels sticky" and "(child's name) enjoyed taking part in singing and question time about the story". In most cases there were no next steps identified to support children in their development. We also found that there were no evidence of staff identifying and taking on board individual children's likes, needs or interests. We discussed this with the manager, and advised that an audit of the children's profiles needs to be undertaken to ensure all staff are recording children's requests and suggestions, and to ensure that observations are continuous, rich and purposeful and next steps are identified for individuals. See Recommendation 1 We noted that the nursery were making use of floor books to plan projects and take areas of interest forward with the children. Staff in the room for 0-3 told us that the topics were generally adult led, for example a recent topic, 'transport'. Staff in the 3-5 room told us that they were trying to involve the children more in their learning. Simpson Playhouse, page 14 of 33

15 We suggested that this practice could be improved by supporting children to think about what they want to find out and document the progress in taking the area of interest forward. This would strengthen the children's experience of project planning. We discussed the possibility of viewing floor books in other nurseries to look at examples of good practice, and also training for staff. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. The manager now needs to review and improve staff practice in relation to observation, recording and assessing children's development progress. National Care Standards Early Education and Childcare up to the age of 16, Standard 4: Engaging with Children; and Standard 12: Confidence in Staff. Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths We found that there was a number of key policies and procedures which informed staff and parents of best practice in relation to health and wellbeing. They were available on request for parents and in the staff room for the staff. This meant that parents and staff could make reference to them at any time. We sampled children's files and saw that parents provided registration details when their child started at the nursery. This included emergency contacts, allergy and medical information and any dietary requirements. The staff told us that this information helped them to know more about the child and their individual needs, and supported continuity of care and learning between the nursery and home. We saw evidence that parents and children were offered settling in sessions so that they could become familiar with the nursery and the staff. A key worker system was in place so that children could form vital relationships with their carers. We observed that staff knew the children and their individual personalities. Following a Recommendation made at the previous inspection, the manager had produced care plans for children with additional support needs, in consultation with parents. Simpson Playhouse, page 15 of 33

16 The staff spoken with told us that they had attended child protection training, and we found that they were knowledgeable about the procedures to follow should they have concerns. We saw that the babies and youngest children were sleeping in travel cots and the older children rested on floor mats. Children were familiar with the routine and staff had a sensitive, caring approach to settling the children for a sleep/rest. The manager told us about arrangements for cooking and food preparation. She advised that a new cook had been appointed and was following the menus planned by the provider and manager. At the time of the inspection the cook told us that all the food was freshly cooked on the premises. She also told us she was now more confident cooking for a larger number and had a greater awareness of portion sizes. As requested by environmental health, the cook had updated the CookSafe procedures. We saw that the food was freshly cooked during both visits. We also saw that there was enough food for children to have a second portion, and that sandwiches were available for those children not wishing to try the food on offer. We saw that most children enjoyed their lunches and a good number enjoyed a second portion. Parents told us: "My child loves the food and has second and third helpings". "Food varied and I get told what my child has or hasn't eaten". The nursery had a system in place to obtain details of children's allergies and food intolerances. We saw that this information had been shared with the cook and staff team.. We found that the children's physical wellbeing was actively promoted within the nursery. Children benefited from daily opportunities to spend time outdoors, in the nursery garden and on walks and outings in the community. Parents advised that the children got out all the time. Specific comments included: "They are out each day and make good use of the community. They go to the parks, beach and harbour". "They are out quite a lot and make good us of the community". Inspection report continued All five parents who responded to the Care Standards Questionnaires indicated that they strongly agreed and agreed that their children had the opportunity to sleep or rest, and regularly got fresh air and exercise. They also strongly agreed and agreed that their children were provided with a healthy well-balanced diet. Simpson Playhouse, page 16 of 33

17 Areas for improvement Inspection report continued When we spoke to the cook we found that she was unfamiliar with the best practice guidance and had not yet referred to it during meal preparation. We saw that there were no recipes for her to follow to assist her with portion sizes. We asked the manager to provide opportunities for the cook to become familiar with best practice such as 'Adventures in Foodland', 'Fun First Foods' and the 'Nutritional Guidance for Early Years'. The manager should also support the cook to produce recipes which will help with planning and preparing food for large numbers. At the previous inspection we recommended the manager produce care plans for children with additional support needs. At this inspection we acknowledged that care plans had been produced. While all staff were aware of the children's care needs, we found that not all staff knew where to find the individual care plans. We asked the manager to ensure that all staff are fully aware of the details of individual children's care plans and that all staff know how to access the care plans. See Recommendation 1 Staff spoken with were aware of the procedures to follow should they have concerns in relation to child protection. However, we found that the service policy did not provide clear guidance for staff. It was in need of review, taking account of up to date legislation, including reference to the Aberdeenshire Child and Family Protection Committee, which was now in place. See Recommendation 2 At the time of the inspection we saw that staff in the room for 0-3 were not following best practice during nappy changing and supporting children to use potties. We saw staff wore the same apron for four nappy changes and this included returning children to the room. We also found that staff continued to wear their disposable gloves when dressing the babies and children and returning them to the room. On one occasion staff were observed to wear the same gloves when applying cream to a child. Furthermore, children were not supported to wash their hands after nappy changing, before leaving the toilet area. We brought this poor practice to the attention of the manager. We also and asked her to take immediate action to ensure staff understood the importance of hand washing and the need to change their gloves and aprons after each nappy change, to prevent the risk of cross contamination and the spread of germs. See Requirement 1 We saw that staff supporting children to use potties were questioned by the children as to why they were wearing gloves and aprons. This would indicate that this was not usual practice. Furthermore, we saw that the used potties were carried through the playroom to be emptied in the sluice area. On one occasion the staff walked past other staff who were preparing snack, while some children were already eating their snack. We also found that a potty had been placed in the sluice sink along with children's cups and mugs and dishes used by staff. This was brought to the manager's attention and she took immediate action to have these removed to Simpson Playhouse, page 17 of 33

18 prevent the risk of cross contamination and the spread of germs. See Requirement 1 At the time of the inspection staff were not following best practice during the preparation for lunch in the room for children 0-3 years. We noted that staff did not: clean the tables wash their own hands support babies and children to wash their hands prior to eating their lunch. We brought these concerns to the manager during feedback. We asked her to take immediate action to ensure the current practice ceased, and that staff were aware of best practice in relation to infection prevention and control. We also advised the manager and the room leader to undertake regular audits of staff practice until they are satisfied that staff are fully aware of best practice, and have implemented best practice in to their own approach to preparing for meal times and supporting children to wash their hands, before snack and meal times and after using the toilet or having their nappy changed. See Requirement 1 We saw that the current approach to the management of medication was not in line with best practice. We found that there was no record of medication stored on the premises and the medicine bottles were unnamed. One medicine was out of date and was later removed when this was highlighted by the inspector. Unnamed and out of date medicines posed a potential risk of children being administered the wrong medication or receiving out of date medication. The manager must now review and update the nursery policy and procedures for the management of medication. The document 'The Management of Medication in Daycare and Childminding Services' will provide useful information to assist in further developing the medication policy, procedure and record keeping. See Requirement 2 We acknowledged that the manager took seriously our concerns reported on in this statement. Following feedback she had contacted the health protection team and was signposted by them to useful websites to assist in improving practice in relation to infection prevention and control. At the time of this report being written, the manager provided us with details of medication stored on the premises and updated policies for nappy changing and the use of potties. We saw that these provided staff with clearer step by step instructions for nappy changing and the use of potties. Grade awarded for this statement: 2 - Weak Number of requirements: 2 Number of recommendations: 2 Simpson Playhouse, page 18 of 33

19 Requirements 1. The provider and manager must review and improve the practice in relation to infection prevention and control, to ensure the health and welfare of service users. In order to comply the provider must: a) Review and update the service infection control procedures in line with best practice; b) Develop and implement clear procedures for hand washing, nappy changing and the use of potties, to include appropriate use of protective gloves and aprons; c) Ensure all staff have access to training and are supported to develop their awareness of best practice and implement this into practice. This is in order to comply with: The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011, No 210: 4(1)(a), (d) - Requirements to make proper provision for the health and welfare of service users and have appropriate procedures for the control of infection; Regulation 15(a), (b) - to make proper provision of sufficient and suitably qualified and competent staff. National Care Standards Early Education and Childcare up to the age of 16, Standard 3: Health and Wellbeing; and Standard 12: Confidence in Staff. Timescale: within 2 weeks of receipt of this report. 2. In order to ensure the health and welfare of service users, the provider and manager must review and improve their management of medication, taking account of current best practice guidance on the management of medication in day care and childminding services. In particular, they must: a) update the medication policy to include all the required information and to ensure clear support and guidance is provided to staff; b) ensure accurate up to date records are maintained of all medications on the premises for the children's use. Details should always be completed when medications are returned to the families; c) ensure all staff are provided with training in completing medication records correctly; d) implement quality assurance systems for checking medication records, storage of medication and the medication audit. This is in order to comply with: Inspection report continued The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) Regulation 4(1)(a) - Welfare of service users. Simpson Playhouse, page 19 of 33

20 National Care Standards Early Education and Childcare up to the age of 16, Standard 3: Health and Wellbeing; and Standard 12: Confidence in Staff. Timescale: Within 2 weeks of receipt of this report. Recommendations Inspection report continued 1. The manager must ensure that all staff are fully aware of the additional support needs of the children and where to access the vital information within the care plans. This will ensure the additional support needs of the children are provided for. National Care Standards Early Education and Childcare up to the age of 16: Standard 3 - Health and Wellbeing; and Standard 12 - Confidence in Staff. 2. The manager must review and update the service child protection policy and procedures and ensure staff follow the correct procedures. National Care Standards Early Education and Childcare up to the age of 16, Standard 3: Health and Wellbeing. Simpson Playhouse, page 20 of 33

21 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 Service Strengths Information detailed in Quality Theme 1, Statement 1 is also relevant to this Statement. Areas for improvement See Areas for Improvement identified within Quality Theme 1, Statement 1. Grade awarded for this statement: 4 - 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 saw that there was a secure entry system in place at the entrance. The visitors' book was completed by people visiting the nursery. These arrangements helped to make sure that children were kept safe and staff were aware of who was in the building. We saw that staff kept records of children attending the nursery. All staff had completed first aid as part of core training and were aware of the procedures for dealing with accidents and incidents. Accidents and incidents had been recorded appropriately and shared with parents. Staff undertook regular cleaning of the premises. We saw that risk assessments had been reviewed and maintenance contracts were in place for annual utility service checks. Regular inspections were made by the Environmental Health service, and the service was compliant with all required regulations and standards. We noted that the cook had updated the CookSafe file as requested by Environmental Health. We found that the manager took an active role in observing practice and ensuring the rooms were regularly changed around, with the needs of the children in mind. We Simpson Playhouse, page 21 of 33

22 saw children moving freely between different areas, increasing independence as they helped themselves to equipment and made decisions about what to play with. Parents spoken with told us that they thought staff had made good use of the space, and that their children were always safe, stimulated and challenged. The information detailed in Quality Theme 1, Statement 3 in respect of infection control and child protection was also relevant to this Statement. We saw that outdoor learning had been identified as an area for improvement. We looked at the children's wish lists and some of the new pieces of equipment that they had requested and were in place in the rooms. All respondents to the Care Standards Questionnaire strongly agreed and agreed that the environment was safe, secure and stimulating. They also strongly agreed and agreed that there was enough space and a suitable range of equipment and play materials. Areas for improvement We noted that the nursery had procedures in place for recording accidents and incidents. However, we found that there had been no audits undertaken of accidents and incidents in the nursery. The manager now needs to carry out regular audits of accidents and incidents to identify any potential or actual hazards. This information should be used to contribute to making the environment safer for children. During the inspection we found that the door between the playroom and children's toilet area was always open. Furthermore, we saw that the staff and children did not always close the cubicle doors, which compromised the children's privacy and dignity. This also posed a concern around infection control, particularly during snack and lunch times, due to the close proximity of the toilets to the area set up for meals and snacks. See Recommendation 1 We also saw that the toilet cubicles did not all have appropriate toilet roll/paper towel dispensers. This posed a risk of poor infection control practice as a result of the position of paper towel storage. Appropriate dispensers for toilet rolls and hand towels should be fitted. See Recommendation 1 During the inspection the manager contacted the health protection team, who agreed to give advice to assist the manager in addressing the Recommendations recorded within this Statement. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 2 Inspection report continued Simpson Playhouse, page 22 of 33

23 Recommendations Inspection report continued 1. We asked the provider and manager to take measures to control the spread of infection in the room for children aged 0-3 years, in line with best practice. This may involve them reviewing their procedures for children accessing and using the toilet area or re-siting the area for snack preparation and where children eat the snack and meals. National Care Standards Early Education and Childcare up to the age of 16, Standard 2: A Safe Environment; and Standard 3: Health and Wellbeing. 2. We told the manager to take immediate action to have toilet roll and paper towel dispensers installed following guidance from the health protection team. This will help to control the spread of infection when children are using the toilets in the nursery. National Care Standards Early Education and Childcare up to the age of 16, Standard 2: A Safe Environment; and Standard 3: Health and Wellbeing. Simpson Playhouse, page 23 of 33

24 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 Service Strengths Information detailed in Quality Theme 1, Statement 1 is also relevant to this Statement. Areas for improvement See Areas for Improvement identified within Quality Theme 1, Statement 1. Grade awarded for this statement: 4 - 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 During the inspection we observed staff working in the nursery, and saw that they were caring and motivated to provide children with a safe, stimulating place to learn and play. We found that they supported one another and worked well as a team. We found that an induction programme was in place for all new staff which ensured they were aware of the service's policies and procedures. The manager and staff told us that this helped ensure that everyone understood their role and their responsibilities in line with company policy. Recently recruited staff told us that they had been well supported during their induction, and had worked through their induction booklet to ensure they were familiar with the policies and procedures. We found that all of the nursery staff were either registered with the Scottish Social Service Council (SSSC) or had applied to register in accordance with the required timescales. The SSSC is the body that regulates care staff and decides the level of qualification for each post. Simpson Playhouse, page 24 of 33

25 The system for staff annual appraisal was in place, which helped the manager to work together with staff to agree areas for development, formally reflect and assess staff performance, and think about how this impacted on the outcomes for children. We saw that the manager had undertaken a training needs analysis, which highlighted training undertaken and when core training required to be updated. Staff told us they had received in-house training on infection control, and had booked to attend training on planning and assessment. Staff told us they were encouraged to contribute to staff meetings and found them useful for sharing information. We looked at the minutes of recent staff meetings and found that the areas of focus were purposeful, and included : >a reminder to staff to update children's care plans every six months or when required >signposting staff to best practice materials and encouraging them to take time each week to read these documents >organising learning visits to other nurseries >involving staff in updating the nursery aims. All five parents who responded to the Care Standards Questionnaire strongly agreed that there were always enough staff in the service, and that they had the skills and experience to care for their children. Areas for improvement We found that the manager continued to support and guide staff to enable them to improve outcomes for children. She needed to continue to provide clear direction to enable them to continue to effectively meet the needs of the children. In particular, the manager and senior staff need to support staff to increase their awareness in relation to infection control and the management of medication. See Recommendation 1 and Requirements made in Quality Theme 1, Statement 3. We also asked the manager implement Individual support and supervision sessions for staff, which would contribute to the quality assurance programme and the staff appraisal system. More information in relation to quality assurance is included within Quality Theme 4, Statement 4. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1 Inspection report continued Simpson Playhouse, page 25 of 33

26 Recommendations Inspection report continued 1. The manager and senior staff needs to review staff performance and implement measures to ensure the overall quality of service and experiences provided to children and their families continues to improve. National Care Standards Early Education and Childcare up to the age of 16, Standard 12: Confidence in Staff Simpson Playhouse, page 26 of 33

27 Quality Theme 4: Quality of Management and Leadership 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 management and leadership of the service. Service strengths Please refer to information recorded under Quality Theme 1, Quality Statement 1. Areas for improvement Comments made in Areas for Improvement in Quality Theme 1, Quality Statement 1 also apply to this Quality Statement. Grade awarded for this statement: 4 - 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 found that the manager and senior staff were available within the service on a daily basis. Parents spoken with stated that the whole team was always willing to listen to parents and took time to speak to them. They said they found them to be approachable and flexible, taking account of individual needs and circumstances. The feedback from parents was also reviewed as part of the quality assurance process, and changes made to the service if appropriate (see also Quality Theme 1, Statement 1). Staff were also involved in the quality assurance processes. They confirmed that the management team was approachable and that they felt valued. The contributions from the staff team to improvements within the nursery were always welcomed, encouraged and acknowledged. We saw that the manager had started to monitor staff practice and their interaction with the children. This gave her an oversight of all staff and the care provided for the Simpson Playhouse, page 27 of 33

28 children. We looked at the monitoring records and saw that strengths had been recognised and areas for improvement had been highlighted and fed back to staff. We saw that staff had started to use the Education Scotland Curriculum for Excellence to measure the performance in relation to progress of those children in the 3 to not yet attending primary school category. Education Scotland's Pre-Birth to Three guidance was used to guide and evaluate planning in the playroom for the younger children. We saw that the manager and staff team had involved children in choosing new resources and giving ideas for snack and preferred activities. The nursery was a partner provider for pre-school education with Aberdeenshire Council. As such, visits were made to the nursery on a regular basis by the council's development worker and Early Years Coordinating Teacher. Information provided from these visits was also used for ongoing quality assurance purposes. We saw that, in consultation with the development worker, improvement plans had been produced. We found that the nursery was making progress in: >Assessment for learning and children's profiles >Evaluation of the provision >Space for learning. The nursery had complied with regulation by the Care Inspectorate. They had completed annual returns and self assessments as they were asked to. All of this showed us that they were committed to checking that they were performing to a high standard and looking for ways to make improvements. Areas for improvement Inspection report continued We suggested that the manager introduce regular support and supervision sessions, which would help staff identify their strengths, build on what works well and help them to recognise areas which could be improved on. These steps would contribute to continual improvement in the effectiveness of the provision and outcomes for children. See Requirement 1 We found that some monitoring of staff practice was undertaken. We suggested this could be further developed to ensure a clear focus was identified for monitoring. This would support staff in developing specific aspects of their practice. The findings from staff monitoring should be used at one to one supervision sessions to support staff with the evaluation of their work. See Requirement 1 The issues that we have identified throughout the report have been taken into consideration when awarding the grade for this Statement. Quality assurance systems should be improved upon to ensure that the issues identified throughout this report are addressed, monitored and maintained. This will help ensure that the outcomes for children attending the service improve. See Requirement 1 Simpson Playhouse, page 28 of 33

29 Grade awarded for this statement: 3 - Adequate Number of requirements: 1 Number of recommendations: 0 Requirements 1. The provider and manager must further develop their system of quality assurance to improve outcomes for children by monitoring and improving all areas of practice. In order to comply the provider must: a) Develop and implement a rigorous quality assurance procedure; b) Implement regular effective support and supervision for all staff; c) Implement regular effective monitoring of staff practice to ensure staff are implementing the care service's policies and procedures and are promoting positive outcomes for children. This is in order to comply with: Inspection report continued The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011, No 210: 4 (1)(a) - Requirements to make proper provision for the health and welfare of service users. Regulation 15(a) and (b) - to make proper provision of sufficient and suitably qualified and competent staff. National Care Standards Early Education and Childcare up to the age of 16, Standard 12: Confidence in Staff; Standard 13: Improving the Service; and Standard 14: Well-Managed Service. Timescale for implementation: within 6 weeks of receipt of this report. Simpson Playhouse, page 29 of 33

30 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 the Care Inspectorate re-grading a Quality Statement within the Quality of Management and Leadership Theme (or for childminders, Quality of Staffing Theme) as unsatisfactory (1). This will result in the Quality Theme being re-graded as unsatisfactory (1). Simpson Playhouse, page 30 of 33

31 5 Summary of grades Quality of Care and Support Weak Statement 1 Statement Good 2 - Weak Quality of Environment Good Statement 1 Statement Good 4 - Good Quality of Staffing Good Statement 1 Statement Good 4 - Good Quality of Management and Leadership Adequate Statement 1 Statement Good 3 - Adequate 6 Inspection and grading history Date Type Gradings 16 May 2012 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 17 May 2011 Unannounced Care and support 4 - Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good 23 Aug 2010 Unannounced Care and support 5 - Very Good Environment 4 - Good Staffing Not Assessed Management and Leadership 2 - Weak Simpson Playhouse, page 31 of 33

32 7 Jan 2010 Unannounced Care and support 5 - Very Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Simpson Playhouse, page 32 of 33