No Limits Caithness Day Care of Children Bank Row Wick KW1 5EY

Transcription

1 No Limits Caithness Day Care of Children Bank Row Wick KW1 5EY Inspected by: Kara Doonan Type of inspection: Unannounced Inspection completed on: 1 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 11 4 Other information 20 5 Summary of grades 21 6 Inspection and grading history 21 Service provided by: NOSCA Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Kara Doonan Telephone enquiries@careinspectorate.com No Limits Caithness, 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 4 Good Quality of Management and Leadership 3 Adequate What the service does well At this inspection, we found that the service provided good opportunities for children and their families to give feedback and make suggestions for improving the service. We observed staff to be responding to the children's needs in a caring and supportive manner. We concluded that the staff valued and recognised the importance of the children's individual needs and in providing the appropriate care to meet these. We found that children were cared for within designated rooms within the family centre and accessed the secure garden area. We found all areas to be clean and tidy. We observed the staffs' interactions with the children. We found them to have a caring, considerate and professional manner at all times. Through observation we felt the children were confident and comfortable with the staff. We concluded that the staff and children had formed positive relationships. What the service could do better All accident forms should include an accurate and detailed account of any accidents that occur including time, place and outcomes and actions taken. Parent/carers must be informed of the accident and records should indicate when and how this has taken place. The management must complete a full premise risk assessment focusing on infection No Limits Caithness, page 3 of 22

4 control. This should include facilities designated for personal care must only be used for this. All planned actions should follow best practice guidance for example appropriate disposal of Personal Protective Equipment (PPE). What the service has done since the last inspection This was the service first inspection. Conclusion Children were receiving a service that provided them with the opportunity to take part in arrange of activities. The service provided the children opportunities to develop friendships and interact with others. Who did this inspection Kara Doonan No Limits Caithness, page 4 of 22

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Prior to 1 April 2011, this function was carried out by the Care Commission. Information in relation to all care services is available on our website at This service was registered with the Care Inspectorate on 29 January Requirements and recommendations If we are concerned about some aspect of a service, or think it needs to 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 Order made under the Act or a condition of registration. Where there are breaches of the regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. The service is registered to provide a care service for children and young people with additional support needs, to a maximum of 10 children, aged from 4 years up to the age of 16 years. A maximum of 4 of these places may be used for children/young people aged 16 to 18 years. The service aims to provide or assist in the provision of facilities in the interests of social welfare for recreation, education, health promotion, exercise and sporting activities or other leisure time occupation of children and young people with physical and /or learning and / or communication difficulties or additional needs with the object of improving their condition of life. 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 4 - Good Quality of Management and Leadership - Grade 3 - Adequate No Limits Caithness, page 5 of 22

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. No Limits Caithness, page 6 of 22

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 We wrote this report following an unannounced (short notice) inspection. This was carried out by inspector Kara Doonan The inspection was completed during a short notice visit on 1 August 2013 between 9:10am and 4:20pm As part of the inspection we took account of the completed self assessment forms that we asked the provider to complete and submit to us. We sent 10 care standards questionnaires to the manager of the service to distribute to relatives or carers of children who use the service. Relatives and carers returned 4 questionnaires before the inspection. During this inspection process, we gathered evidence from various sources, including the following; We spoke with: - the service manager - practitioners - the children using the service We looked at - children's information records - policies - service questionnaires/ evaluations - medication records - accident records - registration certificate - insurance certificate No Limits Caithness, page 7 of 22

8 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 report continued 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 No Limits Caithness, page 8 of 22

9 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: No 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 completed self assessment document from the service provider. We were satisfied with the way the service provider had completed this and with the relevant information they had given us for each of the headings that we grade them under. The service provider identified what they thought they did well and areas for development. Taking the views of people using the care service into account Throughout the inspection the inspector was in the playroom with the children. This allowed the inspector to carry out observations of a children's full day at the service. We observed the children taking part in a range of activities from arts n crafts, face painting to building with construction toys. We found the children were enjoying taking part and showing positive responses to activities and staff. A popular activity was the face painting, in which most children participated and especially enjoyed painting staff's faces. The children welcomed the inspector and some of the children were keen to interact and invite them to participate in the activities. The children that communicated with the inspector did so with enthusiasm. No Limits Caithness, page 9 of 22

10 Taking carers' views into account We sent out 10 questionnaires and 4 were completed and returned to us before our inspection. When we asked about the overall quality of the services their relative or friend receives in this service: - 2 people indicated they strongly agreed, 1 person indicated they agreed and 1 person indicated they disagreed they had been involved in developing the service. - 2 people indicated they strongly agreed, 1 person indicated that they agreed and 1 person indicated they did not know if they were happy with the quality of the service. - 1 person indicated they strongly agreed, 2 people indicated they agreed and one person did not know that the environment is safe, secure, smoke free, pleasant and stimulating. - 1 person indicated that they strongly agreed, 2 people indicated they agreed, 1 person indicated they did not know that staff asked their child's views about activities and planning. - 1 person indicated that they strongly agreed, 2 people indicated they agreed and 1 person indicated they did not know that they had confidence in staffs skills and experience. Comments included: Inspection report continued 'My child actively looks forward to their holiday and Saturday clubs. These clubs give them a chance to develop friendships with children and develop relationships outside the family circle. Their ability to deal with my child's needs bring them out of their shell and has become a happy chatty child.' 'The club has only recently been taken over with new management and staff. Handover appeared to be non existent.' No Limits Caithness, page 10 of 22

11 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 At this inspection, we found that the performance of the service was good for this statement. The service met all aspects considered, providing opportunities for children and their families to give feedback and make suggestions for improving the service. We gathered evidence from talking to staff, observing and talking to the children, gathering feedback from family members and information written and verbally presented by the service. Staff informed us about the methods used to provide a service that reflected the needs of the children and families. This included visits to the children's homes prior to them starting to use the service, daily observations and discussions to find out what activities the children wanted to take part in. The children's needs and wishes were gathered at enrolment and used to plan their care. Some staff were trained in using makaton to communicate with the children. We concluded that staff showed respect and valued children's choices. As a result, staff planned daily activities and routines in response to children's needs and wishes. The children had designed and painted the large wall mural in the main playroom. The management explained that this gave children a feeling of ownership over the club and the facilities. Most children were escorted to and from the service. The staff escorting the children ensured they shared and gathered information from parents/carers on a daily basis. This kept staff informed of any changes to the children's routines or daily needs. No Limits Caithness, page 11 of 22

12 Areas for improvement The service had 'have your say' evaluations to be completed by parents at the end of the summer holiday club. Once these are collated the service planned to combine these along with the outcome of this inspection to develop a service improvement plan. Staff were completing a 'reflection of practice' evaluation throughout the summer club. At the end of the summer holidays, the staff planned to review their practice and identify areas for improvements. We would suggest that the service demonstrates the impacts/outcomes for children in response to consultations. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths At this inspection, we found that the performance of the service was good for this statement. We looked at how the service planned and supported the children's needs. We looked at the information held on the children, spoke to staff about how this information was used and carried out observations to see it being implemented. The records viewed included registration forms and children's plans. These provided detailed information about the children including communication methods to be used, preferences and personal interests. Staff informed us they used this information to plan appropriate care and support. Children were assisted by one or two staff members depending on their individual needs. We observed staff to be responding to the children's needs in a caring and supportive manner. We concluded that the staff valued and recognised the importance of the children's individual needs and in providing the appropriate care to meet these. Areas for improvement Inspection report continued We discussed the personal plans legislation with management. They agreed to further develop the records held to ensure that this is incorporated. The accident forms did not contain information such as where accident occurred, outcomes or actions taken (see recommendation one). By having this detail of information the management could evaluate accidents and as a result improve safe measures put in place to address any identified risks. No Limits Caithness, page 12 of 22

13 Where staff and children have been involved in the accident/incident an accident/ incident form should be completed for each person involved. Staff completed written observations on the children. The forms indicated staff planned and recorded next steps in supporting children's development. Most next steps sections viewed were blank. Staff should ensure that they complete all records following the services procedures. This would support them to demonstrate they identified and met children's needs and interest. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. All accident forms should include an accurate and detailed account of any accidents that occur including time, place and outcomes and actions taken. Parent/carers must be informed of the accident and records should indicate when and how this has taken place. National Care Standards Early Education and Childcare, Standard 3; health and wellbeing and Standard 14; well managed service. No Limits Caithness, page 13 of 22

14 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 At this inspection we considered the opportunities for children and their families to give feedback and make suggestions for improving the service. We gathered evidence from observing children and staffs interactions and information written and verbally presented by the service. We have reflected our findings for this statement under quality theme one, statement one. Areas for improvement We have reflected our findings for this statement under quality theme one, statement one. 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 At this inspection, we found that the performance of the service was good for this statement. We considered how the premise where the service is provided was maintained and kept fit for purpose. We gathered evidence through viewing the areas, equipment, examining relevant records and observing how environment and equipment was used. We found that children were cared for within designated rooms within the family centre and accessed the secure garden area. We found all areas to be clean and tidy. Staff held daily discussions to plan how to meet child's individual needs. This included No Limits Caithness, page 14 of 22

15 personal care, moving and handling and adult to child ratios. We found only staff with appropriate training assisted children, for example, with personal care. The service had policies and procedure in place, for example, for behavioural management and moving and handling. We found practice that supported these including children following good hygiene practices, for example washing hands before lunch time. Areas for improvement Most of the equipment used within the changing/personal care facilities was found to be maintained and fit for purpose. There was no general waste bin for disposal of hand towels. Staff confirmed that they used the nappy bin to dispose of all waste in the changing/personal care facility. The room used for children's personal care included changing facilities and a quiet, chill out area. The mops used for cleaning in the kitchen and toilets were stored in the kitchen side by side. We observed staff taking wipes from the changing facilities to wipe children's hands in the main playroom. We have made a requirement that the service completes a thorough risk assessment of the premises focusing on infection control. This is to ensure that all appropriate safety measures are in place to reduce the spread of infection (see quality theme four, statement four for requirement) Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued No Limits Caithness, page 15 of 22

16 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 At this inspection we considered the opportunities for children and their families to give feedback and make suggestions for improving the service. We gathered evidence from talking to children, parents/carers and staff and information written and verbally presented by the service. We have reflected our findings for this statement under quality theme one, statement one. Areas for improvement We have reflected our findings for this statement under quality theme one, statement one. 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 At this inspection, we found that the performance of the service was good for this statement. The service had met all aspects considered in relation to a professional, trained and motivated workforce, which operates to National Care Standards, legislation and best practice. We looked at staffs communication and interaction with the children, staff awareness and knowledge of the children in their care, and how staff shared practice. The manager and staff, required to, where registered with the relevant professional body such as Scottish Social Services Council (SSSC). Staff had either gained, or were No Limits Caithness, page 16 of 22

17 working towards, the relevant qualifications to meet the SSSC conditions of registration. Staff files viewed contained staff progress reports, notes of supervision meetings, staff summer holiday challenges, staff appraisals forms and training records. As the service started operation in April 2013 not all were fully completed at the time of the inspection. The manager confirmed that systems were in place to implement a staff appraisal system to support staffs personal development plans. We observed staffs interactions with the children. We found them to have a caring, considerate and professional manner at all times. Through observation we felt the children were confident and comfortable with the staff. We concluded that the staff and children had formed positive relationships The staff informed us that they worked well together and felt supported. This resulted in service having an ethos of working in partnership and created a welcoming and friendly working environment. Areas for improvement Staff who had not attended training or gained certificates in using communication techniques such as makaton told us they would like the opportunity to attend these. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued No Limits Caithness, page 17 of 22

18 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 At this inspection we considered the opportunities for children and their families to give feedback and make suggestions for improving the service. We gathered evidence from talking to children, parents/carers and staff and information written and verbally presented by the service. We have reflected our findings for this statement under quality theme one, statement one. Areas for improvement We have reflected our findings for this statement under quality theme one, statement one. 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 At this inspection, we found that the performance of the service was adequate for this statement. We found that most aspects we considered were met. This included the quality assurance systems and processes being used to assess and improve the service being provided. We looked at the services evaluation process and talked to staff and management. We found that the service had evaluation forms for parents and staff; these would be completed at the end of the summer holiday club. Management informed us that all feedback would be collated and the results used to plan actions to improve the No Limits Caithness, page 18 of 22

19 service. Staff had undergone an induction to ensure they were aware of their roles and responsibilities. The daily discussion sessions permitted staff time to reflect and make changes to the children's care plans if needed. The outcome was staff felt valued and confident within the roles. Each child had a written record detailing the care and support required to meet their needs and interests. Staff used these to plan appropriate care and support. Areas for improvement The service and manager should ensure that a thorough risk assessment for infection control is undertaken (see requirement one). The named manager of the service had changed. The service did not notify the Care Inspectorate of this immediately. The service should ensure they gain a copy of 'Records that all registered care service must keep and guidance on notification reporting'. This is available at The management informed us that they completed the service self assessment submitted to the Care Inspectorate. The management should consider methods to involve all staff, parents and children in completing this. Grade awarded for this statement: 3 - Adequate Number of requirements: 1 Number of recommendations: 0 Requirements 1. The management must complete a full premise risk assessment focusing on infection control. This should include facilities designated for personal care must only be used for this. All planned actions should follow best practice guidance for example appropriate disposal of Personal Protective Equipment (PPE). This is to comply with The Social Care and Social Working Improvement Scotland (Requirements for Care Service) Regulations 2011 (SSI 2011/210) regulation 4 (1) (a)- welfare of users Timescale: two weeks from the date of receiving this report No Limits Caithness, page 19 of 22

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 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). No Limits Caithness, page 20 of 22

21 5 Summary of grades Quality of Care and Support Good Statement 1 Statement Good 4 - Good 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 All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. No Limits Caithness, 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: No Limits Caithness, page 22 of 22