City of Edinburgh Council Social Work Dept. - Family Focus - Care Support Service

Transcription

1 City of Edinburgh Council Social Work Dept. - Family Focus - Care Support Service Seaview House 52 Seaview Crescent Edinburgh EH15 2LT Inspected by: (Care Commission Officer) Type of inspection: Sheila Emerson Announced Inspection completed on: 5 March /9

2 Service Number Service name CS City of Edinburgh Council Social Work Dept. - Family Focus - Care at Home Service address Seaview House 52 Seaview Crescent Edinburgh EH15 2LT Provider Number Provider Name SP City of Edinburgh Council Inspected By Inspection Type Sheila Emerson Care Commission Officer Announced Inspection Completed Period since last inspection 5 March Months Local Office Address Unit 10a, Ground Floor Galabank Business Park Wilderhaugh Galashiels TD1 1PR 2/9

3 Introduction Family Focus is registered as a care at home service run by the City of Edinburgh Council. It's purpose is to provide weekly support to families who care for children and young people with complex and special care needs. Children may be aged from birth to sixteen years. Children are allocated a support worker from within the team who is responsible for undertaking the support noted in the assessment of need and care plan. In certain circumstances two workers may be allocated to ensure the safety of the child and to promote consistency. The aims of the service include offering children positive experiences outside the family and enabling children to fulfil their potential. Care may also be offered within the family home to enable parents/carers to have a short break. The service also aims to respect the individuality of each family and family member, to meet differing needs and to provide equality of opportunity. Family Focus is run by a manager and the assistant unit manager, both of whom are also in charge of the residential facility for children with special and complex needs, within which the offices of the Family Focus service are located. The service employs a whole time equivalent of nearly nine staff including the manager and assistant unit manager and support workers. The latter undertake the direct work with children and families, although the assistant unit manager had been undertaking some support worker duties at the time of the inspection with occasional help from the manager. The service had been understaffed by over one whole time equivalent post for some months but two new staff had recently been appointed. At the time of the inspection a total of 36 children and young people were being provided with a service. The service was first registered by the Care Commission in November The inspection was undertaken by Sheila Emerson, Care Commission Officer between 5 and 31 March Basis of Report Before the Inspection Annual Return The service submitted a completed Annual Return as requested by the Care Commission. The Self-Evaluation Form The service submitted a self-evaluation form as requested by the Care Commission. Views of service users Questionnaires were sent to ten parents of children using the service of whom seven responded. In addition, three of them were contacted personally. It was appropriate to see only one service user in person. Their views are noted overleaf. 3/9

4 Regulation Support Assessment This service was inspected after a Regulation Support Assessment (RSA) was carried out to determine the intensity of inspection necessary. The RSA is an assessment undertaken by the Care Commission Officer (CCO) which considers: complaints activity, changes in the provision of the service, nature of notifications made to the Care Commission by the service (such as absence of a manager) and action taken upon requirements. The CCO will also have considered how the service responded to situations and issues as part of the RSA. This assessment resulted in this service receiving a low RSA score and so a low intensity inspection was required as a result. The inspection was then based upon the relevant inspection focus areas and follow up on any recommendations and requirements from previous inspections, complaints or other regulatory activity. During the inspection process Staff at Inspecction The following staff were seen at inspection: The manager The assistant unit manager Five support workers were seen as a group and one of them was also seen on an individual basis. In addition, questionnaires were received from six staff. The trainer in the Crisis Aggression Limitation Management, (CALM) method Evidence The following records were inspected: The case record of four service users Incident records Policy for the protection of vulnerable adults Multi agency child protection procedures The Inspection Focus Areas, Protecting people (including child and adult protection and restraint) and Scottish Social Services Council (S.S.S.C.) code of conduct and staff training were inspected as well as the associated National Care Standards for 2007/08: Standard 4 Management and staffing In addition, action taken on the recommendations of the last inspection was inspected. Action taken on requirements in last Inspection Report There were no requirements made at the last inspection. Comments on Self-Evaluation The service completed a thorough self evaluation of the service they provided. This had been undertaken with the staff group and identified some areas for development. View of Service Users The young person spoken with had been receiving the service on a regular basis for several years. They expressed very positive views and clearly enjoyed time spent with their support 4/9

5 worker. Their views were followed in choosing activities and on occasion their worker was able to meet with one of their friends for joint activities. They got on well with all staff seen and felt staff were "good fun". They also felt staff would keep them safe. View of Carers All parents who gave feedback rated the service and staff skills and experience as "satisfactory" or "very satisfactory". All confirmed that their child had a written care plan and that they got the care and support needed. Of the parents spoken to, it was reported that staff were open to discussion about any issues and that these had been resolved. All reported their child enjoyed their time with their support worker and that feedback was provided by staff as appropriate. Parents clearly saw this as a valuable service. Two commented on the value of the service to the whole family. One parent commented on the issue of lack of cover if their support worker was absent for any reason. This had been an issue noted at previous inspections and discussed with the managers. Staff had clearly taken steps to address this issue as far as possible within their resources. The use of two support workers, additional cover from the managers, and prioritising need had gone some way to resolving this issue. 5/9

6 Regulations / Principles National Care Standards National Care Standard Number 4: Care at Home - Management and Staffing Strengths Elements of this standard which apply to the inspection focus areas being inspected have been considered. In addition, action taken on the recommendations of the last inspection has been inspected. Child protection Staff of the service stated they had access to copies of the Area Child Protection Committee guidelines and the council child protection policy. All staff had received input into the new Inter Agency procedures. Evidence from attendance at the staff meeting and from records, indicated staff were mindful of the need to protect children in the widest sense including promoting safety at all times. All staff had undertaken training in child protection and had been provided with information with regard to procedures should abuse be suspected. Records indicated appropriate action had been taken when there was concern over a child. All staff had also undertaken, or were undertaking, qualifications which had provided more specialist input into child protection. Protection of vulnerable adults Whilst the focus of the service was working with children, staff had been provided with information with regard to the council's policy "Protecting Vulnerable Adults. Ensuring Rights and Preventing Abuse" which gave information with regard to types of abuse and the procedure to be followed when abuse was suspected. A record inspected indicated that appropriate action had been taken when there had been the possibility of abuse. Staff stated that they had regular opportunities in team meetings and supervision to discuss practice issues and that managers were always receptive to discussions about any concerns in individual situations. Staff had contact details of their managers at all times. Restraint A copy of the good practice guidance on restraint, "Holding Safely" was available. Restraint used was based on the Crisis Aggression Limitation Management, (CALM) method, the emphasis of which was on the de-escalation of challenging behaviour. All staff had been trained in this, had regular updates and were mindful of the fact that restraint was only used as a last resort. Within the service there was access to the CALM trainer for advice in particular situations. There was evidence from staff discussion that thought and effort was put into ensuring that young people were managed in a positive way and that situations which may cause them distress or to become challenging were avoided whenever possible. Discussions included 6/9

7 the parents of children as well as the children themselves whenever possible. S.S.S.C. codes and staff training. Six staff returned questionnaires with their views of the service. Feedback indicated that all staff felt they had good access to training opportunities and all had, or were undertaking, necessary qualifications. All had a copy of the S.S.S.C. code of conduct. A training needs assessment specific to the service was said to have been undertaken and the manager was a member of a group within Edinburgh City Council which was considering the specific needs of staff caring for children with disabilities. Staff also reported that they had access to specific training identified through their supervision and continual professional development programme. Any medical training necessary was reported to be undertaken by a qualified medical practitioner. Staff presented as enthusiastic and keen to develop the service for the benefit of the children and families with whom they worked. It was a recommendation of the last inspection that: "Records should evidence that care plans are updated in accordance with policy to ensure that medication details are current." This recommendation had been met. Areas for Development The service had a policy and procedure with regard to the physical restraint of children. However it had been identified that this needed to be expanded to include restraint in a wider sense and taking into account the good practice guidance contained in the publication of the Mental Welfare Commission "Rights Risks and Limits to Freedom". (See recommendation 1). Managers had identified that risk assessments for restraints should be expanded and had started this process. Whilst one inspected was satisfactory, one was incomplete. (See recommendation 2). A Professional Review and Development programme was being introduced at the time of the inspection. The manager reported that it was difficult for her staff to access training in food hygiene and updates in first aid training due to demand within the council. She continued to lobby for better input in these areas. Whilst evaluation of training was undertaken, the managers had identified the need to improve this. The following were recommendations of the last inspection: "The service should ensure that records of physical intervention record any attempt to debrief the young person and note all who have been informed of the incident, in accordance with the guidance in the document produced by the Scottish Executive, "Holding Safely". All staff should also be made aware of this document." 7/9

8 Whilst staff were aware of the "Holding Safely" guidance, the incident form on which physical interventions were recorded did not evidence that all relevant parties were informed. In addition, the forms sampled did not contain evidence that there had been oversight by an external manager. (See recommendation 3). "The service should ensure that all staff have undertaken training in child protection specific to children and young people with disabilities." There was reported to be no specific training specifically available. However staff were developing communication methods with the children in their care. These included the use of a board game, "Listen to me" in relation to making complaints and "My book about me" in order to facilitate feedback from the children. Whilst some training had been given to staff in communicating with children with disabilities, the manager had identified the need to develop this. As progress was being made with regard to trying to ensure children had means to give feedback to staff, this recommendation will not be repeated. The manager had identified the need to update the induction process and was to ensure new staff were provided with training in the protection of people early in the induction programme. 8/9

9 Enforcement There has been no enforcement action against this service since the last inspection. Other Information There is no other information of relevance to this inspection. Requirements No requirements were identified at this inspection. Recommendations Recommendation 1. The service should develop the policy on restraint to ensure it contains all relevant parts of the good practice guidance contained in the publication of the Mental Welfare Commission "Rights Risks and Limits to Freedom". All staff should be made aware of the implications of this for practice. National Care Standards, care at home, Standard 4, 1 and 2, Management and staffing. Recommendation 2. The service should ensure that risk assessments for the use of restraint are fully completed and reviewed at regular intervals. National Care Standards, care at home, Standard 4, 1, Management and staffing. Recommendation 3. The service should ensure that records of physical intervention note all who have been informed of the incident, and that the oversight of the external manager, along with any subsequent action necessary is recorded. This should be in accordance with the guidance in the document produced by the Scottish Executive, "Holding Safely". National Care Standards, care at home, Standard 4, 1, Management and staffing. Sheila Emerson Care Commission Officer 9/9