Monreith Road Care Home Service 152 Monreith Road East Cathcart Glasgow G44 3DF Inspected by: (Care Commission Officer) Type of inspection: Anne Borland Announced Inspection completed on: 6 June 2006 1/11
Service Number Service name CS2003001062 Monreith Road Service address 152 Monreith Road East Cathcart Glasgow G44 3DF Provider Number dummy Provider Name SP2003003390 Glasgow City Council Inspected By dummy Inspection Type Anne Borland Care Commission Officer Announced dummy Inspection Completed Period since last inspection 6 June 2006 5 months dummy Local Office Address 1 Smithhills Street Paisley PA1 1EB dummy 2/11
Introduction Monreith Road is a Local Authority children's Unit provide by Glasgow City Council. Care is provided over 24 hours for up to 8 young people whom, for a variety of reasons, cannot at this point in their lives live at home. The building is a large, spacious semi detached Victorian building set in it's own gardens in the south side of Glasgow. The area has good public transport links. The aim of the service is to provide a safe, caring environment in which young people can realise their potential. Basis of Report The inspection was carried on the 6th June 2006. During the inspection the Officer spoke with four young people, and six staff members The Officer was also able to speak with the LAC nurse. Interaction between the staff members and service users was observed. The Officer also joined young people at their evening meal. Staff were observed to be purposeful and positive in their interactions with young people and communicated effectively with colleagues. The young people themselves presented as relaxed and settled in the home. The young people's general presentation was that of being well cared for. The Officers also looked at a range of policies, procedures and records some of which are included in the following: Service users personal plans and review documentation. The Staff training records. Fire safety records The accident and incident book Violent incident forms Young peoples meeting minutes The above were taken into account and reported on whether the service was meeting the following National Care Standards for Care Homes for Children and Young People: Standard 2 - First Meetings Standard 4 - Support Arrangements Standard 5 - Your Environment Standard 6 - Feeling Safe and Secure Standard 7.7 - Management and Staffing Arrangements Standard 10 - Eating Well Action taken on requirements in last Inspection Report There were no requirements made at the last inspection. Comments on Self-Evaluation The service manager did not complete a Pre- Inspection Return or self evaluation statement about the service. 3/11
View of Service Users The Officer spoke with four young people. Young people could advise the Officer that they felt safe in the service and that bullying was not prevalent. All expressed confidence that they had specific members of staff to help and talk to about problems if the need arose. All felt that sanction imposed were fair and explainations were given by staff members. All stated a range of activities were available. Young people confirmed that their views were sought in relation to the planning of their care. The general opinion was that the food was not always good but did acknowledge that choice was made available. One young person felt the security for personal items could be improved upon. View of Carers The Officer did not speak with any carers at this inspection. 4/11
Regulations / Principles Regulation : National Care Standards National Care Standard Number 2: Care Homes for Children and Young People - First Meetings The officer found evidence in records and in discussion with staff and young people that, when possible, pre-admission visits to the care home takes place. When possible staff members take time to prepare the other young people for the arrival of new residents to the unit. Evidence was found which demonstrated that planning meetings are held promptly after a young person is admitted to the unit. Young people confirmed that staff members keep them informed of their home situation and the likely effect this will have on their stay. The Officer recognises that the short term notice often given about the arrival of a new person does not allow for the redecoration and refurbishment of bedrooms. However, the Officer viewed the bedroom of a newly admitted young person, is of the view, that better preparation of room could have been possible. National Care Standard Number 4: Care Homes for Children and Young People - Support Arrangements The Officer samples the personal plans of 3 young people and found evidence of inter-agency working, agreed goals and regular reviews. Contact with family members and significant others was in evidence. Young people confirmed that staff members spend time before and after reviews to discuss plans for the future. 5/11
In the plans sampled young people had formal placement agreements and day- to day placement arrangements which encompassed health needs, educational, social and religious beliefs. The care home has good links with the LAC nurse who is a regular visitor to the home. Multi-disciplinary reviews are held to discuss any significant changes to the circumstances of young people. The Officer noted that Individual Crisis Management Plans were not always updated. This should be addressed. Day- to Day placement agreements did not contain the signature of agreement of parents and young people. (recommendation 1) The written updates did not set specific targets with a named responsible person. (recommendation 2) The Officer was advised that currently no system is in place to ensure specific hearing tests are carried out after admission. In addition the Officer noted that not all medical books are kept up-to-date or cross referenced to assessments made by LAC nurses. This should be addressed. National Care Standard Number 5: Care Homes for Children and Young People - Your Environment On the day of inspection the care home was found to be attractively decorated, well maintained, clean and tidy. Furnishings throughout were in good condition and fit for use. All furnishing, bedding and curtains comply with fire safety standards. At the time of inspection all young people had a bedroom of their own. All were of spacious and the radiators in most rooms could be used to adjust the heating level.most rooms were comfortable and well decorated. Young people confirmed that they are consulted, at times of redecoration, about the colour of their room. Young people have a choice of bathing or showering facilities with working locks on doors. Young people have access to a quiet room or bedroom if they wish privacy from the group. The kitchen is open to young people and easily accessible. 6/11
The home has pleasant gardens and garden furniture. The care home is of spacious dimensions which allows young people to have space, room to enjoy activities and privacy from each other. The care home is a smoke free environment. All young people can hold keys for their room although many chose not to. The dinning table is situated in the lounge and does not have adequate seating to allow all young people and staff members to dine together if wished. The home currently has unused areas attached to the kitchen which could be utilised as a dinning room. This should be considered. The lockable drawers can be removed, hence are not secure. an alternative type of lockable space should sought. The bathrooms and shower rooms whilst attractively tiled and decorated lacked personalising and curtains. This should be addressed with the lack of window coverings forming recommendation 3. On the day of inspection not all bathrooms had available handwashing liquid. This was addressed at the time of the inspection. The yale lock was still on the door of the former office which was now utilised as a bedroom. This could be locked from the inside and could not be overridden by a master key. The senior practitioner advised this would be dealt with immediately. National Care Standard Number 6: Care Homes for Children and Young People - Feeling Safe and Secure The staffing rota shows that there is always a minimum of two staff members on shift with the typical number being three staff on shift. Staff have been issued with the Scottish Social Service Code of Conduct and are made aware of the agencies policies on relationships between staff and young people. Whistle blowing procedures are in place which gives staff members the responsibility to alert senior managers of questionable practice. Staff who spoke with the Officer could give situations of when safe care practices are used. Examples given were of the appropriate of taxis, use of out of hours staff and child protection procedures. 7/11
Records demonstrate that staff members are able to use procedures to report young people missing when appropriate. There was evidence of a pro-active stance regarding bullying. This was a subject of discussion at children's meetings as a way of educating young people of the varying forms bullying can take. Young people reported to the Officer that bullying in the unit was not an issue and expressed confidence that staff members would tackle it if it arose. Young people, who spoke with the Officer, could name staff in whom they could confide about situations or issues which was causing them concern. An accident book is maintained. Clear guidance is available to staff under the conditions under which physical restraint will be used. Staff members have a mandatory responsibility to complete violent incident forms when restrain has been used and account for practice. These forms are then considered by management and external management to monitor practice. Staff are trained on how to manage challenging behaviour ( Therapeutic Crisis Intervention). Young people at risk from their own behaviour or the influence of others behaviour are involved in vulnerable young persons reviews. Clear instructions are in writing to inform visitors of rules of conduct during their time in the house. Fire fighting equipment, the fire detectors and system are regularly maintained. A current fire risk assessment is in place and was completed by a person deemed competent. An action plan was in place and progressed. Comprehensive guidance on fire safety, compiled by the service manager to the unit, was available for staff. Records were kept of staff who had completed fire training. Evidence was in place of regular drills and fire tests being carried out. The unit has monitoring visits by external management. Young people could name the external manager and service manager whom they state were visitors to the house. There was insufficient evidence of regular checks of emergency lighting being carried out. The kitchen door was being jammed open to ensure staff could adequately monitor the whereabouts of young people. However, this should be replaced by an electromagnetic door opener. ( recommendation 4) 8/11
The service book for the minibus could not be examined as it was locked in the broken glove compartment. This should be attended too. National Care Standard Number 7: Care Homes for Children and Young People - Management and Staffing The only element of this standard to be examined in this inspection was that the provider follows safer recruitment practices ( standard 7.7). The manager confirmed that all recruitment files were held centrally. These will be subject to a central audit by the Care Commission to ensure safer recruitment practices are being adhered too and will be included in the next inspection report of this service. None noted at this time. National Care Standard Number 10: Care Homes for Children and Young People - Eating Well Young people are encouraged and assisted to complete food preference forms which becomes the basis of the menu plan. The menu shows that alternative meals are always available. The Officer looked in the kitchen store cupboards and fridge and evidenced that food is fresh, unprocessed and includes fresh fruit and vegetables. The cook and chef have attended food hygiene training. The young people are encouraged to eat with staff members at the table. Young people are encouraged by the chef to participate in the preparation of meals. The food quality on the day of inspection was well presented and nutritionally balanced. Young people ate well on the day of inspection. Staff members are fully informed of the health needs which are effected by diet. The LAC nurse was present in the unit on the day of inspection to advise staff on best practice regarding the health needs and dietary needs of a young person. Food and snacks for those with particular health needs were available. 9/11
Young people health needs are fully considered in relation to their dietary intake. The kitchen does not have a dishwasher which could impact on the ability sterilise dishes. This should be addressed. Staff member should consider completing the food preferences sheet with young people as part of the admission process. 10/11
Enforcement There is no enforcement action taking place regarding this service. Other Information The service is in the process of varying their registration to allow them to accommodate 9 young people. The Office had discussions with the external manager about dividing a larger style bedroom so that if the variation were granted no sharing of rooms would be necessary. Requirements There were no requirements made following this inspection. Recommendations Recommendation 1 -Standard 4.1- Personal plans should be signed by parents and young people to signify involvement and agreement. Recommendation 2 - Standard 4.1 - Care plan updates should include specific goals to meet assessed need and preference, timescales involved and who is responsible. Recommendation 3 - Standard 5. All bathrooms, shower rooms and toilets should have window coverings. Recommendation 4 - Standard 6 - Emergency lighting should be checked in keeping with the provider's own procedures. The kitchen door should be replaced with a door which can close automatically in the event of a fire. Anne Borland Care Commission Officer 11/11