Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Arosfa Mold Type of Inspection Baseline Date(s) of inspection 17th April 2013 Date of publication 16 May 2013 You may reproduce this Report in its entirety. You may not reproduce it in part or in any abridged form and may only quote from it with the consent in writing of Welsh Ministers Please contact CSSIW National Office for further information Tel: 0300 062 8800 Email: cssiw@wales.gsi.gov.uk www.cssiw.org.uk
Summary About the service Arosfa was registered in October 2012 as a service to provide short break care for young people with disabilities from the age of 8 years until their 19 th birthday. The service is provided by Action for Children for Flintshire County Council, and can accommodate up to 3 young people at any one time over 7 days per week and is located in Mold. At the time of the inspection, the home was providing a service for 23 young people. The registered manager is Jude Vaughan and the responsible individual is Julie Gillbanks. What type of inspection was carried out? This was an unannounced baseline inspection. Discussions took place with the registered manager of the service and the staff on duty during the inspection. The views of staff were sought by questionnaire. Records were examined including a young person s file and further documents were provided by the manager following the inspection visit. We (CSSIW) observed the interactions between the staff and the young people during the inspection. What does the service do well? There is a strong sense of person centred care. This is because there are detailed systems in place to identify the individual requirements of the young people using the service. The organisation provides a range of relevant training for staff and management, which has raised awareness of the young people s needs. The service works well with other agencies to best meet the needs of the young people and has been nominated for a Flintshire Community Partnership award. What has improved since the last inspection? This was the first inspection of the service. What needs to be done to improve the service? There were no areas of non compliance identified during this inspection. The manager confirmed that she will be monitoring the impact of the increased number of young people using the service together with the reduction in staff hours. If the manager considers there needs to be adjustments made to staffing levels because of children s needs, this will be actioned 3
Quality of life Young people can be confident that they will have a voice and will be encouraged to speak up and that they will be listened to. This is because the service provides opportunities for the young people to express their views. The opinions and views of the young people were actively sought by staff during this inspection in the form of verbal prompts. They are asked for their views on their experiences at the end of each visit and this is recorded. Some of the young people who stay at the home have complex communication needs and the staff are trained to support young people s communication through Makaton and the Picture Exchange Communication System. Staff have undertaken specialist training to meet the individual health requirements of the young people. The young people s rights are respected and the home promotes the use of advocates who visit the home on a monthly basis. Communication books are used to share information with parents and schools. There was evidence of good communication between the service and the school as key workers visit the school so that care plans are followed in both settings to provide consistency. The young people experience a sense of achievement and well being because there is a commitment to learning and development. The young people have individual plans, which focus on areas such as self help, communication and independent living skills. The staff explained that while they try to encourage the young people to eat healthily, some of the young people have specific dietary preferences and staff respect that the young people have choice and control over the food that they wish to eat. The meal during the inspection was cottage pie with vegetables and the young people were encouraged to eat by staff giving assistance, time and praise. Staff provide appropriate, responsive care because they have an up to date understanding of the young people s individual needs and preferences. This was evidenced by the level of information sought about the young people from the parents and other agencies involved. The young people s progress is discussed in supervision meetings with staff and at team meetings and multi agency review meetings are held every six months. It was clear that the staff value the young people and we observed that the interactions were warm and caring. The young people were enjoying themselves, and were relaxed and comfortable with their carers and in the environment. 4
Quality of staffing The young people can be confident in the care they receive because staff are competent to meet their needs as they are appropriately qualified and experienced. Staff confirmed that they feel able to express their views and feel listened to and they confirmed that they have monthly supervision sessions with the manager. The staff present during the inspection said that the manager has an open door policy and can be approached to discuss issues. Staff have access to a range of training made available through Action for Children, and the manager stated that staff have attended additional training provided by Flintshire County Council. The impact of this level of training is that the staff have a better understanding of the young people s needs. For example, staff have recently attended training relating to sight impairment. Staff said that they feel motivated and that they enjoy the work that they do because they are making a positive difference to the young people s lives. However, some staff expressed anxieties about the number of changes that have taken place since the move from Cornel Clyd. There has been a change of premises with a new layout, changes to staffing hours and practices and there are new young people using the service. Previously, the service provided care for up to two young people at any one time, whereas the current provision now caters for up to three young people. Before, there were always two members of staff on duty, thus providing one to one care, now there can be two staff caring for three young people, although on the day of the inspection, there were three members of staff caring two young people. The manager understood the issues that were raised by staff and confirmed that the service is newly operational, and continuous assessments will be made in relation to staffing levels. The staff were able to describe the histories and needs of the residents who were present during the inspection and the care plans that underpin their work with individuals. Staff were observed to be attentive to the young people during this inspection. 5
Quality of leadership and management Young people and their families can be clear about what the service sets out to do as there is a statement of purpose available stating the nature of the provision. Young people can be confident that they are safe because the service is well run, with due care and attention given to national minimum standards and regulations. The manager is proactive in seeking advice to promote the well being and safety of the young people, and has sought guidance from the CSSIW when appropriate. The manager acknowledged that there have been issues with the move of premises and the expansion of the service. She said that the number of new young people introduced to the service has meant that there has been some unpredictability in determining the level of support required. She stated that although more young people are using the service at any one time, extra staff have been made available at busy times. For example, a third member of staff will be present to assist with care until bedtime, although this would not help if there were difficulties during the night. The manager explained that when issues have arisen, plans have been put in place to meet the needs of individual children such as a member of staff has been scheduled to work during the night to care for a young person who wakes up. The service is checked on a monthly basis by another manager within Action for Children in compliance with Regulation 32. The manager said that since the reorganisation of Action for Children into service clusters, there has been improved links with the other services within the cluster to share good practice. A report is provided on a quarterly basis to the commissioning authority regarding developments and sustainment of the service. As the service has only been operating for six months, the manager has yet to compile a quality of care review report. The manager has devised questionnaires that have recently been issued to parents to gain feedback about the new provision and a newsletter has been devised to share information with parents. Flintshire County Council monitors the provision by obtaining the views of the professionals who visit the service and a report is compiled using the data gathered every six months. Feedback from social workers in the latest report included that there were no concerns, that the young people were relaxed and happy and that staff were supportive and attentive. 6
Quality of environment The property is a purpose built building, designed specifically for a children s home. The premises are owned by Flintshire County Council who is responsible for maintenance and repairs. The property is a large detached domestic style building, and was found to be clean, light and airy, with suitable furniture and decorated in neutral colours. The young people are able to personalise the rooms when they stay by selecting preferred bedding and decorating the walls with photos and pictures. It was evident that the young people s preferences had been catered for during this inspection. On arriving at the home, we felt welcomed, comfortable and relaxed. The young people can be assured that they are safe from strangers entering the premises because of the security arrangements in place. Key fobs are used to enter the internal rooms and can be reset to ensure that only the relevant people can have access to areas of the home and this can be monitored. Personal information is properly protected as it is held in the office, which is kept locked at all times. The young people s wellbeing is promoted because of the range of facilities and equipment provided to meet their needs. New specialist equipment has been purchased on the recommendation of the occupational therapist involved with one of the young people. The young people s bedrooms are a good size and there are sufficient and suitably equipped bathrooms, and the communal areas are comfortable and homely. A particular feature of the home is the outdoor space, which has been landscaped to provide lawned areas and raised beds, one of which was planted up with herbs and another is to be used to grow vegetables. The young people have use of a trampoline, covered sandpit, swing chair and there is a large gazebo which is both attractive and practical to provide an area for play and eating that is shaded from the sun. One of the young people made use of the garden during the inspection and it was good to see a member of staff participating in the outdoor activities. 7
How we inspect and report on services We conduct two types of inspection; baseline and focussed. Both consider the experience of people using services. Baseline inspections assess whether the registration of a service is justified and whether the conditions of registration are appropriate. For most services, we carry out these inspections every three years. Exceptions are registered child minders, out of school care, sessional care, crèches and open access provision, which are every four years. At these inspections we check whether the service has a clear, effective Statement of Purpose and whether the service delivers on the commitments set out in its Statement of Purpose. In assessing whether registration is justified inspectors check that the service can demonstrate a history of compliance with regulations. Focussed inspections consider the experience of people using services and we will look at compliance with regulations when poor outcomes for people using services are identified. We carry out these inspections in between baseline inspections. Focussed inspections will always consider the quality of life of people using services and may look at other areas. Baseline and focussed inspections may be scheduled or carried out in response to concerns. Inspectors use a variety of methods to gather information during inspections. These may include; Talking with people who use services and their representatives Talking to staff and the manager Looking at documentation Observation of staff interactions with people and of the environment Comments made within questionnaires returned from people who use services, staff and health and social care professionals We inspect and report our findings under Quality Themes. Those relevant to each type of service are referred to within our inspection reports. Further information about what we do can be found in our leaflet Improving Care and Social Services in Wales. You can download this from our website, Improving Care and Social Services in Wales or ask us to send you a copy by telephoning your local CSSIW regional office. 8