Auchengavin Care Home Service Children and Young People Auchengavin Farmhouse Luss, by Alexandria G83 8NX Type of inspection: Unannounced Inspection completed on: 2 September 2014
Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 9 4 Other information 22 5 Summary of grades 23 6 Inspection and grading history 23 Service provided by: Common Thread Ltd Service provider number: SP2005007437 Care service number: CS2013317441 If you wish to contact the Care Inspectorate about this inspection report, please call us on 0345 600 9527 or email us at enquiries@careinspectorate.com Auchengavin, page 2 of 24
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 5 Very Good Quality of Environment 5 Very Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well Auchengavin was providing a high standard of care and support to children and young people who need a safe, caring and nurturing environment. Staff are registered with the Scottish Social Services Council (SSSC) and had a variety of training opportunities. A particular strength of the service is the committment the team have to achieve the best outcomes for each individual child by listening to them and involving them in their care. A particular strength of the service was the way in which they were involving the young people, parents and others in the service and its continual improvement. What the service could do better The service manager and the provider had very good quality assurance systems which are used effectively. They were working on the continual improvement of the service through their systems of feedback and through further developing their quality assurance processes. What the service has done since the last inspection This is the first inspection of this service which was registered October 2013. Auchengavin, page 3 of 24
Conclusion Inspection report continued Overall, we found that participation was embedded in daily life and there was a sense of normal family life to daily routines. Activities are planned to suit everyone's interests and the young people were actively involved in the planning of these. This ensured that the young people could develop their skills and abilities at a pace that was right for them. Education and academic achievement was valued alongside the social and emotional development of the young people and the acquiring of skills right for them as individuals. There was an established process of partnership working between staff and external professionals to support young people's safety and to promote consistency of care. Auchengavin, page 4 of 24
1 About the service we inspected Auchengavin Residential Children's House is provided and managed by Common Thread Ltd. It is registered to provide a care home service to a maximum of four children between the ages of 8 and 18 years. It is situated at Auchengavin Farmhouse, Luss, by Alexandria, Argyll and Bute. The accommodation is rural and sits within a large garden. It includes two lounges, a large kitchen/dining room, a utility room, an office, a general purpose/meeting room and four bedrooms. There is also a staff sleepover room and an adult toilet which is also wheelchair accessible. The premises and large grounds offer the children and young people good opportunities for positive experiences. The service supports young people who have experienced significant difficulties in their lives, sometimes a great deal of trauma. While learning how to manage these difficult feelings, sometimes some of the young people can display very challenging behaviour. The aims and objectives of Auchengavin include to work with the young people in a respectful, caring manner which involves them in their care and to provide focused work for individual children. Three young people were accommodated on the evening we inspected the service. The Manager was present together with two Residential Childcare workers. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 5 - Very Good Quality of Environment - Grade 5 - Very Good Quality of Staffing - Grade 5 - Very Good Quality of Management and Leadership - Grade 5 - Very Good 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 www.careinspectorate.com or by calling us on 0345 600 9527 or visiting one of our offices. Auchengavin, page 5 of 24
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 carried out this unannounced inspection visit on 27 August between 3:30pm and 9:30pm. Before the inspection we received a self assessment from the service and sent out care standards questionnaires to young people using the service. We contacted social workers responsible for placements at the service and asked them for their views on the quality of the service. We met with the manager and staff on duty at the time of our visit and spoke individually with each of the three young people resident, we also spoke with two parents. We examined a wide range of paperwork including young people's care plans and individual risk assessments and associated records. We looked at staff rotas and training plans and a range of other documentary evidence provided as evidence of the service's development since the time of registration, including: The registration certificate Self Assessment Notifications Minutes of staff and young people's meetings Staff communication book Staff registration with SSSC Staff Supervision Complaints Incidents Quality Assurance Systems The medication System Auchengavin, page 6 of 24
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 www.firelawscotland.org Auchengavin, page 7 of 24
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. The Care Inspectorate received a completed self-assessment document from the provider. We were satisfied with the way the provider completed this and with the relevant information included for each heading that we grade services under. Taking the views of people using the care service into account Each of the young people told us they felt safe, listened to and cared for. We have included some of their comments under individual quality statements. Taking carers' views into account We spoke with two parents of the young people. Both spoke highly of the service and described being fully involved, listened to and having respect for the support the service was providing to their child and their family. We have included some of their comments under individual quality statements. Auchengavin, page 8 of 24
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: 5 - Very 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 Auchengavin has a variety of informal and formal ways that young people and other people with an interest in the service can have their voices heard. We spoke with Social Workers who described staff and management as open and helpful in their shared support of the young people. We were told that the therapeutic element of the service takes full account of the young person's individual experience and was a particular strength. Staff were working exceptionally well in identifying what was important to the individual young people and in taking seriously their wishes and any concerns they may have. Young people we spoke with described being listened to and respected and having good relationships with staff where good humour was also enjoyed by both. We were told by a young person that when the local Police visited recently, staff were welcoming and that the young people enjoyed their visit. The young people told us about the service: "They're good, they take me places, we're going to Blackpool soon." "I always know the staff that are looking after me." "I've never been restrained" "We walk in the mountains, go to the lochs and to gymnastics." "Its good, it's better than the last place, its bigger and quieter, staff are brilliant and funny, they take stuff as a joke." Auchengavin, page 9 of 24
"We decide what we eat, we do the weekly menu and get to choose two meals, we can change it that day if we don't want it." "We have young people's meeting and we talk about what we want, things change quickly." "The staff interviews are done at Lockerbie, all new staff go there and the young people are involved, we always meet new staff before they come to work here." We saw an example of a transitional plan for a young person. This had been developed in partnership with the young person's Social Worker in preparation for her moving into the service. This fully involved the young person and made clear her likes/dislikes and routines to the new staff team as well as all other information important to her care. We were told by each of the young people, that staff and managers ask for their ideas about how they can make things better and they described feeling safe and cared for at Auchengavin. The atmosphere in the house and the interactions between staff and the young people reflected this. Areas for improvement The service have a number of systems in place to identify areas for improvement and are currently working on their methods for obtaining feedback from people with an interest in the service. They are also looking at developing focus groups specifically to assist with participation and engagement. See Quality Theme 1, statement 3 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Auchengavin, page 10 of 24
Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued During this first and unannounced inspection of the service, we found a very good standard of care being provided to the young people resident at the time. The health and wellbeing needs of each child were being fully taken into account by the staff team. The warm and helpful relationships staff had developed with the young people were helping ensure the health and well-being of the young people was being fully supported. We saw evidence of age appropriate games and activities and the young people enjoying their environment. We saw evidence of through risk assessment taking place soon after admission and risks of self harm and other coping behaviours taken very seriously, with the young people being very well supported, We saw within individual behaviour support plans, behaviour management plans and assessment plans that staff were involving the Children and Adolescent Mental Health Service (CAMHS) where appropriate for the individual child. The young people were being supported to attend dental and other medical appointments. This meant the children were in better physical and mental health and able to get the best from their education and from the support of the service. Each of the young people were attending school, we saw evidence of the Manager and staff group working well in identifying how the education needs of the individual young people could be meaningfully addressed alongside their social and emotional needs. We saw that the team had developed with the young people a 'coat of arms' for the house where the young people had agreed with staff there were only two main rules in the house: to respect one another and to not hurt one another. This was another reflection of a caring and capable staff group prioritising the young people and helping them respect themselves and others. We saw staff working hard to help children develop resilience and a strong sense of identity. They had a good understanding of the importance to young people of secure attachments and a sense of belonging. The young people were benefitting from this in their relationships with each other in particular. Auchengavin, page 11 of 24
The young people we spoke with told us: " I like some staff. They are sound, pure funny. I like the young people." "It's good here, it's better than the last place, its bigger and quieter, staff are brilliant and they are funny, he (Support Worker) takes stuff as a joke, he's brilliant." Social Work and Health Professionals who work with the service told us: "I have been very impressed with the staff team and their knowledge and practice in relation to a child... The staff have supported the child in a positive and sensitive way to reflect on his behaviour and to take responsibility for his behaviour, this has been effective and the child has emotionally invested in this placement. This suggested he feels safe and trusts the staff he is working with." A health professional working with the service told us that the staff team have coped admirably with a variety of complex care needs in the young people. He described senior external staff as being of very good support to the staff team. Feedback included: "At the heart of Common Thread and Auchengavin is the aspiration to be child centred and person centred. There is also the recognition that they need multidisciplinary, support, advice and consultation to support and improve their practice." A parent of one of the children resident told us: "I'm very very happy with the care. They've put new strategies in place for him and they explain them to me so I can use them at home with him, it's helping at home. I talk with the staff most days, I can phone the manager any time. My son's behaviour has been great at Auchengavin, there's been a big change in him." The Manager and staff team were proud of the young people and their accomplishments and were giving the young people regular positive feedback about their successes in building relationships, being involved in sports and working hard on their education. Auchengavin, page 12 of 24
Areas for improvement We discussed with the Manager the feedback from a young person regarding staffing and identified with the Manager an area for improvement which we are following up on with the service. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Auchengavin, page 13 of 24
Quality Theme 2: Quality of Environment Grade awarded for this theme: 5 - Very 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 During this inspection we did not specifically look at participation in relation to the environment, but we accept that the very good standard which we found in Quality Theme 1 Statement 1 and young people's participation was consistent for each of the quality themes. Areas for improvement See Quality Theme 1, statement 1 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Auchengavin, page 14 of 24
Statement 2 We make sure that the environment is safe and service users are protected. Service strengths Auchengavin was providing a safe and nurturing environment for the young people resident at the time of the inspection. The Manager and staff were very clear about the importance of the environment in contributing to good quality care and we saw evidence throughout the property of staff helping the young people create a comfortable homely environment which helped them feel safe and at home. We found the property to be secure. There were no shared rooms and the service was within its registered numbers. When we visited, the house was well-kept, organised and clean. Furniture and fittings were on the whole well-kept and in the main the house was well maintained. Damage had been caused to the kitchen and the Manager was ensuring the repairs were being addressed. The Manager had given a lot of thought to creating a homely and comforting physical environment for the young people. Staff had regular training and this provided them with knowledge and skills to help keep the young people safe. When we looked at young people's care plans and Individual Crisis Management Plans, accident and incident records and medication records, we saw evidence of the service taking risks seriously, assessing them with the young people and attempting to reduce them. Staff were helping the young people to manage their feelings and behaviour and, in part as a result, there had been no safe holds of the young people resident at the time of inspection. The service had notified us of serious incidents and we were satisfied with the way in which these had been managed. We saw an example of the on call system being used well, the situation managed well and the young people well supported. A particular strength of this staff group was their willingness and ability to reflect on their support of the young people and to adapt their approaches to get the best outcomes for the young people. Areas for improvement The Manager had identified the need to make progress with the repair of the kitchen and was taking all steps to ensure the delay was kept to a minimum. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Auchengavin, page 15 of 24
Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths During this inspection we did not specifically look at participation in relation to staffing, but we accept that the very good standard which we found in Quality Theme 1 Statement 1 and young people's participation was consistent for each of the quality themes. Areas for improvement See Quality Theme 1, statement 1 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Auchengavin, page 16 of 24
Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Inspection report continued Since the time of registration the service had cared for young people with a variety of difficulties, some of which presented significant challenges in supporting the young people with their feelings and associated behaviour. The team had worked hard and not lost sight during this period of their main focus being the young people's wellbeing. We found the service at a more settled place during this inspection and the staff team had reflected on some of the challenges that had faced the service and been able to learn from them with the support of their management team. A health professional who works closely with the service told us he felt Auchengavin had not had an easy start for a new team and had managed the challenges they faced very well. In discussion with staff they told us they had a thorough induction into their role, that they were given good opportunities to access education and training and were receiving good levels of support and supervision. We found the staff team we met to be professional, well-trained and child focused. Their commitment to the young people was evident both in their manner with them and in their accounts of both the strengths and the support needs of the young people. The young people were having fun with staff and there was warmth and good humour between them. Staff had a sound knowledge of the relevant theory in supporting young people who have suffered trauma and loss. It was apparent in their support of the young people that they were skilled at using this knowledge in practice. Staff stated that the management team were very supportive of them. As well as having a good knowledge of the young people's individual support needs, we saw in the sample of paperwork we looked at, that staff had a very respectful and caring approach to the young people. Auchengavin, page 17 of 24
When we spoke with staff we also found them to be professional in their approach. As well as being well-informed on children's rights and support needs, staff were able to be light-hearted about, and with, the young people. We saw a very high standard of care and of staff support being delivered on shift during the inspection. We could see that staff knew the young people well, including those more newly resident. A Social Work professional told us about the care provided to a young person she had placed at the service: "Overall the care provided to the young person was of an extremely high standard. The staff team were creative in exploring recreational activities with the young person and they were also extremely supportive and flexible when it came to family contact...i was impressed with the therapeutic approach that was taken and the staff team were regularly helping the young person to develop coping strategies and ways to express herself...the staff team were resilient and demonstrated tenacity in relation to their committment to the young person." A parent told us: "The staff are great. If I'm worried I can get hold of staff no problem, I've not had any problems. Staff help me as well as my son, they pick me up so I can see him." The young people we spoke with told us: "You get a good laugh with them, they're always there for you." "I got a very nice welcome when I arrived." "This feels like a lovely house, they're so generous, they listen, they always take time to talk to you" Areas for improvement Planned and protected time for staff supervision could be improved. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Auchengavin, page 18 of 24
Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very Good 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 During this inspection we did not specifically look at participation in relation to management and leadership, but we accept that the very good standard which we found in Quality Theme 1 Statement 1 and young people's participation was consistent for each of the quality themes. Areas for improvement See Quality Theme 1, statement 1 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Auchengavin, page 19 of 24
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 Inspection report continued Auchengavin had a number of internal quality assurance mechanisms in place to monitor and evaluate that standards of care for the children and young people were in line with the aims and objectives of the service. We looked at staff training and support within this area also. Staff stated that the management team were very supportive. Young people also spoke highly of the management of the service and felt they were encouraged to participate in developing all aspects of the service. We found that regular quality assurance checks were carried out across different aspects of care provided. This was evidenced in discussion with staff and management, and within records. The staff and management recognised the importance of close working relationships with external agencies, families and social workers to ensure young people had every opportunity to achieve their goals and aspirations. Young people informed us that the service worked well with others, including Social Workers and families. The service was recruiting staff in line with their values and committment to working with the young people with respect and compassion.the staff group were using meetings to reflect on their practice and reviews of practice were taking place and allowing the team to adapt their ways of supporting the young people. A health professional who works with the service described many strengths he has seen in the service including: "..having shared values throughout the organisation, that these are continually referenced in practice, the continual aspiration for clear and assertive communication modelled by management, the ability to advocate on behalf of the child or young person and an aim to provide a continuous learning environment" Auchengavin, page 20 of 24
A parent told us she was very happy with how involved the Manager was in the care of her child and how helpful she found the Manager working with her in finding the best way of supporting the young person both while in the residential unit and at home. Each child, member of staff and parent we spoke with spoke highly of the Manager and his commitment to the young people and staff. We saw evidence of the Manager working with not only Social Work but the Police and other community partners to create the best outcomes for the young people. An open style of communication was helping the service be involved in the local community and encouraging good experiences for the young people in their community. The very good outcomes we saw for the young people evidenced in the other quality themes are a reflection on the very good management and leadership of the service. Areas for improvement The service was working hard to consolidate learning and to continually improve. Within their quality assurance processes they had identified a need to establish a sound system of internal quality assurance inspections and they were on target to do so. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Auchengavin, page 21 of 24
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). Auchengavin, page 22 of 24
5 Summary of grades Quality of Care and Support - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Environment - 5 - Very Good Statement 1 Statement 2 5 - Very Good 5 - Very Good Quality of Staffing - 5 - Very Good Statement 1 Statement 3 5 - Very Good 5 - Very Good Quality of Management and Leadership - 5 - Very Good Statement 1 Statement 4 5 - Very Good 5 - Very Good 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. Auchengavin, page 23 of 24
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 0345 600 9527. 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: www.careinspectorate.com or by telephoning 0345 600 9527. Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: 0345 600 9527 Email: enquiries@careinspectorate.com Web: www.careinspectorate.com Auchengavin, page 24 of 24