Neil Street Childrens Unit Care Home Service 41 Neil Street Greenock PA16 9JA Inspected by: (Care Commission Officer) Type of inspection: Jackie Calder Announced Inspection completed on: 7 February 2008 1/10
Service Number Service name CS2003001105 Neil Street Childrens Unit Service address 41 Neil Street Greenock PA16 9JA Provider Number dummy Provider Name SP2003000212 Inverclyde Council Inspected By dummy Inspection Type Jackie Calder Care Commission Officer Announced dummy Inspection Completed Period since last inspection 7 February 2008 6 months dummy Local Office Address 4th Floor 1 Smithhills Street Paisley PA1 1EB dummy 2/10
Introduction Neil Street Children's Unit provides a service for a maximum of 8 children and young people who are looked after and accommodated by Inverclyde Council, Housing and Social Work Service. There were 6 young people living in the unit at the time of inspection aged between 11 and 17 years old. Neil Street is purpose built and is situated in a residential area of Greenock. Admissions to the unit are usually planned with young people being able to live there for some time, however the unit can also offer places for young people who require respite or an assessment. Neil Street is able to support young people to move on to independent living and adult life. The ethos of the unit is stated as 'we aim to provide an environment for young people which actively promotes positive growth and change within a caring and structured residential setting with caring and motivated staff.' Basis of Report Before the Inspection:- The Annual Return The service submitted a completed Annual Return as requested by the Care Commission. T The Self-Evaluation Form The service submitted the self evaluation form for consideration at the next inspection. 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 medium RSA score and so a medium intensity inspection was required as a result. The inspection was then based upon follow up on the recommendations and requirements from the previous inspection in August 2007 and associated National Care Standards for the particular service type. During the inspection process:- This announced inspection took place over 1 day on Tuesday the 5th February 2008 and was conducted by one Care Commission Officer between 9.45am and 5.00pm. The National Care Standards and Inspection Focus Areas addressed at this inspection were as follows:- National Care Standards for Care Homes for Children and Young People:. Standard 6: Feeling Safe and Secure. Standard 7: Management and Staffing 3/10
. Standard 11 Keeping well-lifestyle. Standard 17: Moving on Focus Areas: Child protection. Restraint. Scottish Social Services Council -staff training. Throughcare and Aftercare. Mental health and well-being The Officer spoke with the Manager, the Depute, the external manager and members of care staff. The Officer also spoke with two young people and observed the care and support given to them by staff. The Officer also met with a manager from the Facilities and Resources Management department within the local authority to discuss concerns about the catering arrangements. During the inspection evidence was gathered from a number of sources including: Care Plans Policies and procedures Accident and Incident recording Training records Violent Incident recordings. Staff de-briefing records. Mental Health publications. The Officer walked around the premises. All of the above information was taken into account during the inspection process and was reported on. Fire Safety Issues The Fire (Scotland) Act 2005 introduced new regulatory arrangements in respect of fire safety, on 1 October 2006. In terms of those arrangements, responsibility for enforcing the statutory provisions in relation to fire safety now lies with the Fire and Rescue service for the area in which a care service is located. Accordingly, the Care Commission will no longer report on matters of fire safety as part of its regulatory function, but, where significant fire safety issues become apparent, will alert the relevant Fire and Rescue service to their existence in order that it may act as it considers appropriate. Further advice on your responsibilities is available at www.infoscotland.com/firelaw Action taken on requirements in last Inspection Report There were no requirements arising from the previous inspection. Comments on Self-Evaluation The information contained within the self-evaluation was considered as part of the inspection process. View of Service Users The Officer received four completed questionnaires from young people and was able to 4/10
speak with two young people on the day of inspection. Two of the other young people declined to speak with the Officer and the other two young people were on home contact. Comments from the young people were very positive about the care and support they received whilst living at Neil St:- 'I really like it here. I can speak to staff about anything-it's like a 5 star hotel'. 'My mum can visit and she is made to feel welcome.' 'It's ok living here, the staff are nice and I like my room. I feel safe here but I would not like my mates to visit'. In the questionnaires received the main issue for young people was the food. This will be reported on under Standard 7 within this report. View of Carers The Officer was unable to speak with any parents or carers during this inspection. 5/10
Regulations / Principles National Care Standards National Care Standard Number 6: Care Homes for Children and Young People - Feeling Safe and Secure Strengths The inspection focus areas relevant to this standard (child protection and restraint) were addressed fully at the last inspection. Further progress with these areas will be reported below. Young people spoken with confirmed that they felt safe and secure living in the home. In the questionnaires received all 4 respondents wrote that they 'felt safe and secure'. Staff spoken with were aware of their role and responsibility in keeping young people safe in Neil St. Incident and accident recordings were accountable and robust and there were no significant complaints. When staff had been involved in an incident, the opportunity to be de-briefed had improved. There was evidence that staff were de-briefed and reflection took place during supervision or at team meetings. The Manager assured the Officer that staff received support. Staff continued to receive updated training in T.C.I. and Child Protection. Areas for Development Staff need to take time to define within a support plan the intervention that is most effective for a young person and why. The bins were still in the direct path to the garden area and posed a possible threat to safety and were unpleasant on a warm day. Staff were also required to pull the bins up a significant number of steps for them to be emptied. It will be a recommendation that the bins are sited elsewhere to ensure the safety and well-being of young people and staff is not being compromised. This recommendation is continued from the previous inspection. National Care Standard Number 7: Care Homes for Children and Young People - Management and Staffing Strengths The inspection focus area of SSSC and staff training will be reported on under this standard. Staff spoken with stated that morale was good at the present time and that they stated that they received good support from each other and the management team. Staff presented as being committed and motivated to working with the young people in their care. 6/10
Staff spoken with stated that they received regular supervision. All staff have now received training in the Continuing Professional Development Plans and each staff member will begin using these with their supervisor in the near future. The young people in Neil St were involved in the recruitment of the new Depute Manager. The service are to be commended for involving the young people in this way. Almost all staff within Neil St. had a qualification suitable for registration with the Scottish Social Services Council.The Manager had SVQ IV and was in the middle of doing the Registered Managers Award and the Depute was hoping to start SVQ IV in the near future. Staff had attended training sessions on 'Anti-racism' and 'Risk Assessment' over the last few months and they had found these to be helpful. External training for staff on fire awareness had also been set up. Areas for Development The catering arrangements within the home were unsatisfactory. Catering was supplied by another department within Inverclyde Council. The homes' regular cook had been unavailable for some time so the young people and staff were often having meals supplied by an outside source. Evening meals were having to be cooked by a member of care staff which was taking them away from their direct care duties. In discussion with the Manager from the catering section the Officer was advised that it was' difficult to find staff to work in Neil St'. This situation must be rectified as a matter of urgency to ensure that the young people get freshly prepared meals, prepared by a permanent, qualified cook. This will be the subject of a requirement. National Care Standard Number 11: Care Homes for Children and Young People -Keeping Well - Lifestyle Strengths The inspection focus area of Mental Health and well-being will be reported on under this standard. Young people spoken with confirmed that they could speak with staff if they had any worries or concerns. The young people were each allocated a key worker however young people could speak with any staff member or the management team if they preferred. Mental health and well-being was part of the assessment and care planning process within the home. Young people could discuss their concerns at any time but they were also involved in regular 'core group' meetings which involved them and the people most involved in their care and support. Staff felt that they promoted 'well-being' on a daily basis. There were close links with the Child and Adolescent Mental Health Team (CAMHS) and the Looked After and Accommodated Children (LAAC) Nurse. There was good evidence within the care plans of links with relevant professionals to support those young people with mental health issues. 7/10
Staff had received a brief training input on mental health and young people from a member of staff from Yorkhill Hospital Department of Child and Family Psychiatry. Staff had found this session to be informative and helpful. There were mental health publications available within the home for staff to refer to. The Manager and the staff group were well aware of the issues that could affect the young people of substance misusing parents. There were good links with the Community Drugs team for advice and support if required. Staff stated that they felt confident in supporting young people with bereavement and loss and would feel comfortable giving 'physical comfort' where appropriate. Areas for Development There were no areas identified. National Care Standard Number 17: Care Homes for Children and Young People - Moving on Strengths The inspection focus area of Throughcare and Aftercare will be reported on under this standard. Staff within Neil St. were aware of the pathway planning process and felt that they had an active part to play in supporting young people to move on from the home. There were three young people in Neil St who were aged 16 or over and whilst the plan would be that they stay in Neil St for the foreseeable future, staff were also working with them to help them prepare to leave the home e.g. completion of housing applications. All of these young people were in full time education. The home had close links with the local Throughcare Team. Throughcare team members would attend the regular core group meetings for the young people. There was evidence within the care plans of good support and communication with the Throughcare team. Young people still kept in touch with Neil St when they left and were welcome to visit or phone. Areas for Development There were no areas identified. 8/10
Enforcement There has been no enforcement action against this service since the last inspection. Other Information There were four recommendations arising from the previous inspection. Progress with these is as follows:- 1.Staff must record incidents of 'de-escalation/challenging behaviour' in a comprehensive manner. The record should detail action taken, the techniques used and the outcome. The record should be written with appropriate language and tone. Young people and staff must also have an opportunity to be de-briefed (life space interview) following an incident of restraint/challenging behaviour. Incidents recordings were reviewed and found to be robust and improved. A checklist had been initiated to ensure that each incident was recorded and de-briefed in a uniform manner. This recommendation has been met. 2. The bins were in the direct path to the garden area and posed a possible threat to safety and were unpleasant on a warm day. Staff were also required to pull the bins up a significant number of steps for them to be emptied. It will be a recommendation that the bins are sited elsewhere to ensure the safety and well-being of young people and staff is not being compromised. There had been little progress with this. This recommendation will continue. 3. All staff, including sessional staff, must receive regular, formal supervision. Group supervision for sessional staff had been set up. Senior staff at another home were responsible for this and it appeared to be going well. This recommendation has been met. 4. The budget available to purchase items for the home such as furniture, soft furnishings and items for the young peoples' bedrooms needs to be flexible so that the choice that residents have is not restricted. The Officer was advised that there was a proposal to pilot the use of a credit card to but items for the young people however no date had been set for this. This recommendation will continue to ensure that a system is put in place to promote choice for young people. The home had responded well to the individual needs of one young person by setting up a specific resource for him within the existing building. The kitchen was due to be fully refurbished in the near future. Requirements 1. The catering situation must be rectified as a matter of urgency to ensure that the young people get freshly prepared meals, prepared by a permanent, qualified cook. This is in order to comply with SSI/114 Regulation 4 (1) (a) Welfare of users. Timescale:- within 1 month from receipt of this report. Recommendations 1. It will be a recommendation that the bins are sited elsewhere to ensure the safety and well-being of young people and staff is not being compromised. This is a continued recommendation. Jackie Calder 9/10
Care Commission Officer 10/10