Netherton Childrens Unit Care Home Service Children and Young People 16 Blaeloch Drive Castlemilk Glasgow G45 9QR Inspected by: Anne Borland Type of inspection: Unannounced Inspection completed on: 5 September 2013
Contents Page No Summary 3 1 About the service we inspected 4 2 How we inspected this service 5 3 The inspection 9 4 Other information 17 5 Summary of grades 18 6 Inspection and grading history 18 Service provided by: Glasgow City Council Service provider number: SP2003003390 Care service number: CS2006138057 Contact details for the inspector who inspected this service: Anne Borland Telephone 0141 843 6840 Email enquiries@careinspectorate.com Netherton Childrens Unit, page 2 of 20
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 4 Good Quality of Environment Quality of Staffing N/A N/A Quality of Management and Leadership 4 Good What the service does well The young people in the service were happy living in the Netherton. The staff team provided a positive and nurturing environment for the young people. What the service could do better Current documentation should be in place for all children. Children should have initial LAAC reviews within statutory timescales. The current system of service audits should improve. Medication should be taken as prescribed. What the service has done since the last inspection The staff team have readjusted well to the changes from being an enhanced unit. Good practice, routines and team work were evident. Conclusion Netherton staff team provide a high level of support and care to the young people in their care. Who did this inspection Anne Borland Netherton Childrens Unit, page 3 of 20
1 About the service we inspected Netherton Children's Unit has been registered with the Care Commission since 19 October 2007. The detached, six bedroom property is owned by Glasgow City Council and is situated in a private housing estate in Castlemilk, Glasgow. The house was built as part of the Council's Residential Action Plan aimed at providing the highest standards of care for Looked After and Accommodated children and young people. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 4 - Good Quality of Environment - N/A Quality of Staffing - N/A Quality of Management and Leadership - Grade 4 - 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 0845 600 9527 or visiting one of our offices. Netherton Childrens Unit, page 4 of 20
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 This unannounced inspection was carried out over two days commencing on the 6th August 2013. During the course of the inspection we spoke with six young people, four residential workers, the senior practitioner and the manager. Relevant records were examined some of which included: The support plans for threee young people, Complaints log, Medication Records, Violent incident recordings, Young people meeting minutes, Team meeting minutes, Unit Development Plan, Monthly manager reports. Monthly care plan audits. Feedback on the inspection findings was provided to the manager and external manager on the 5th September 2013. 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 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. Netherton Childrens Unit, page 5 of 20
Fire safety issues Inspection report continued 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 Netherton Childrens Unit, page 6 of 20
What the service has done to meet any recommendations we made at our last inspection Following the last inspection the service received three recommendations. These are detailed below with an account of progress made. Staff should undertake health and safety training as recommended in the Health and Safety audit findings to meet with Standard 7.9 Management and Staffing National Care Standards for Care Homes for Children and Young People. This had been met and training had been undertaken. The service should resolve the staffing issues to meet with Standard 7.8 Management and Staffing National Care Standards for Care Homes for Children and Young People. This had been partially meet and plans were in place for post to be filled. The frequency of staff supervision, team meetings and training undertaken should improve to meet with Standard 7.2 & 7.8 Management and Staffing National Care Standards for Care Homes for Children and Young People. This had been met and there was improvement in this area. 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: Yes - Electronic 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 fully completed self-assessment document from the provider with relevant information included for each heading that we grade services under. The provider identified what it thought the service did well, some areas for development and any changes it had planned. Netherton Childrens Unit, page 7 of 20
Taking the views of people using the care service into account The Inspector spoke with six young people. Young people confirmed being involved in care reviews and being offered the opportunity to write their own report. Young people all said that they had staff members to whom they could talk too when upset or worried and some confirmed having individual time with key worker. All thought the staff were fair and kind. All spoke positively about recent activities and the holidays. Food was described as really good and the catering staff were people who were valued and liked by the young people. All thought the rules were fair and the inspector was advised that these were talked about in young people's meetings. Two young people were unhappy at the behaviour by another young person and advised that they had complained about this and it was a little better. Taking carers' views into account The inspector did not speak with any relatives.16 Netherton Childrens Unit, page 8 of 20
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: 4 - 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 At this inspection we found that the performance of the service was good for this statement. The staff team at Netherton promoted engagement with the young people. This was carried out in a number of ways as detailed below. Young people attended formal care reviews with some young people contributing a 'Having your say' report and others completed electronic 'viewpoint' questionnaires. The service operated a key worker system with which meant that children and young people spent individual time with staff to discuss their care plan. Children and young people spoke positively about this and regarded it as beneficial. This had been a significant change in the way young people were consulted. Young people now attended house meetings to discuss common issues and contribute to planning activities, menu planning, discuss house rules, proposed decoration and holiday plans. Young people also spent time discussing relationships and boundaries and the frustrations which arose living in a group situation. As a result young people were becoming more able to verbalise feelings and show empathy towards one another. Yong people were encouraged to personalise their own bedrooms and were allocated funds to do this. As a result the bedrooms were homely and posters and such like reflected the hobbies and interests of the young people. Room colours had been chosen by the young people and were in the process of redecoration had commenced during the inspection. The service had access to 'Who Cares?' the independent advocacy service and the organisations Children's Rights Officer (CRO) and helped young people to access these resources when needed. Young people had worked with the CRO to look at resolving Netherton Childrens Unit, page 9 of 20
group issues of bullying and the impact of negative behaviour had on living within the home. Areas for improvement The manager advised that the findings of the questionnaires completed with young people would contribute to the unit development plan. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths Inspection report continued At this inspection we found that the performance of the service was good for this statement. The young people had their health needs assessed by the Looked After and Accommodated Children's Nurse (LAAC Nurse). Following the assessment the LAAC nurse could make referrals for specialised services. This had included a referral for grief counselling for young people who suffered a significant loss. Although counselling was not considered to be appropriate at this point, the staff team were managing the impact of loss using an extremely sensitive and caring approach. Young people advised the inspector this had helped them cope with their feelings of sadness. Staff also used consultation with the child psychologist to work effectively with children who exhibited challenging behaviour and this had brought some success in helping with regulating the behaviour. Staff kept a detailed account of all health appointments which were attended by young people. The blue BAAF health books were kept up to date. Young people were supported and encouraged to attend health appointments. There was evidence of young people attending dentists and opticians for routine checkups in addition to attendance for treatment. Good daily routines were in place with children and young people encouraged in personal care. All the young people looked well-presented and healthy. Young people were positive about the meals provided and confirmed menus reflected their food preferences. Meals were attractively presented and included healthy options with fresh fruit, vegetables and salad provided daily. Meal times were promoted as positive occasion by the staff team and were well managed. As a result, children and young people ate well joining the staff for meals at the table. Physical exercise was promoted and most young people had been given the opportunity to participate in trying out new experiences. This was linked to individual preferences and abilities. Some examples included nature walks, swimming, attending the gym and cycling. A full programme of outings took place over the summer holiday with each young person having a holiday away from the unit. All spoke positively Netherton Childrens Unit, page 10 of 20
about their experiences. The development of social skills was promoted and children and young people were encouraged to use local resources such as youth clubs, the local library and make friends in the community. The staff team sought out a wide range of activities to broaden the experiences of the children and young people and this had included events hosted by Glasgow City Council such as, off track biking competition, arts in the city- movie making. Young people had attended 'story telling' and events which uses the drama as a means to assist children express feelings, fears and wishes. It was evident in speaking with young people that they enjoyed good opportunities in their free time. Young people were encouraged to take on age appropriate responsibilities. This included tidying their rooms, cooking and baking. A recent success was supporting two young people in learning about public transport. Now these young people travelled independently to and from education placements and the city centre for recreational outings. Family contacted was supported by staff. Staff were sensitive to the complexities of contact and planned well. This included appreciating the impact on children who did not have contact in exacerbating feelings of loss. This was also managed extremely well with planned outings arranged and spending time with the child in the recognition and acknowledgment of the child's upset. Children and young people were supported to keep memory boxes and staff took time to discuss the contents with the child. Children and young people were proud of their memory boxes and two young people offered to share the contents with the inspector during the inspection. Areas for improvement Medication for one young person had not been taken as prescribed with no reason recorded for this. (Refer to recommendation) For one young person the LAAC( Looked after and accommodated child ) review had not been held within statutory timescales. This had an impact on the planning and accessing of resources to meet the considerable needs of the young person in order to support the placement. This will form a requirement. Grade awarded for this statement: 4 - Good Number of requirements: 1 Number of recommendations: 1 Requirements Inspection report continued 1. LAAC reviews require to be held within statutory timescales to agree the support needs and resources required to support the care plan. This is in order to comply with: The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011- No 210 Regulation 5(1) Personal plans Timescale for implementation: immediate effect of receipt of this report. Netherton Childrens Unit, page 11 of 20
Recommendations Inspection report continued 1. Medication should be administered as prescribed. This is to meet with Standard 12.7 Keeping Well-Medication. National Care Standards for Care Homes for Children and Young People Netherton Childrens Unit, page 12 of 20
Quality Theme 2: Quality of Environment - NOT ASSESSED Netherton Childrens Unit, page 13 of 20
Quality Theme 3: Quality of Staffing - NOT ASSESSED Netherton Childrens Unit, page 14 of 20
Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 4 - 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 Refer to Statement 1,Theme 1 Areas for improvement Refer to Statement 1,Theme 1 Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 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 At this inspection we found that the performance of the service was good for this statement. The service has a quality assurance document which guides staff on best practice in regards to seeking the views of service users and stakeholders on how the service can improve. The unit has a development plan which was updated in November 2011. The external manager was a regular visitor to the home and met with the manager regularly to discuss issues and progress made in the service. The senior night workers carried out record sampling to monitor practice. The manager provided the external manager a monthly report which reported on all aspects of the service performance. This included examination of complaints, violent incidents, staff attendance, Heath and Safety, staff training and the progress of the young people. The manager met regularly with the head of residential services and service manager to discuss operational issues and progress of the young people. Meetings also took place with Personnel to discuss any staffing issues and the Finance section to discuss Netherton Childrens Unit, page 15 of 20
budget management. Weekly reports were sent to social workers regarding the progress of young people. Monthly care plan audits were sent to external management to ensure appropriate progress was being made. Notifications are made as appropriate by the service to the SSSC and the Care Inspectorate. The service had a complaints system which was known to the young people and issues of dissatisfaction were recorded in the complaints book along with the resolution and action taken. The organisation used electronic survey monkeys to gather staff views on a range of subject with the latest being regarding training for residential child care workers. The results are to be used to inform the future training programme. Areas for improvement The senior staff and manager had given priority to direct time with the children and young people over the summer holiday period. It was anticipated that unit development plans would progress now that school and education placements were about to recommence. During the feedback the manager and service manager agreed the current audit findings, action planning needed reviewed so that 'gaps' found during inspection, such as, the medication and delay of the LAAC review were addressed with the appropriate people to ensure these matters were resolved. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Netherton Childrens Unit, page 16 of 20
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). Netherton Childrens Unit, page 17 of 20
5 Summary of grades Quality of Care and Support - 4 - Good Statement 1 Statement 3 4 - Good 4 - Good Quality of Environment - Not Assessed Quality of Staffing - Not Assessed Quality of Management and Leadership - 4 - Good Statement 1 Statement 4 4 - Good 4 - Good 6 Inspection and grading history Date Type Gradings 28 Mar 2013 Unannounced Care and support Not Assessed Environment 4 - Good Staffing Not Assessed Management and Leadership 3 - Adequate 21 Dec 2012 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing 5 - Very Good Management and Leadership Not Assessed 15 Dec 2011 Unannounced Care and support 3 - Adequate Environment Not Assessed Staffing 3 - Adequate Management and Leadership Not Assessed 7 Feb 2011 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed Netherton Childrens Unit, page 18 of 20
30 Sep 2010 Announced Care and support 5 - Very Good Environment Not Assessed Staffing 4 - Good Management and Leadership Not Assessed 22 Mar 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing 3 - Adequate Management and Leadership Not Assessed 13 Nov 2009 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing 3 - Adequate Management and Leadership 5 - Very Good 26 Feb 2009 Care and support Not Assessed Environment Not Assessed Staffing 4 - Good Management and Leadership 4 - Good 9 Oct 2008 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing 4 - Good Management and Leadership 4 - Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Netherton Childrens Unit, page 19 of 20
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 0845 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 0845 600 9527. Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: 0845 600 9527 Email: enquiries@careinspectorate.com Web: www.careinspectorate.com Netherton Childrens Unit, page 20 of 20