Care Visions Orca Care Home Service Orca House The Manse Chapelknowe Canonbie DG14 0YB Telephone: 01387 372296 Type of inspection: Unannounced Inspection completed on: 6 June 2017 Service provided by: Care Visions Group Limited Service provider number: SP2003002569 Care service number: CS2003044279
About the service Orca has been registered since 2002 and is operated by the Care Visions Group as a care home service for up to four children and young people. There were two young people living at Orca House when we visited. What people told us We spoke with both young people during the visit and they were largely positive about the service although there had been some unsettled periods recently. Their views, and the views of two relatives are also reflected in this report. Self assessment No self assessment was required from the service this year but we had access to their most recent service improvement plan, details of service review activities and met with management to clarify the progress made with this and priorities for the future. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership 3 - Adequate not assessed not assessed What the service does well From the evidence we gathered we found that outcomes for young people using the service over the last 12 months were mixed. However, we heard consistently that all young people were receiving nurturing care from committed staff. For two young people the service had worked hard to ensure that family relationships were sustained during and beyond the placement. Young people are respected and included in the day to day functioning of the service. There was also good evidence of the efforts of staff to ensure that young people had a healthy lifestyle and were encouraged to be active. We found that the following strengths were key to ensuring that the service will be able to consistently achieve good outcomes for young people. Relationships developed by staff with young people and their families - we found consistent evidence of the genuine commitment of staff to the young people they were caring for. Staff spoke of using shared interests to develop these relationships and the importance of these connections during moments of crisis. We were satisfied that this relational approach to care was embedded within the staff group and extended to the efforts staff made to involve parents and work closely with other professionals in the team around the child. Feedback from young people emphasised the importance of the relationships they had with key staff who, in turn, spoke fondly of the young people. page 2 of 7
Working well as a team - there have been a number of changes in the team over the last year or so but the staff we spoke with were confident that the group of staff brought together since the beginning of the year were working well together, providing good peer support and were oriented in working for the best interests of children and young people. They felt that a culture of openness and reflection was helping to form a coherent team of knowledgeable and experienced practitioners. Support for staff - Supervision has improved, it is regular and valued by staff and records showed a robust process. Appraisal is now embedded and we saw a good example of this identifying clear developmental priorities and reviewing performance over the last year. Support to staff from the manager was reported on favourably as was support from other senior staff (on call) and external management. All staff spoke positively about opportunities for professional development and this included the manager delegating areas of responsibility. What the service could do better We found some evidence which gave us some concern about the predictability and continuity of care and the ability of the service to consistently achieve good outcomes. Function/Purpose of the service - we found that the function of the service was unclear and providing a mixture of planned short term, emergency placements and longer term provision was contributing to an uncertainty within the staff group about the purpose of the service. We also considered that problems with 'matching' meant that there were a number of unplanned endings to placements. We accepted that decisions to end placements were being made in the best interests of young people at that time. However, it inevitably means increasing the number of moves for young people and, as a consequence, compound experiences of loss, separation and rejection. Implementing care plans - we found that at least one young person has no clear care plan and decisions about on-going care were unclear. This found the young person themselves very unsettled and unsure of his future. We also found that there were a number of young people who had experienced significant gaps in formal education whilst placed at Orca and one verbalised concern that a culture of 'non-school attendance' had developed in the service. One young person had been without formal education for over a year. We were satisfied that the service had worked hard to address this issue but the nature of recent short term placements meant that a 'no school' perception was likely to continue. Staff turnover - we found that there has been significant changes in the staff team over the last year and this was referred to in a lot of the evidence we considered during the inspection. Retention of staff appears to be a challenge for this service. Whilst we recognised the individual narratives for staff moving on collectively this meant that more than half of the team have left over the last year and this has affected the morale of staff and ultimately the care provided to young people, especially during crisis. The staff we spoke with also identified the need for a review of the induction process and suggested a more managed introduction to the service which has experienced as much unsettled behaviour as Orca has in the last year. In Summary we found that there were elements of care and support specifically around matching and decisions about placements which were constraining performance and ultimately affecting experience of care and outcomes for young people. There are clearly some key challenges for the service but we also found that the current staff group are committed, motivated and resilient. This should be seen as a strength to build on. page 3 of 7
Requirements Number of requirements: 0 Recommendations Number of recommendations: 3 1. To ensure that the service provides planned and predictable care, and can consistently achieve good outcomes for young people, the provider should work with the team to review the experience of the last couple of years and articulate a shared vision for the service and a clear understanding of it's purpose. National Care Standards, Management and, Standard 7(9) 2. To ensure that the service supports good outcomes for children and young people the service must ensure that all young people have a clear care plan, are enabled to achieve their potential and the 'non-school attendance' culture is challenged. National Care Standards, Support Arrangements - Standard 4 and Learning - Standard 13 3. To ensure that young people continue to experience stable, consistent nurturing care the service must ensure that the retention of staff is prioritised; evaluating what it does now and developing a clear and coherent strategy for making any necessary improvements. National Care Standards, Management and - Standard 7(7,8 and 9) Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. Inspection and grading history Date Type Gradings 5 May 2016 Unannounced Care and support Management and leadership 29 Jun 2015 Unannounced Care and support Management and leadership page 4 of 7
Date Type Gradings 15 Dec 2014 Announced (short notice) Care and support Management and leadership 12 Jun 2014 Unannounced Care and support Management and leadership 15 Jul 2013 Unannounced Care and support Management and leadership 6 Dec 2012 Unannounced Care and support Management and leadership 26 Oct 2011 Unannounced Care and support Management and leadership 27 Jan 2011 Unannounced Care and support Management and leadership 14 Sep 2010 Announced Care and support Management and leadership 26 Mar 2010 Unannounced Care and support Management and leadership page 5 of 7
Date Type Gradings 19 Jun 2009 Announced Care and support Management and leadership 16 Dec 2008 Unannounced Care and support Management and leadership 3 Jul 2008 Announced Care and support Management and leadership page 6 of 7
To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at www.careinspectorate.com Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 Find us on Facebook Twitter: @careinspect Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 7 of 7