Gladstone Childcare Ltd - Ragfield House Care Home Service Children and Young People Ragfield Nr Crail Anstruther KY10 3XG Telephone: 07824 347744 Inspected by: Donna Borek Type of inspection: Unannounced Inspection completed on: 27 May 2013
Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 10 4 Other information 19 5 Summary of grades 20 6 Inspection and grading history 20 Service provided by: Gladstone Child Care Ltd Service provider number: SP2006008379 Care service number: CS2007151048 Contact details for the inspector who inspected this service: Donna Borek Telephone 01382 207200 Email enquiries@careinspectorate.com Gladstone Childcare Ltd - Ragfield House, page 2 of 22
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 The service ensures that young people feel well looked after, cared for and supported. The staff team work well together and have been active in professional development to meet young people's needs. The manager of the service ensures that the values and philosophy underpinning the service are well communicated to staff and young people. What the service could do better The service should continue to maintain the very good practice. Self evaluation processes could be further developed in partnership with stakeholders to reflect outcome objectives. What the service has done since the last inspection Areas for development identified by the service had been progressed. One recommendation made at the last inspection visit had been appropriately addressed. Gladstone Childcare Ltd - Ragfield House, page 3 of 22
Conclusion Inspection report continued Overall, the quality of care and support, environment, staffing and management and leadership is assessed as being very good. Who did this inspection Donna Borek Gladstone Childcare Ltd - Ragfield House, page 4 of 22
1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at www.careinspectorate.com This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April 2011. Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve, we may make a recommendation or requirement. recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service, but where failure to do so will not directly result in enforcement. Recommendations are based on the National Care Standards, relevant codes of practice and recognised good practice. A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reform (Scotland) Act 2010 and Regulations or Orders made under the Act or a condition of registration. Where there are breaches of Regulations, Orders or Conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. Ragfield House is a large bungalow in a rural location near Crail in North East Fife. It has accommodation for up to three children/young people and is suitable for both boys and girls. Ragfield has a large garden with swings, trampoline and a variety of other play equipment. A conservatory to the front of the house is used for computer games and craft work. The children/young people can choose their individual colour schemes and furniture styles to suit their bedrooms. At the time of the inspection there were three young people living in the house and attending local schools. Based on the findings of this inspection this service has been awarded the following grades: Gladstone Childcare Ltd - Ragfield House, page 5 of 22
Quality of Care and Support - Grade Quality of Environment - Grade Quality of Staffing - Grade Quality of Management and Leadership - Grade Inspection report continued 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. Gladstone Childcare Ltd - Ragfield House, page 6 of 22
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 An unannounced inspection visit was carried out by Donna Borek between 15 May and 27 May 2013. During the visit we spoke with young people, staff and managers and looked at a range of documents and records. We visited and looked around all of the premises used to provide care for young people. At the end of our visit we talked with the manager of the service about what we found. 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. 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 Gladstone Childcare Ltd - Ragfield House, page 7 of 22
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 Gladstone Childcare Ltd - Ragfield House, page 8 of 22
What the service has done to meet any recommendations we made at our last inspection Appropriate action was taken to address one recommendation made at the last inspection. 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 self assessment was completed and submitted. Taking the views of people using the care service into account We received three questionnaires directly from young people. The information in the questionnaires told us that young people felt generally well cared for and looked after. One young person commented " I like all the staff". Taking carers' views into account The views of families and carers were not sought on this occasion. Gladstone Childcare Ltd - Ragfield House, page 9 of 22
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: 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 We looked to see that the service involves young people and their carers/supporters in assessing and improving on the quality of care and support, environment, staffing and management and leadership. In the self assessment the service told us: "A high level of individual work is undertaken with all young people and the staff team have implemented various strategies...young people are aware they have access to staff, management and external agencies such as social work and children's rights...staff feel that coming together time is an important aspect of enabling the young people to have their say and express views". When we talked to young people and staff we heard that young people are involved in arrangements for planning their own care and support. Young people said: "Staff listen to me, ask me about things and are good at being there for me". "Angries out helps me". "I like my room". We saw that when staff spend time with young people they listen carefully to what is being said and make sure that when something needs to change to improve a situation for a young person, that change is supported. Gladstone Childcare Ltd - Ragfield House, page 10 of 22
We heard that young people meet together to discuss aspects of the service and to suggest ideas for improvement. The documents we looked at showed that feedback questionnaires completed by young people were comprehensive and well used. Taking the above information into account we assessed quality in this area as very good. Areas for improvement The service should complete the review of the welcome pack and make this available for all those using the service. The service should continue to maintain the very good practice in this area. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths We looked to see that the health and well-being needs of young people were being met. In the self assessment the service told us: "The staff work well with young people at Ragfield recognising the importance of a healthy body and mind and this is evidenced within the individual work undertaken with the young people to support them in discussing any issues they have which affects their emotional well-being. Recently, group work has been undertaken in respect of dental hygiene which was very positive and as part of the young people's aspirations...". Discussions we had with staff and records we looked at confirmed that individual work was being carried out sensitively to support young people to take responsibility for their health and well-being. Young people said: "They helped me when I had to stay in hospital " "(We) do life story work which is good fun". Inspection report continued Gladstone Childcare Ltd - Ragfield House, page 11 of 22
We saw that staff had worked to encourage very good school attendance for young people and that holding safely, and child protection issues had been appropriately identified and managed. Records showed the service was very good at maintaining nutritional plans for individual young people and that overall health and well-being was regularly reviewed and looked at after child meetings with other appropriate professionals. Taking all of the above into account, we assessed quality in this area as very good. Areas for improvement Records detailing individual work undertaken could be expanded further to include more narrative of discussions. Individual risk assessments could be developed further to include a more comprehensive analysis of young people's needs. The service should consider developing and carrying out a written initial assessment to consider how well the young person has settled into the service. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Inspection report continued Gladstone Childcare Ltd - Ragfield House, page 12 of 22
Quality Theme 2: Quality of Environment Grade awarded for this theme: Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the environment within the service. Service strengths See Quality Theme 1, Statement 1. Taking into account the information reported in Quality Theme 1, Statement 1 we assessed quality in this area as very good. Areas for improvement The service should maintain the very good practice in this area. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Statement 2 We make sure that the environment is safe and service users are protected. Service strengths We looked to make sure that the environment is safe and that young people are protected. In the self assessment the service told us: "The staff feel that the team meeting process of discussing health and safety, the young people, reviewing their plans and assessments on a weekly basis ensures a safe living environment... Risk assessments are an ongoing part of keeping young people safe and we are now trying to involve them in this process to further underpin their safety in respect of the young people and their choices". We looked all around the house and saw that this was bright and airy. Gladstone Childcare Ltd - Ragfield House, page 13 of 22
Records showed very good health and safety measures were in place and that this included well-known child protection and whistleblowing arrangements. Staff talked about the routines in place to maintain high standards in this area. Taking all of the above into account and the areas for development below, we assessed quality in this area as very good. Areas for improvement The service should consider further developing individual risk assessments for young people, including sibling relationship assessments where appropriate. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Inspection report continued Gladstone Childcare Ltd - Ragfield House, page 14 of 22
Quality Theme 3: Quality of Staffing Grade awarded for this theme: Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths See Quality Theme 1, Statement 1. Taking into account the information reported in Quality Theme 1, Statement 1 we assessed quality in this area as very good. Areas for improvement The service should maintain the very good practice in this area. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths We checked that the service have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. In the self assessment the service told us: "Staff have undertaken loss and bereavement training and CALM training. We have insisted on a member of staff being trained as a CALM trainer to ensure that the staff team receive appropriate training and guidance". When we talked with staff and the manager, and when we looked at records, we found very good examples of multi agency working by staff in the service. Appropriate information was being shared in relation to the young people's plans. Gladstone Childcare Ltd - Ragfield House, page 15 of 22
Staff were very positive about their work and felt they were encouraged to get to know the young people well. Staff meetings, comprehensive discussion between staff, regular training and safer recruitment information were well evidenced at the time of our visit. Taking all of the above into account we assessed quality in this area as very good. Areas for improvement Staff development should be supported to effectively embed learning from ongoing training into their practice. The manager should ensure that timeous written records are always maintained. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Inspection report continued Gladstone Childcare Ltd - Ragfield House, page 16 of 22
Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 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 See Quality Theme 1, Statement 1. Taking into account the information reported in Quality Theme 1, Statement 1 we assessed quality in this area as very good. Areas for improvement The service should maintain the very good practice in this area. Grade awarded for this statement: 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 We looked to ensure the service has quality assurance processes which involve service users, carers, staff and stakeholders. In the self assessment the service told us: "A service evaluation process has been developed for children, families and external agencies... all aware of the complaints procedure and a booklet explaining the process is provided for all young people...the external advisory board visits the project on an informal basis to seek the views of young people, managers and staff to assist in the development of the service provision". When we visited we found the service had very good audit processes in place and that most records were being reviewed with staff and young people. Gladstone Childcare Ltd - Ragfield House, page 17 of 22
We saw that quality assurance calendars were being used to maintain a systematic approach to drive forward improvements. Areas for improvement We found that while young people and staff had opportunities to contribute to the development of the service provided to them, carer and other stakeholder opportunities were more limited. The service should develop and use more methods of evaluation to ensure the views of all stakeholders, including birth families and other professionals, can be used to develop the quality of all aspects of service provision. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Gladstone Childcare Ltd - Ragfield House, page 18 of 22
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 None. 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). Gladstone Childcare Ltd - Ragfield House, page 19 of 22
5 Summary of grades Quality of Care and Support - Statement 1 Statement 3 Quality of Environment - Statement 1 Statement 2 Quality of Staffing - Statement 1 Statement 3 Quality of Management and Leadership - Statement 1 Statement 4 6 Inspection and grading history Date Type Gradings 6 Jun 2012 Unannounced Care and support Environment Staffing Management and Leadership 11 Oct 2010 Unannounced Care and support Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed 2 Jun 2010 Announced Care and support Environment Not Assessed Staffing Not Assessed Management and Leadership Gladstone Childcare Ltd - Ragfield House, page 20 of 22
14 Jan 2010 Unannounced Care and support Environment Not Assessed Staffing Not Assessed Management and Leadership 1 Jul 2009 Unannounced Care and support Environment Staffing Management and Leadership 11 Oct 2008 Unannounced Care and support Environment Staffing Management and Leadership 4 - Good 29 May 2008 Announced Care and support Environment Staffing 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. Gladstone Childcare Ltd - Ragfield House, page 21 of 22
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 Gladstone Childcare Ltd - Ragfield House, page 22 of 22