Care service inspection report

Size: px
Start display at page:

Download "Care service inspection report"

Transcription

1 Care service inspection report Full inspection NAS SW Scotland Supported Living Housing Support Service The Stables Administration & Resource Centre The National Autistic Society Sorn Road Catrine Mauchline Inspection completed on 02 June 2016

2 Service provided by: The National Autistic Society Service provider number: SP Care service number: CS Inspection Visit Type: Unannounced Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and set out improvements that must be made. We also investigate complaints about care services and 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. Contact Us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com page 2 of 51

3 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 3 Quality of staffing 4 Quality of management and leadership 2 Adequate Good Weak What the service does well The service offers a secure environment where adults with autism are helped to feel safe and have access to a range of community health services. Staff are assisted by the provider's advisory team to support service users manage challenging situations and communication difficulties. Very good attention hade been given to induction training for new staff. What the service could do better The service provider needs to address continuing difficulties with staff retention in order to achieve a more settled team of support staff. The service needs to provide more visible senior leadership and management in order to observe day-to-day practice and engage with support staff to improve outcomes for people using the service. page 3 of 51

4 What the service has done since the last inspection Inspection report The service continues to implement an improvement plan and there are signs of improvement albeit slow. Significantly, the progress of change is seriously impaired by continuing staff turnover. Conclusion The service had continued to implement an improvement plan and we confirmed improvement in relation to the administration of medicines. We saw evidence of progress in other areas but most of our previous recommendations had only been partially implemented and more work was necessary to achieve the required improvements. The provider's Head of Operations and Scottish Director are very well aware of the need for continued improvement and the provider recognises that improved staff retention is an essential component of any sustained improvement. page 4 of 51

5 1 About the service we inspected Inspection report The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April The service, which is also known as Catrine Bank, is located within the campus of Daldorch House School and registered to provide a housing support and care at home service for up to 29 people aged 16 years and over who have an autistic spectrum disorder. The service is also registered to provide a care at home service and we have taken account of the National Care Standards for both types of service. Twenty-three people were being supported by the service at the time of our inspection. The service shares its address with a separately registered Day Opportunities service. This is inspected separately and the report of the most recent inspection of that service is available on our website. Recommendations A recommendation is a statement that sets out actions that a care service provider should take to improve or develop the quality of the service, but where failure to do so would not directly result in enforcement. Recommendations are based on the National Care Standards, SSSC codes of practice and recognised good practice. These must also be outcomes-based and if the provider meets the recommendation this would improve outcomes for people receiving the service. Requirements A requirement is a statement which sets out what a care service must do to improve outcomes for people who use services and must be linked to a breach in the Public Services Reform (Scotland) Act 2010 (the "Act"), its regulations, or orders made under the Act, or a condition of registration. Requirements are enforceable in law. page 5 of 51

6 We make requirements where (a) there is evidence of poor outcomes for people using the service or (b) there is the potential for poor outcomes which would affect people's health, safety or welfare. Based on the findings of this inspection this service has been awarded the following grades: Quality of care and support - Grade 3 - Adequate Quality of staffing - Grade 4 - Good Quality of management and leadership - Grade 2 - Weak 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 or by calling us on or visiting one of our offices. page 6 of 51

7 2 How we inspected this service The level of inspection we carried out In this service we carried out a high intensity inspection. We carry out these inspections where we have assessed the service may need a more intense inspection. What we did during the inspection Before our inspection we asked the service to circulate our care service questionnaires and staff questionnaires. We received back two care service questionnaires completed by relatives on behalf of people who use the service. We received seven completed staff questionnaires. We took account of the service's Action Plan following our previous inspection, a self-assessment completed by the service and an updated 'improvement plan' shared with us by the service. One inspector made an unannounced visit to the service from 5:15pm to 8:30pm on 17 May An unannounced return visit was made by two inspectors on 24 May from 10:15am to 6:15pm with further visits being made the following day from 9am until 6:15pm (one inspector) and the following day, 9am to 3:45pm. Between the first and second visits we began to phone families, social workers and other members of community learning disability teams for people using the service (selected by random) and continued this during the second week of the inspection. We also spoke to family members visiting the service during our visits and to staff working in the service (including behaviour support staff, team leaders and support staff). We met with people supported by the service and spoke briefly with them where this was possible as well as observing interaction between staff and people who use the service. We used a case-tracking model, focusing particularly on two service users each from Houses 1 and 2. We did not visit House 3 during this inspection other than to follow-up matters raised with us by a relative. House 3 had recently been registered with the Care Inspectorate as a care home service although the provider had subsequently requested that, temporarily, this registration be deemed 'inactive'. page 7 of 51

8 We examined support plans and associated documents and records including communication sheets, behaviour support plans, risk assessments and monthly reports. The registered manager was absent during this inspection and staff present were unable to provide us quality assurance and complaints records. We returned to the service to provide verbal feedback on 2 June 2016 when we met with the provider's new Head of Operations together with the manager of the adjacent Day Opportunities service. Two Team Leaders and a representative of the host local authority were also in attendance. 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 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 page 8 of 51

9 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 service's self assessment mostly assesses the service provided to have achieved a higher standard that we saw during this inspection. More attention should be given in future self-assessments to how the inputs described have achieved positive outcomes for people supported by the service. Taking the views of people using the care service into account We were unable to have any more that short exchanges with people using the service. We observed interaction between staff and the people they support. We saw that young people using the service were at ease with support staff and able to communicate their needs and wishes to them. Taking carers' views into account Whilst relatives value and respect much of the support provided by staff, many say they have lost trust and confidence in the service provider. Whilst some still believe strongly that the setting provided at Catrine Bank is the best and most secure place for their relative to live others told us that they are now looking for alternative placements. Such mixed views are epitomised by the comments of two parents: one told us that: "The service is absolutely matched to my son's needs. I am absolutely satisfied with the support, care and environment provided. His overall improvement in his behaviour and language is a testament to the benefits of the service." page 9 of 51

10 The other said: "There are too many changes happening and there is a lack of leadership, short-staffed and no clear direction. This service is nowhere near the standard that it used to be. I am actively looking for an alternative placement for my son if things don't improve." In addition to this, some families of people supported by the service and the sponsoring local authorities do not feel they've been consulted regarding the change back from providing a combined housing support and care at home service to offering a residential care home. Many feel they have been presented with a fait accompli with inadequate explanation of how this will affect outcomes for the people supported by the service. page 10 of 51

11 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: 3 - Adequate Statement 2 We enable service users to make individual choices and ensure that every service user can be supported to achieve their potential. Service Strengths Based on our findings during this inspection adequate standard had been maintained overall in relation to this quality statement. This had slipped from the findings of our previous inspection due to the continuing impact of short staffing, especially at weekends. Staff demonstrated good understanding of service users' interests, preferences and limitations due to their autism or other specific needs. Staff also demonstrated good understanding of the way in which individual service users communicate their needs and wishes. Service users' rooms had been personalised according to their interests and families had been encouraged to participate in this. Parents' comments include that service users like Catrine Bank and look forward to returning there after home visits. The service has maintained a wide repertoire of communication methods which staff used to varying degrees to support the communication needs of the people they support. This was supported by the provider's speech and language therapist and included choice charts, pointing books, PECS cards (Picture Exchange Communication System), social stories and increasingly, personal i-pads. page 11 of 51

12 The Speech and Language Therapist had additional methods at their disposal including 'talking mats' which helped those with the greatest communication difficulty to express their views on specific matters. The outside area provided a limited range of amenities including swings, a sandpit and basketball hoop. Depending on the support package agreed with the placing authority, some service users attended the provider's day opportunities service where they participated in a range of activities and resources including woodworking workshop, a horticulture area, a wooded area with a fire grate and some went fishing. Service users were supported to maintain their interest in a wide range of recreational opportunities and good use was made of local amenities within the nearby village and further afield. Staff demonstrated good knowledge of the amenities that worked well for the service users they worked with, for example, different swimming pools, walks, shops, places of interest and places to eat and drink. During our inspection some therapy dogs visited and met with service users who were known to enjoy meeting them. This was a regular activity. The service had built good relationships with staff at a variety of locations including cinemas, restaurants and horse-riding stables. Risk assessments gave good attention to the potential risks associated with different activities and destinations and strategies for managing such risks safely. We found some examples of well-established key-teams where the Key Worker had taken a strong lead in coordinating the support provided by the team to the person using the service. Where this had happened this included very good account being taken of the known views and preferences of the person they supported and their family. There was also evidence of staff commitment to maintaining regular communication with the families of people they support. Positive comments include that staff provide useful monthly written reports and communicate well with parents when they support home visits. Following our last inspection we recommended that managers should ensure that the subject of meaningful activities remains high on the agenda of keyteam discussion and is supported through staff training. page 12 of 51

13 We found that some progress had been achieved with this and this was particularly evident where there was a strong key-team and where staffing levels had been appropriately maintained. Where service users utilised the services of the adjacent day services project, this had played a big part in offering both enjoyable and meaningful activities. This was confirmed at a review meeting that we attended where it was evident that the service user had benefitted from the combined support of their own support staff as well as staff from the separately registered day opportunities and outreach services. See also Areas for Improvement below. Areas for improvement As reported above, following our last inspection we recommended that managers should ensure that the subject of meaningful activities remains high on the agenda of key-team discussion and is supported through staff training. Team Leaders told us of plans to create the new post of Activities Organiser. This was a positive proposal which demonstrates the provider's recognition of the importance of activities. This may be beneficial but the main priority should be to equip staff to support activities with service users and ensure they have the time and resources to do so. We suggested that another approach may be to designate activity 'champions' in each house. The main factor that had impacted on the provision of appropriate and meaningful activities had been staffing shortages, especially at weekends. Staff turnover had also affected the service's ability to provide activities as newer and else experienced staff sometimes lacked the confidence to support service users' participation. A relative told us that some of the activities their son used to participate in had ceased but not been replaced with alternatives; they also said that staff no longer had the time to support some of the outings their son had previously enjoyed. They told us that their son was often bored and spent too much time in their room, a view which the service user's social worker confirmed. They felt that he wanted to go out more and that staff knew this but it remained a problem. Other parents referred to similar disappointments and told us that they were now considering moving their relatives from the service. page 13 of 51

14 Another relative spoke of staff fears about self-injurious behaviour which they felt had sometimes led to staff-avoidance of instigating activities. Staff agreed this had been the case but added that there had been some recent improvement which the parent also acknowledged. This indicated a need for continuing attention to staff developmental needs in relation to self-injurious behaviour. See also Quality Theme 3, Statement 3. We note that, although the service's day opportunities service has some very good facilities, these were under-used by staff at evenings and weekends. We have repeated our recommendation in a slightly amended form. (See Recommendation 1 under this quality statement). Following our last inspection we recommended that The National Autistic Society should continue to evaluate the outcomes of measures to improve communication with families. During this inspection, due to the absence of the registered manager, we were unable to ascertain whether or not the service was evaluation such outcomes. As reported above, we saw some evidence of very good communication with young people's families and some family members told us that they had experienced improvement in this area. Other families however expressed unhappiness with the frequency and content of communication with managers and told us that they sometimes did not feel listened to. Overall the views we received were mixed with some acknowledgement of good and even very good communication (See also Quality Theme 1, Statement 3) but also serious concerns about the difficulties families experience in maintaining good communication with the service. Additional comments by parents include the need for a more consistent team approach to implementing agreements and the need to ensure the telephone is answered, especially at weekends. Some parents felt that the staff they spoke to were not conversant enough with service users' needs or recent events. One parent told us that they felt like they were sometimes 'fobbed off' by staff who did not really know their relative. We have repeated our recommendation. (See Recommendation 2 under this quality statement). page 14 of 51

15 Following our last inspection we recommended that the National Autistic Society should ensure that records maintained by staff are sufficiently detailed to ensure good understanding of the described event and to inform communication with families. We looked at daily observation notes maintained by staff and found that, although these provided a general flavour of the service user's day, they provided insufficient detail to enable a staff member on a later shift to respond to any questions by concerned parents. For example where potentially serious incidents had occurred, the communication notes made only passing reference to these, e.g. the statement 'X had a behaviour in the car and on return arrival back at house', referred to a very serious incident which a parent would expect to be fully informed about. The record made no reference to whether anybody been informed about the matter. One means of addressing this without duplicating recording, would be for staff to cross-reference their entry with the relevant incident report form and to retain a copy in the service user's folder. We have repeated our recommendation. (See Recommendation 3 under this quality statement). We also recommended following our last inspection that the National Autistic Society should continue to work with placing authorities to ensure that each person supported by the service has access to independent advocacy should the need arise. Some steps had been taken to address this and this was the focus of continuing discussion but little progress had been made. Our discussions with managers, staff and parents highlight the importance of advocacy for service users, most of whom are non-verbal and dependent on others to help them express their views. Where parents had been strong advocates themselves this had led to improvements in care and support and greater attention to detailed support delivery by managers and staff. We note however that some service users' families are not in a position to advocate so actively on behalf of their relative. The service provider's speech and language specialist continued to play an important part in ascertaining the views of service users. Their annual 'impact recording' exercise with service users provided invaluable insight concerning this and team managers had now been trained to use some of their own impact recording now. This had already helped them to find out some matters of concern to specific service users and address these. page 15 of 51

16 It will be important to ensure that this training continues and that more staff have the confidence and the skills to find out from the people they support what they think of the service they receive. The examples of this type of 'impact recording' that we saw in some of the files we sampled were old and out of date, e.g. not updated since A volunteer 'autism buddy' had visited the service and met with the speech and language specialist but hadn't met with young people. They had no previous experience with autism and would need a lot of support with communication with most young people. This is a positive initiative but is not an alternative to independent advocacy and is likely to take a considerable time to introduce and become effective. One parent we met spoke of their son having a very effective independent advocate from their local authority advocacy service. The manager had suggested to placing authorities that they should consider sharing the costs of providing an independent advocacy service for Catrine Bank. Provider should give consideration to contracting with an independent advocacy provider to provide this service. We have repeated our recommendation in order that all people supported by the service have access to the support of an independent person who can advocate on their behalf. (See Recommendation 4 under this quality statement). We recognise that the needs of some people supported by the service require a 'low arousal' environment with minimal visual stimulus. We also accept that some people using the service are liable to destroy items such as pictures and ornaments or attempt to shred curtains. This resulted in public areas being minimalist in regard to décor and lacking the features normally associated with a homely environment. More consideration could be given to means of reducing the starkness of this environment to create an environment with more visual stimulus for those who will benefit from this. For example, we suggested consideration be given to some stencilling in public areas. Similarly there was scope to develop the outdoor area to reduce its sparseness. page 16 of 51

17 Grade 3 - Adequate Number of requirements - 0 Recommendations Number of recommendations The National Autistic Society managers should continue to ensure that the subject of meaningful activities remains high on the agenda of key-team discussion and is supported through staff training and development. National Care Standards, Care at home, Standard 3.1: Your personal plan and Standard 4.6: Management and staffing. 2. The National Autistic Society should continue to evaluate the outcomes of measures to improve communication with families. National Care Standards, Care at home, Standard 3: Your personal plan and Standard 11.4: Expressing your views. 3. The National Autistic Society should ensure that records maintained by staff are sufficiently detailed to ensure good understanding of the described event and to inform communication with families. National Care Standards, Care at home, Standard 4.1: Management and staffing. 4. The National Autistic Society should continue to work with placing authorities to ensure that each person supported by the service has access to independent advocacy should the need arise. National Care Standards, Care at home, Standard 11.4: Expressing your views. page 17 of 51

18 Statement 3 We ensure that service users' health and wellbeing needs are met. Service Strengths Based on our findings during this inspection an adequate standard had been maintained in relation to this quality statement. We confirmed that the service has close relationships with a wide range of relevant local health services. There was a choice of two local doctor's surgeries and managers and staff told us that both provide very good support and adapt their approach to suit the needs of the people supported by the service. The service benefitted from regular visits by dental hygienists and dentists, as well as specialist nurses (e.g. diabetes), occupational therapy and dieticians. Good support was also provided by psychological and psychiatric teams. There was an agreed 'fast-track' protocol for accessing accident and emergency services and hospital visits could be organised through the community learning disability hospital liaison nurse. This had helped to ensure that planned hospital appointments went smoothly and that service users were met by people who were aware of their individual needs. We observed interaction between staff and service users and found that this was sensitive and person-centred. In particular we saw that staff had good understanding of service users' communication needs and supported them well to express themselves and make choices. This had included effective use of social stories to introduce any proposed change in normal routines. Following our last inspection we recommended that managers should ensure that parents, or guardians and care managers from the placing authority are always consulted regarding the content of the Person Centred Plan, including any updates and provided with up-to-date copies of these. We added that these should be sufficiently detailed to ensure that staff can support the health and wellbeing needs of the people they support consistently. page 18 of 51

19 It was difficult for us to ascertain this from plans, many of which were in need of updating. However, in discussion with staff and parents and at review attended by parents and a social worker, we saw evidence of team leaders and key teams being attentive to carers' views and we were shown some good examples of plans being updated in response to changing needs and events. As reported elsewhere, this worked best where there was a well-established key team. Parents' comments to us include that communication with home had significantly improved in the past year. One parent told us that the key team 'knows what I expect and I get it'; this included regular updates about health and behavioural incidents as well as information about activities outings and spending. See also Areas for improvement. Following previous inspection we have made requirements and recommendations concerning the administration of medicines. Following our last inspection we recommended that the National Autistic Society should continue to look at how best to implement our previous recommendation to introduce an approach to the administration of medicines in which suitably trained staff administer medicines from their original packaging. This was an area which had continued to improve: the service had moved its contract to a new pharmacy which team leaders said provided a better service; the number and frequency of medicine administration errors had reduced significantly. Staff who we spoke to demonstrated increased confidence in relation to medicines administration and our observations confirmed a vigilant approach. Team Leaders confirmed that they were currently undertaking their Professional Development Award (PDA) in medicines management and support staff continued to undertake accredited training in medicines administration. Team Leaders' comments include that this training had been very helpful; and had helped them to identify and implement further improvements to the service's system for the administration of medicines. Our recommendation had been met but the provider should continue to give careful attention to auditing medicines management. See also Areas for Improvement. page 19 of 51

20 Areas for improvement At the time of our previous inspection the provider spoke of their intention to appoint a Health and Wellbeing Coordinator. This proposal had not been progressed and, during this inspection, we suggested that the designation of health and well-being champions' in individual houses may be a more effective means of achieving the desired improvements in the health and wellbeing of people supported by the service. Support planning paperwork was extensive and contained some very good detail, especially regarding daily routines. It was frequently difficult for us to ascertain from paperwork how up to date it was and how responsive it had been to changing needs and preferences. It was also difficult to ascertain the current focus of work being undertaken and the desired outcomes of this. We found examples of occasions when action points identified through local authority reviewing procedures had not been included in the service's support plans. Social workers told us that service users' daily routines that had sometimes remained unchanged for a considerable period. We found evidence that, despite the service's detailed approach to support planning, behaviour support plans and individual risk assessments, this did not necessarily inform staff's day-to-day work with service users. Most staff signature sheets and review sections that we saw were blank and there was no evidence of carers and guardians signing to confirm their agreement to the content. Although other recording tools, e.g. communication diary and daily living skills, demonstrated the service's intent to maintain good recording systems, these were frequently blank or little-used. Consideration should be given to introducing a more condensed form of support planning, more conducive with use as a tool to inform day-to-day support. (See Recommendation 1 under this quality statement). Following our last inspection we recommended that the National Autistic Society should ensure that, through reviewing processes with guardians, the placing authority and other relevant professionals, a firm decision is made as to whether or not the needs of each person supported by the service can best be met through provision of a care home service. page 20 of 51

21 We were unable to confirm from service users' files whether or not statutory social work reviews had occurred for people using the service. However, the service convened its own reviews, chaired by Team Leaders and, at these meetings, a date was set for the next meeting. Local authority social workers confirmed to us that the service is attentive to maintaining a pattern of six monthly reviews and that they count one of these as their annual review. At a review meeting that we attended, the service's transition from a joint housing support and care at home service to a residential care home service was not on the agenda. We asked about this and the chair assured members that this proposed change would not alter the way that support is provided and needs met. However, when we spoke with Team Leaders they had very little awareness of the progress of the proposed change nor the timescale for this. Parents that we met were less confident about the implications of this proposed change. They told us and did not feel they had been consulted about it and representatives of some social work departments also told us of their concerns about the change. We have repeated this recommendation. (See Recommendation 2 under this quality statement). At a review we attended we confirmed there had been an improvement in the way that managers and staff respond to matters raised by parents. We note that some family members had been extremely articulate and persistent in advocating on behalf of their relative and confirmed that this had helped ensure their views were taken account of. Parents' comments include however that, were it not for their tenacity, this would not be the case. They also spoke of problems ensuring that all staff follow agreed approaches; sometimes this was due to new and less experienced staff joining the team but parents also thought it was due to poor communication and staff forgetfulness. We note that this review had been convened by the service and that the service needed to be proactive in ensuring that all the people they support are subject to the statutory local authority reviewing process. Where a strong core-team had been established and maintained this had resulted in increased consistency and positive outcomes. This worked best where a strong lead was given by an experienced key worker. page 21 of 51

22 There were some good examples of this but, one parent we met, whose son's need were very complex, was no longer certain who the key worker was and told us of their concern that staff working with him had only very limited understanding of such complex needs and behaviour. This view was confirmed by members of the service users community learning disability team and also by our own observations. A conversation with the key worker confirmed this view; they were new and unqualified and, although they had been accepted well by the service user, they felt that they needed more training specific to the service user's main presenting behaviour. For example, staff sometimes identified challenging or distressed behaviours as a symptom of pain and we observed them administer pain relief in such circumstances. A specialist nurse visiting the service had also observed this. Staff freely acknowledged that it could be an indicator of other needs but administered pain relief nevertheless. In order to ensure appropriate administration of pain relief, the service should develop a more refined protocol for the administration of PRN (as required) medicines, agreed with the GP, and taking account of the views of family members and other health professionals. It may sometimes be useful to invite the service user's guardian to join in such discussions with the service user's doctor. See Recommendation 3 under this quality statement. We saw that, where people using the service had such very complex needs, the provider's behaviour support team had provided the team with a very detailed 'positive behaviour support plan' (PBSP) which staff were conversant with. A Team Leader confirmed that following such plans had increased staff confidence and reduced the number of incidents. It was evident nevertheless that, despite their obvious care and commitment, certain behaviour had challenged the skills of key teams. Team leaders and other managers expressed the hope that, as they service achieves more settled key teams for each person, this would help them to build skills and experience appropriate to the individual's needs. See also Quality Theme 3, Statement 3. page 22 of 51

23 Several staff that we spoke to described their apprehension about dealing with certain types of behaviour and almost half of those who completed staff questionnaires said that they sometimes did not feel safe at work. Some staff raised questions about the suitability of the range of strategies available to them for restrictive physical interventions (RPI). The service provider's policy and procedures indicates that staff may use methods in which they are not trained in the event of there being 'no alternative' provided that this involves the use of the minimum amount of force necessary. We have previously raised this with the provider and they had explored other methods but concluded that a bespoke approach was best. Staff with experience of other care settings with different approaches to challenging behaviours told us that they felt there were more suitable strategies available which would better equip staff and improve the safety of interventions. The service provider should review their policy and procedures amended these to make clear that no restrictive physical intervention may be used other than suitably accredited interventions in which staff have been trained. The range of interventions used should be kept under review to ensure that support staff are always equipped to keep service users and others safe. (See Requirement 1 under this quality statement. See also Quality Theme 3, Statement 3). Following our last inspection we recommended that the service should continue to develop Individual Financial Plans to ensure they are explicit enough for all parties to understand exactly who is responsible for each area of financial responsibility. The service provider's Finance Manager had left the organisation and we were told that the post was under review. Team Leaders and support staff were unaware of progress of this recommendation but an assistant in the finance office confirmed that there were still a small number of families with whom there was still no agreement. Service users' support plan folders included a section for an individual finance plan but none were in place. Carers and guardians confirmed that they receive information about monthly expenditure from their relative's personal funds, others still felt confused about financial arrangements. Some families thought they had been overcharged or charged for services that they did not receive. This had subsequently been reimbursed. page 23 of 51

24 There continues to be some confusion in regard to billing from the provider as some families and local authorities are unsure what the payments cover. We understand that the provider is now carrying out an audit of individual financial arrangements. This needs to lead to a clear understanding of charges and what these cover. Some family members described their concern in relation to the proposed change from housing support to residential care. Specific concerns include the reduction in personal disposable income for people using the service and arrangements for purchasing clothing and other personal items. We have repeated our recommendation. (See Recommendation 4 under this quality statement). We also recommended that inventories of personal belongings should be maintained in order to ensure a complete record of property belonging to people supported by the service. This had not been progressed and files we looked at did not include an up to date inventory of personal belongings. We have repeated our recommendation. (See Recommendation 5 under this quality statement.) Following our last inspection we recommended that managers should continue to give attention to ensuring that, at all times, staffing levels are maintained in accord with the assessed needs of the people they support. Managers and staff acknowledged that staffing shortages continue to be a significant concern, especially at weekends and, in one house, staff comments include that they were 'always short-staffed'. Staff and parents told us of occasions when the service had been unable to provide 2:1 staffing for activities where this was required which had resulted in planned activities being curtailed. Staff had attempted to find flexible ways of maintaining activities, for example, by 'sharing' staff. We also saw evidence of a potentially serious incident when an inexperienced staff member had undertaken an activity 1:1 when it was riskassessed as requiring two staff. We have therefore made a requirement in order to ensure that, at all times, staffing levels are appropriate to the health and welfare of people supported by the service. See also Quality Theme 3, Statement 3 and the Requirement we have made there. page 24 of 51

25 We also recommended that accident forms should include a section for review by the service manager and/or members of the behaviour support team. This should identify whether or not any actions are necessary such as changes to the support plan, behaviour support plan or risk assessment, staff training, etc. This recommendation had not been implemented. Although the service provider had some sophisticated report pro-formas, these were more effective as a means for gathering statistical information about service users' behaviour than reviewing and improving the type of support provided. See also Quality Theme 4, Statement 4 and Requirement 2 made under that statement. Grade 3 - Adequate Requirements Number of requirements The National Autistic Society must review and update its policy and procedures for the use of Restrictive Physical Interventions in order to make clear to employees that, if on any occasion, any form of restrictive physical intervention is considered the only practicable means of securing the welfare and safety of the service user or any other service user, they must only use methods in which they are trained to achieve this. This requirement is made under the terms of SSI 2011/210, Regulations 4 (10 [c] and 9 (2) [b] in order to ensure that no service user is subject to restraint, unless it is the only practicable means of securing the welfare and safety of that or any other service user and that staff have the skills and experience necessary for the work that they are to perform. Timescale for implementation - 1 month from the publication of this report. Recommendations Number of recommendations The National Autistic Society should review its approach to support planning in order to achieve an approach which is compatible with regular review and page 25 of 51

26 update by staff and capable of informing the day-to-day support of people using the service. This should be agreed with the service users' guardians and social workers. National Care Standards, Care at home, Standard 3: Your personal plan. Inspection report 2. The National Autistic Society should ensure that, through reviewing processes with guardians, the placing authority and other relevant professionals, a firm decision is made as to whether or not the needs of each person supported by the service can best be met through provision of a care home service. National Care Standards, Care at home, Standard 2: The written agreement and Standard 3: Your personal plan. 3. The National Autistic Society should develop a more refined protocol for the administration of PRN (as required) medicines, agreed with the GP, and taking account of the views of family members and other health professionals. National Care Standards, Care at home, Standard 2: The written agreement and Standard 8.3: Keeping well - Medication. 4. The service should continue to develop Individual Financial Plans to ensure they are explicit enough for all parties to understand exactly who is responsible for each area of financial responsibility. National Care Standards, Care at home, Standard 2: The written agreement. 5. The National Autistic Society should ensure that the service maintains inventories of service users' personal belongings in order to ensure a complete record of property belonging to people supported by the service. National Care Standards, Care at home, Standard 2: The written agreement. page 26 of 51

27 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 4 - Good Statement 2 We are confident that our staff have been recruited, and inducted, in a safe and robust manner to protect service users and staff. Service Strengths Based on our findings during this inspection a very good standard had been maintained in regard to this quality statement but, as noted elsewhere in this report, more attention needs to be given to staff retention. We confined our examination of this quality statement to looking at staff induction training. Newer staff that we met confirmed that their induction training had supported prepared them well for their work with service users. Staff comments include that nothing could have completely prepared them but that team leaders and other team members had supported them well in the early stages of their employment. We confirmed that this included attention to individual sessions of supervision by a Team Leader. Induction training had usually been delivered as an eleven day block over a fortnight. This included an introduction to understanding autism, health and safety, risk management and accredited training in the management of challenging behaviour including the circumstances in which the use of restrictive physical interventions are permitted. Following initial induction, staff were supported to undertake a number of on-line learning modules including more detailed autism-specific and safeguarding training. page 27 of 51

28 Areas for improvement Staff we spoke to thought that the training provided during the first few months at Catrine Bank had been very good but also expressed regret that planned training had sometimes been postponed due to staff shortages. See also Quality Theme 3, Statement 3. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 page 28 of 51

29 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service Strengths Based on our findings during this inspection an adequate standard had been maintained in regard to this quality statement. As noted elsewhere in this report, staff turnover continues to be a serious problem. There have been several successful rounds of staff recruitment and some new recruits have brought relevant and transferable experience to the service. Many of the staff we spoke to presented as well well-motivated and personcentred and, despite evidence of some underlying poor staff morale and continuing staff-turnover, relatives of service users were mostly positive in their descriptions of staff. Most parents that we spoke to described an improvement from last year and comments include: "They try very hard." "It's a difficult job and they're amazing." "They're all for the boys." "They're a great group of staff." Team Leaders told us of plans to hold an 'awards' event which would include long-service awards for longer-serving staff members. Measures like this were intended to help longer serving staff feel that their contribution is recognised and valued. page 29 of 51

30 Following our last inspection we recommended that the National Autistic Society should continue to implement its new targeted rota system. This has continued to be rolled out with a good measure of success for service users with more complex needs but staff shortages and turnover have made it difficult to implement this for all service users. Staff views include that service users with less-complex needs lose out. We saw evidence of very good attention to staff training but also note that this had been affected by staffing shortages. Staff told us that the quality of training had been very good and had equipped them for the work that they do. Members of the Behaviour Support Team had been responsive to specific training needs associated with identified needs (as had the speech and language specialist). Staff members' comments include that the training room had been used more in the past year than in the four previous years. Also that there was a far greater understanding of training being available to all staff and not just for some staff. One staff member felt that, in this respect, the service had become more inclusive. This had included attending conferences which had helped staff to feel much more valued. Staff comments include that attention to qualifying training was much improved with people undertaking this at a steady rate resulting in far more of the staff now having a recognised qualification (SVQ3). Following our last inspection we recommended that, once key teams are established, the National Autistic Society should consider ways of targeting keyteam training specific to the needs of the people they support. Key teams were well established for some service users with an emphasis on maintaining continuity for those with the most complex needs. The benefit of this was evident from review meeting when team leaders confirmed staff had become increasingly confident/competent. This had resulted in a much more consistent approach with the service user with a marked improvement in terms of reduced challenging behaviour (frequency and duration). See also Areas for Improvement. page 30 of 51

Care service inspection report

Care service inspection report Care service inspection report Full inspection 1st Homecare Ltd Housing Support Service Banchory Business Centre Burn O Bennie Road Banchory Inspection completed on 10 June 2016 Service provided by: 1st

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection SSCN Social Care Housing Support Service Suite 3, Floor 2 ELS House 555 Gorgie Road Edinburgh Inspection completed on 03 May 2016 Service provided by: Support

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Stirling Home Care Service Support Service Wallace House 17-21 Maxwell Place Stirling Inspection completed on 13 May 2016 Service provided by: Sue Ryder Service

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Richmondhill House Care Home Service 18 Richmondhill Place Aberdeen Inspection completed on 25 May 2016 Service provided by: Aberdeen Association of Social

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Inspire Huntly Housing Support Service 18 Milton Wynd Huntly Inspection completed on 11 May 2016 Service provided by: Inspire (Partnership Through Life) Ltd

More information

Carr Gomm - Edinburgh Housing Support Service 16-18 London Road Edinburgh EH7 5AT Telephone: 0131 228 6623

Carr Gomm - Edinburgh Housing Support Service 16-18 London Road Edinburgh EH7 5AT Telephone: 0131 228 6623 Carr Gomm - Edinburgh Housing Support Service 16-18 London Road Edinburgh EH7 5AT Telephone: 0131 228 6623 Inspected by: David Todd Type of inspection: Announced (Short Notice) Inspection completed on:

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Assistance In Care Services Ltd Support Service 1 New Law House Saltire Centre Glenrothes Inspection completed on 12 May 2016 Service provided by: Assistance

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Stoneside Flat Care Home Service 18 Stoneside Drive East wood Glasgow Inspection completed on 12 May 2016 Service provided by: Action for Children Service

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Kirkconnel Activity & Resource Centre Support Service Main Street Kirkconnel Sanquhar Inspection completed on 06 May 2016 Service provided by: Dumfries &

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Bield at Home - Linlithgow/Biggar Support Service Westport Resource 1 St Ninians Road Linlithgow Inspection completed on 11 March 2015 Service provided by:

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Skelmorlie After School Club Day Care of Children Skelmorlie Primary School Innes Park Road Skelmorlie Inspection completed on 06 May 2016 Service provided

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Falkirk Council - Leaving Care Service Housing Support Service Unit 1 St Johns Sawmill Etna Road Falkirk Inspection completed on 30 May 2016 Service provided

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Shared Lives Service - Perth & Kinross Adult Placement Service Suite 2 South Inch Business Centre Shore Road Perth Inspection completed on 16 May 2016 Service

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Newcross Healthcare Solutions Aberdeen Branch Nurse Agency Suite K Woodburn House 4/5 Golden Square Aberdeen Inspection completed on 16 May 2016 Service provided

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Annan Activity & Resource Centre Support Service 15 Ednam Street Annan Inspection completed on 05 May 2016 Service provided by: Dumfries & Galloway Council

More information

Oran Home Care Support Service Care at Home Birkbrae Blebo Craigs Cupar KY15 5UG

Oran Home Care Support Service Care at Home Birkbrae Blebo Craigs Cupar KY15 5UG Oran Home Care Support Service Care at Home Birkbrae Blebo Craigs Cupar KY15 5UG Inspected by: Patsy McDermott Type of inspection: Announced Inspection completed on: 15 July 2013 Contents Page No Summary

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Dalweem Care Home Service Taybridge Road Aberfeldy Inspection completed on 03 June 2016 Service provided by: Perth & Kinross Council Service provider number:

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection 33 Malcolms Mount Care Home Service 33 Malcolms Mount Stonehaven Inspection completed on 02 June 2016 Service provided by: Inspire (Partnership Through Life)

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Gorebridge Out of School Care Day Care of Children c/o Gorebridge Primary School 2c Barleyknowe Lane Gorebridge Inspection completed on 14 March 2016 Service

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Milan Day Care Support Service Support Service Portlee Resource Centre for Older People 17 Hawkhill Avenue Edinburgh Inspection completed on 19 May 2016 Service

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Loretto Personalised and Self - Directed Support Services (Glasgow) Housing Support Service 2045-2047 Maryhill Road Glasgow Inspection completed on 29 October

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Willowbank Bungalows 1,2&3 Care Home Service Willowbank Glendaveny Peterhead Inspection completed on 09 May 2016 Service provided by: Aberdeenshire Council

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection School's Out Peebles Day Care of Children Peebles Community Centre Walkershaugh Peebles Inspection completed on 18 May 2016 Service provided by: Perceptive

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Carolton Care Care Home Service 53 Seabank Road Nairn Inspection completed on 05 May 2016 Service provided by: Carolton Care Ltd Service provider number:

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Leonard Cheshire - Dysart Day Support Support Service 91d High Street Dysart Kirkcaldy Inspection completed on 19 May 2016 Service provided by: Leonard Cheshire

More information

Care service inspection report

Care service inspection report Care service inspection report Quality themed inspection (day care for children) Craigour Park Primary School Nursery Class Day Care of Children Craigour Park Primary School Moredun Park Road Edinburgh

More information

Childminder inspection report. Jenni Tots Childcare Glasgow

Childminder inspection report. Jenni Tots Childcare Glasgow Jenni Tots Childcare Glasgow Inspection completed on 26 May 2016 Service provided by: Ballantyne, Jennifer Service provider number: SP2015986781 Care service number: CS2015336256 Inspection Type: Unannounced

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Loreburn Housing Support Service Housing Support Service 27 Moffat Road Dumfries Inspection completed on 31 May 2016 Service provided by: Loreburn Housing

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Tom's Croft Care Home Service Bunachton Inverness Inspection completed on 25 May 2016 Service provided by: Common Thread Ltd Service provider number: SP2005007437

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Community Playgroups (West Calder) Day Care of Children West Calder Community Centre Dickson Street West Calder Inspection completed on 24 May 2016 Service

More information

Childminder inspection report. O'Donnell, Kathleen Edinburgh

Childminder inspection report. O'Donnell, Kathleen Edinburgh O'Donnell, Kathleen Edinburgh Inspection completed on 18 May 2016 Service provided by: O`donnell, Mrs Kathleen Service provider number: SP2003906002 Care service number: CS2003012277 Inspection Type: Unannounced

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Rosyth Support Service - Leonard Cheshire Support Service 195 Queensferry Road Rosyth Dunfermline Inspection completed on 26 May 2016 Service provided by:

More information

Childminder inspection report. Burnett, Margaret Aberdeen

Childminder inspection report. Burnett, Margaret Aberdeen Burnett, Margaret Aberdeen Inspection completed on 08 June 2016 Service provided by: Burnett, Margaret Service provider number: SP2003900448 Care service number: CS2003001722 Inspection Type: Unannounced

More information

Childminder inspection report. Chesworth, Gwenda Muir of Ord

Childminder inspection report. Chesworth, Gwenda Muir of Ord Chesworth, Gwenda Muir of Ord Inspection completed on 04 May 2016 Service provided by: Chesworth, Gwenda Service provider number: SP2003907536 Care service number: CS2003013883 Inspection Type: Announced

More information

Childminder inspection report. McDonald, Gillian Dunfermline

Childminder inspection report. McDonald, Gillian Dunfermline McDonald, Gillian Dunfermline Inspection completed on 20 July 2015 Service provided by: Gillian Mcdonald Service provider number: SP2003904078 Care service number: CS2003007052 Inspection Type: Announced

More information

Childminder inspection report. Still, Angela Aberdeen

Childminder inspection report. Still, Angela Aberdeen Still, Angela Aberdeen Inspection completed on 26 April 2016 Service provided by: Still, Angela Service provider number: SP2003900387 Care service number: CS2003001632 Inspection Type: Unannounced Care

More information

Childminder inspection report. Corbett, Lisa South Queensferry

Childminder inspection report. Corbett, Lisa South Queensferry Corbett, Lisa South Queensferry Inspection completed on 23 March 2016 Service provided by: Corbett, Lisa Service provider number: SP2014986155 Care service number: CS2014328865 Inspection Type: Unannounced

More information

Childminder inspection report. Young, Evelyn and Mirelle Selkirk

Childminder inspection report. Young, Evelyn and Mirelle Selkirk Childminder inspection report Young, Evelyn and Mirelle Selkirk Inspection completed on 19 May 2016 Service provided by: Evelyn and Mirelle Young a Partnership Service provider number: SP2003908200 Care

More information

Aspirations Support Bristol Limited

Aspirations Support Bristol Limited Aspirations Support Bristol Limited Aspirations Support Bristol Inspection report Design House 26 South View Staple Hill Bristol BS16 5PJ Tel: : 0117 965 1447 Website: www.aspirations-support.co.uk Date

More information

Childminder inspection report. Charlene Morning Child Minding Service Glasgow

Childminder inspection report. Charlene Morning Child Minding Service Glasgow Charlene Morning Child Minding Service Glasgow Inspection completed on 02 May 2016 Service provided by: Morning, Charlene Service provider number: SP2015986975 Care service number: CS2015337662 Inspection

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Forth Valley Housing Support Housing Support Service 14 New Mart Road Edinburgh Inspection completed on 10 March 2016 Service provided by: Abbeyfield Scotland

More information

Care service inspection report

Care service inspection report Care service inspection report Quality themed inspection (day care for children) Stanley Primary School Nursery Class Day Care of Children Stanley Road Ardrossan Inspection completed on 01 June 2016 Service

More information

Care service inspection report

Care service inspection report Care service inspection report Quality themed inspection (day care for children) Rising Stars Mobile Play Team Day Care of Children Adelphi Centre 12 Commercial Road Glasgow Inspection completed on 08

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Adalia Wood Care Home Service Orkie Miln Farmhouse Kingskettle Cupar Inspection completed on 25 May 2016 Service provided by: Adalia Wood Ltd Service provider

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection The Paddock Care Home Service The Paddock Ochiltree Cumnock Inspection completed on 11 April 2016 Service provided by: Radical Services Ltd Service provider

More information

Childminder inspection report. Pitcairn Childminding Glenrothes

Childminder inspection report. Pitcairn Childminding Glenrothes Pitcairn Childminding Glenrothes Inspection completed on 27 May 2016 Service provided by: Tracey Docherty trading as Pitcairn Childminding Service provider number: SP2011981555 Care service number: CS2011281193

More information

Childminder inspection report. Roach, Jacqueline Livingston

Childminder inspection report. Roach, Jacqueline Livingston Roach, Jacqueline Livingston Inspection completed on 16 February 2016 Service provided by: Roach, Jacqueline Service provider number: SP2003910099 Care service number: CS2003015632 Inspection Type: Announced

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. The Manor House Whitton Road, Alkborough, Nr Scunthorpe, DN15

More information

Care service inspection report

Care service inspection report Care service inspection report Quality themed inspection (day care for children) Queen Street Nursery School Day Care of Children Queen Street Falkirk Inspection completed on 01 June 2016 Service provided

More information

Dalry Out Of School Care Day Care of Children Dalry Community Centre St. Margaret's Avenue Dalry KA24 4BA Telephone: 01294 835812

Dalry Out Of School Care Day Care of Children Dalry Community Centre St. Margaret's Avenue Dalry KA24 4BA Telephone: 01294 835812 Dalry Out Of School Care Day Care of Children Dalry Community Centre St. Margaret's Avenue Dalry KA24 4BA Telephone: 01294 835812 Inspected by: Catherine Bain Type of inspection: Unannounced Inspection

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Kumari Care Limited 5 Palace Yard Mews, Queen Square, Bath,

More information

Details about this location

Details about this location Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Prince George Duke of Kent Court Shepherds Green, Chislehurst,

More information

Diamond Childcare Agency Child Care Agency Unit 3a Whitecrook Business Centre 78 Whitecrooks Street Clydebank G81 1QF Telephone: 0141 951 4754

Diamond Childcare Agency Child Care Agency Unit 3a Whitecrook Business Centre 78 Whitecrooks Street Clydebank G81 1QF Telephone: 0141 951 4754 Diamond Childcare Agency Child Care Agency Unit 3a Whitecrook Business Centre 78 Whitecrooks Street Clydebank G81 1QF Telephone: 0141 951 4754 Inspected by: Donna Laing Type of inspection: Unannounced

More information

The Hut - Lumphanan Preschool Day Care of Children Lumphanan Recreation Park School Road Lumphanan Banchory AB31 4SU

The Hut - Lumphanan Preschool Day Care of Children Lumphanan Recreation Park School Road Lumphanan Banchory AB31 4SU The Hut - Lumphanan Preschool Day Care of Children Lumphanan Recreation Park School Road Lumphanan Banchory AB31 4SU Inspected by: Karen Provan Type of inspection: Unannounced Inspection completed on:

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Playdays Nursery School Day Care of Children 4 East Suffolk Road Newington Edinburgh Inspection completed on 27 April 2016 Service provided by: Mohamed, Ashira

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Royal Free Hospital Urgent Care Centre Royal Free Hospital,

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection St. Serf's R C Primary School Nursery Day Care of Children Preston Street High Valleyfield Dunfermline Inspection completed on 14 January 2016 Service provided

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Kingsmead Nursing Home Care Home Service Kingswood Drive Kingswells Aberdeen Inspection completed on 26 May 2016 Service provided by: Mead Medical Services

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Home Care Services - Mainstream Team Housing Support Service Southbank House Southbank Business Park Kirkintilloch Glasgow Inspection completed on 29 April

More information

Care service inspection report

Care service inspection report Care service inspection report Validation inspection Windyedge Care Home Care Home Service 55A Strathmore Avenue Forfar Inspection completed on 24 May 2016 Service provided by: Thomas Dailey trading as

More information

Childminder inspection report. Hulse, Hazel Inverurie

Childminder inspection report. Hulse, Hazel Inverurie Hulse, Hazel Inverurie Inspection completed on 21 March 2016 Service provided by: Hulse, Hazel Service provider number: SP2008968596 Care service number: CS2008169823 Inspection Type: Unannounced Care

More information

Care service inspection report

Care service inspection report Care service inspection report Quality themed inspection (day care for children) Rainbow Childcare and Education Ltd Day Care of Children Little Crook Forres Inspection completed on 13 May 2016 Service

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection 3 Bridges Care Home Care Home Service 108 Carmunnock Road Glasgow Inspection completed on 29 April 2016 Service provided by: Northcare (Scotland) Ltd Service

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Harrow Health Limited 37 Love Lane, Pinner, Harrow, HA5 3EE

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Balnacraig School School Care Accommodation Service Fairmount Terrace Perth Inspection completed on 27 May 2016 Service provided by: Balnacraig School Service

More information

Care service inspection report

Care service inspection report Care service inspection report Quality themed inspection (day care for children) Longniddry Primary School Nursery Day Care of Children Kitchener Crescent Longniddry Prestonpans Inspection completed on

More information

Capability Scotland - Sycamore Service Day Care of Children Westerlea 11 Ellersly Road Edinburgh EH12 6HY Telephone: 0131 347 1077

Capability Scotland - Sycamore Service Day Care of Children Westerlea 11 Ellersly Road Edinburgh EH12 6HY Telephone: 0131 347 1077 Capability Scotland - Sycamore Service Day Care of Children Westerlea 11 Ellersly Road Edinburgh EH12 6HY Telephone: 0131 347 1077 Type of inspection: Unannounced Inspection completed on: 25 March 2015

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Telegraph House 97 Telegraph Road, Deal, CT14 9DF Tel: 01304369031

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Bury DCA United Response, City View Business Centre, 9 Long

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inglewood Nursing Home Deal Road, Redcar, TS10 2RG Date of Inspection:

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Dalry Out Of School Care Day Care of Children Dalry Community Centre St. Margaret's Avenue Dalry Inspection completed on 20 April 2016 Service provided by:

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Inverclyde Centre Housing Support Service 98 Dalrymple Street Greenock Inspection completed on 26 April 2016 Service provided by: Inverclyde Council Service

More information

Publications code: REG-0812-032. Registering and running a childminding service: what you need to know

Publications code: REG-0812-032. Registering and running a childminding service: what you need to know Publications code: REG-0812-032 Registering and running a childminding service: what you need to know Contents Introduction 1 Section 1: What is childminding? 2 Section 2: Before you apply to register

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Care & Support at Home Housing Support Service Hillend Centre 2 East Crawford Street Greenock Inspection completed on 12 May 2016 Service provided by: Inverclyde

More information

Residential key lines of enquiry (KLOE), prompts and potential sources of evidence

Residential key lines of enquiry (KLOE), prompts and potential sources of evidence Residential key lines of enquiry (KLOE), prompts and potential sources of evidence Introduction We have developed the key lines of enquiry (KLOEs), prompts and sources of evidence sections to help you

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Mugdock House Care Home Care Home Service Stockiemuir Road Bearsden Glasgow Inspection completed on 20 May 2016 Service provided by: BUPA Care Homes (ANS)

More information

SCAN Program (Supporting Children with Additional Needs)

SCAN Program (Supporting Children with Additional Needs) NOVEMBER 2013 SCAN Program (Supporting Children with Additional Needs) Grant program guidelines The aim of the SCAN Program (Supporting Children with Additional Needs) is to improve access to funded preschools

More information

Abbey College Cambridge

Abbey College Cambridge S c h o o l r e p o r t Abbey College Cambridge 17 Station Road, Cambridge, CB1 2JB Inspection dates 28 30 January 2014 Overall effectiveness 1 Pupils achievement 1 Pupils behaviour and personal development

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Dr R C Gulati & Dr P Gulati 357-359 Dickenson Road, Longsight,

More information

Harrow Council. Overall rating for this service Good. Inspection report. Ratings. Overall summary. Is the service safe? Good

Harrow Council. Overall rating for this service Good. Inspection report. Ratings. Overall summary. Is the service safe? Good Harrow Council Harrow Council - Harrow Shared Lives Inspection report PO Box 7 Adults & Housing Services Civic Centre Harrow Middlesex HA1 2UH Tel: 020 8736 6070 Website: www.harrow.gov.uk Date of inspection

More information

Inspection dates 19 21 March 2014. Effectiveness of leadership and management

Inspection dates 19 21 March 2014. Effectiveness of leadership and management Further Education and Skills inspection report Date published: 25 April 2014 Inspection Number: 429097 URN: 131959 Portland College Independent specialist college Inspection dates 19 21 March 2014 Overall

More information

Job Description. Senior Support Worker

Job Description. Senior Support Worker Job Description Senior Support Worker Introduction Autism Initiatives is committed to working in partnership with service users, their families, commissioners and others to provide a specialist, autism

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Sunrise Operations of Westbourne 16-18 Poole Road, Westbourne,

More information

Kilfillan House Care Home

Kilfillan House Care Home Bupa Care Homes (BNH) Limited Kilfillan House Care Home Inspection report Graemesdyke Road Berkhamsted Hertfordshire HP4 3LZ Date of inspection visit: 06 April 2016 Date of publication: 20 May 2016 Ratings

More information

CHILDREN AND ADULTS SERVICE RESEARCH APPROVAL GROUP

CHILDREN AND ADULTS SERVICE RESEARCH APPROVAL GROUP DURHAM COUNTY COUNCIL CHILDREN AND ADULTS SERVICE RESEARCH APPROVAL GROUP INFORMATION PACK Children and Adults Service Version 4 October 2015 Children and Adults Service Research Approval Group Page 1

More information

Report on announced visit to: The Rohallion Clinic, Murray Royal Hospital, Perth PH2 7BH

Report on announced visit to: The Rohallion Clinic, Murray Royal Hospital, Perth PH2 7BH Mental Welfare Commission for Scotland Report on announced visit to: The Rohallion Clinic, Murray Royal Hospital, Perth PH2 7BH Date of visit: 10 March 2016 Where we visited The Rohallion Clinic opened

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Amvale Medical Transport - Ambulance Station Unit 1D, Birkdale

More information

Care Services in Ferry House - A Review

Care Services in Ferry House - A Review Care service inspection report Full inspection Ferry House Residential Home Care Home Service 8 Gray Street Broughty Ferry Dundee Inspection completed on 03 June 2016 Service provided by: Ferry House Residential

More information

Care service inspection report

Care service inspection report Care service inspection report Full inspection Fairknowe Care Home Service Fairknowe House 3 Cargill Road Maybole Inspection completed on 05 May 2016 Service provided by: Mead Medical Services Limited

More information

Records that all registered care services (except childminding) must keep and guidance on notification reporting

Records that all registered care services (except childminding) must keep and guidance on notification reporting Records that all registered care services (except childminding) must keep and guidance on notification reporting Publication date: February 2012 Amended: 1 April 2015: Changes made on notifying adverse

More information

United Response. Overall rating for this service Good. Inspection report. Ratings. Overall summary. Is the service safe? Good

United Response. Overall rating for this service Good. Inspection report. Ratings. Overall summary. Is the service safe? Good United Response Kumba Imani Millenium Centre Inspection report 4 Princes Road Toxteth Liverpool L8 1TH Tel: 0151 203 1125 Website: www.unitedresponse.org.uk Date of inspection visit: 6 and 29 August and

More information

Age UK Rotherham. Age Concern Rotherham Limited. Overall rating for this service. Inspection report. Ratings. Good

Age UK Rotherham. Age Concern Rotherham Limited. Overall rating for this service. Inspection report. Ratings. Good Age Concern Rotherham Limited Age UK Rotherham Inspection report Galax Building Fitzwilliam Road, Eastwood Trading Estate Rotherham South Yorkshire S65 1SL Tel: 01709835214 Website: www.ageuk.org.uk/rotherham

More information

Acute services with overnight beds Rehabilitation services Date of Publication: October 2012

Acute services with overnight beds Rehabilitation services Date of Publication: October 2012 Review of compliance East Sussex Healthcare NHS Trust Irvine Unit Bexhill Hospital Region: Location address: Type of service: South East Holliers Hill Bexhill-on-Sea East Sussex TN40 2DZ Acute services

More information

Inspection report for children's home. Unique reference number. Type of Inspection

Inspection report for children's home. Unique reference number. Type of Inspection Inspection report for children's home Unique reference number Inspection date Inspector Type of Inspection SC002264 12 October 2009 Caroline Brailsford Key Date of last inspection 23 February 2009 . Crown

More information

Seedlings Montessori at Moorlands

Seedlings Montessori at Moorlands Seedlings Montessori at Moorlands Inspection report for early years provision Unique reference number 6028 Inspection date /03/200 Inspector Brian Evans Setting address Telephone number 023 8046 2555 Email

More information

SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST EXECUTIVE SUMMARY REPORT TO THE TRUST HEALTHCARE GOVERNANCE COMMITTEE

SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST EXECUTIVE SUMMARY REPORT TO THE TRUST HEALTHCARE GOVERNANCE COMMITTEE SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST EXECUTIVE SUMMARY REPORT TO THE TRUST HEALTHCARE GOVERNANCE COMMITTEE I TO BE HELD ON MONDAY 26 NOVEMBER 2012 Subject: Supporting Director: Author: Status

More information

Enhanced dementia practice for social workers and other professionals

Enhanced dementia practice for social workers and other professionals Guidance for trainers Enhanced dementia practice for social workers and other professionals Online resource http://workforcesolutions.sssc.uk.com/enhanced-dementia-practice Understanding dementia Personal

More information

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards.

We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Quince House 77 Adeyfield Road, Hemel Hempstead, HP2 5DZ Tel:

More information

Summerfield Medical Limited

Summerfield Medical Limited Summerfield Medical Limited Summerfield Nursing Unit Inspection report 58 Whittington Road Cheltenham GL51 6BL Tel: 01242 259260 Website: www.summerfieldnursing.co.uk Date of inspection visit: 1 and 2

More information

Care and Social Services Inspectorate Wales

Care and Social Services Inspectorate Wales Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Aylecare Domiciliary Services 11 Alexandra Road Gorseinon Swansea SA4 4NW Type of Inspection Baseline Date(s) of inspection

More information