New Breaks Care Home Service Children and Young People Birns Farm Cottage West Skichen Carmyllie Arbroath DD11 2QX Telephone:

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1 New Breaks Care Home Service Children and Young People Birns Farm Cottage West Skichen Carmyllie Arbroath DD11 2QX Telephone: Inspected by: Marion Neil Type of inspection: Announced (Short Notice) Inspection completed on: 4 March 2013

2 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 17 5 Summary of grades 18 6 Inspection and grading history 18 Service provided by: New Breaks Ltd Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Marion Neil Telephone enquiries@careinspectorate.com New Breaks, page 2 of 19

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 N/A Quality of Environment N/A Quality of Staffing N/A Quality of Management and Leadership 4 Good What the service does well The manager was skilled at identifying service areas for improvement. She was open to suggestions for improvement and sought external advice. She worked well with her staff team to change and improve the service. What the service could do better To continue consultation and participation with service users. The manager may wish to consider developing a policy statement confirming that other family members will not at any time be in the part of the property where the service users reside. To continue to work on the service's action plan, in order to finalise the suggested amendments to the service's policies and procedures, as detailed above (items 1-10). New Breaks, page 3 of 19

4 What the service has done since the last inspection Inspection report continued The manager of the service had carried out a comprehensive and effective review of the services policies and procedures. The recruitment of staff and the employment status of staff were reviewed and updated. The manager of the service had sought additional external support, to assist her in these tasks. Conclusion The service was now in a position to offer placements to children and young people. The manager had worked very well with the regulator to ensure that all suggested improvements were met. Almost all of these improvements were identified by the provider of the service. Who did this inspection Marion Neil Lay assessor: Not Applicable New Breaks, page 4 of 19

5 1 About the service we inspected Before the 1 April 2011, this service was registered with the Care Commission. On this date the new body, Social Care and Social Work Improvement Scotland, (SCSWIS), known as the Care Inspectorate, took over the work of the Care Commission, including the registration of care services. This means that from the 1 April 2011 this service continued its registration under the new body, the Care Inspectorate. New Breaks provides a 24 hour care home service for up to 2 children or young people. It provides respite and/or crisis, short to medium term, accommodation and personal support to vulnerable children and young people, from 7 to 18 years of age, who are cared for by the local authority. The service has one mainstay house in a rural setting. The location of the second house is identified according to the child or young person's care plan. The service is managed by a registered manager and a small staff team of experienced care workers. The service aims to work with children and young people in crisis and return them to their home living situation. Where this is not possible they will work with the placing authority to implement individual personal plans and help move the children/young people on to a planned placement. These children/young people will often be at risk of being admitted to secure accommodation. New Breaks conditions of registration are: To provide a care service to a maximum of two young people aged between seven and eighteen years of age. The accommodation provided shall be at Birns Farm cottage, West Skichen, Carmyllie, Angus, DD11 2QX and at further unspecified addresses. To comply with the current staffing schedules attached dated 15th October 2010, which must be displayed together with the certificate. The aims and objectives of New Breaks include: "... contribute to making a positive difference to the lives of children and young people between the ages of 7 and 18 years, who are experiencing a period of crisis or would benefit from a short to medium term placement, in order to meet their longer term placement needs. New Breaks focuses on the provision of high quality, safe and homely placements, which allow for the progression and opportunity for the child and young person to achieve their full potential in areas such as; New Breaks, page 5 of 19

6 physical and mental health and well-being, education, training and employment, relationships and supports and placement opportunities. Positive progression in these areas is achieved through - the persistence of a small, professionally supported and caring staff team, a calming and homely environment, a solution focused approach, the provision of pro social modelling and support, and facilitation to access key supports and activities which are beneficial to the child or young person." Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - N/A Quality of Environment - N/A Quality of Staffing - N/A Quality of Management and Leadership - Grade 4 - Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. New Breaks, page 6 of 19

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 This inspection was carried out in a short notice visit to the service which took place on the 04 March It was conducted by Marion Neil, Inspector with the Care Inspectorate. She gave feedback about the inspection to the Manager and to one of the members of staff, at the end of this visit, which took approximately 4 hours. There were no service users present during the visit. We carried out a high intensity inspection. We carry out these inspections when we are monitoring a service's progress, eg because an serious incident has taken place, or because serious concerns have been raised about the service. We looked at one theme - the Quality of Management and Leadership. We looked at evidence for two Quality statements in this theme. As this was a second inspection of the service, the service was not required to re-submit the Annual Return and the Self Assessment form. The purpose of the inspection was to assess the progress the service's manager and staff team had made in identifying improvements and in carrying these out. As regulators, we had received a letter of concern from a former staff member, although he had not made an official complaint to us. The nature of the concerns about the service prompted us to visit the service and consider the information given. The improvements noted above had been initiated by the manager of the service. During the inspection visit we talked to the Manager, the Assistant manager - who was present for most of the inspection visit, and to one member of the staff team. We reviewed a number of documents to confirm - that the Manager had carried out improvements over the past 4 months, to consider the concerns raised made by the former staff member. The Manager, the Assistant Manager and the member of staff were cooperative throughout our visit. They provided us with all the documents we asked to see. The inspection visit lasted approximately 4 hours. At the time of the inspection visit there were no service users. New Breaks, page 7 of 19

8 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 report continued 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 New Breaks, page 8 of 19

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: 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. This was a second inspection of this service so the service was not required to resubmit the Self assessment form. Taking the views of people using the care service into account There were no service users using the service at the time of the inspection visit. Taking carers' views into account There were no service users using the service at the time of the inspection visit. New Breaks, page 9 of 19

10 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 - NOT ASSESSED New Breaks, page 10 of 19

11 Quality Theme 2: Quality of Environment - NOT ASSESSED New Breaks, page 11 of 19

12 Quality Theme 3: Quality of Staffing - NOT ASSESSED New Breaks, page 12 of 19

13 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths There were no service users using the service at the time of our inspection visit. However, the service had revised its policies and procedures. The manager confirmed to us that it was her intention to continue to consult with service users, eg the service had template questionnaires in place to seek the views of service users. This would ensure, she said, that service users were given opportunities to make suggestions for improvement. The grade awarded at the previous inspection, grade 5, very good, is confirmed. Areas for improvement To continue consultation and participation with service users. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide Service strengths We found that the service had carried out almost all of the areas for improvement that they identified in an Action Plan submitted to us during a meeting held on the 30 October During the inspection visit we talked to the manager, the assistant manager and to a member of the staff team about the progress made to date on the action plan. We looked at records and documents associated with the action plan, as detailed below. We talked to the manager and the member of staff, and reviewed further records, to consider the concerns raised by a former staff member. New Breaks, page 13 of 19

14 The reason for the action plan was to address areas of improvement, identified by the service following notification to us of an allegation of abuse against a service user. The service had reported a (now former) member of staff to the appropriate authorities (the Public Protection Unit, Dundee City Council Social Work Department and the Scottish Social Services Council) in October This was because another member of staff made an allegation against him about alleged abuse of a service user. Whilst the investigation about this allegation was taking place, we met with the manager on 30 October During the meeting she presented us with an action plan to improve aspects of the service. She said that the improvements were identified to strengthen the services policies, procedures and protocols. This would mean that the risk of any further incidents was minimised. At the time of the meeting, the service did not have any service users. The manager informed us at this meeting that it was not her intention to accept any further service users, until such time as the action plan was completed. This was her suggestion, and was not imposed by the Care Inspectorate. 1) We found at the inspection visit that some aspects of the action plan were to be revised. This was because some changes could not be made until the service had service users again. The manger told us that these changes would remain ongoing. 2) The service is now registered with the Confederation of Small Businesses. The service was employing a Human Resources consultant, covering safer recruitment and health and safety. The manager told us that working with this consultant meant that all staff who work for the service will be employed, rather than self employed. She stated that she thinks changing the employment status of staff in this way means that staff will have greater accountability. 3) The review of job descriptions, reviewed with assistance from the service's external consultant, was completed. We saw a sample of these on the day. They were comprehensive. 4) The service's Induction checklist was reviewed to bring it in line with best practice guidance from the SSSC. It was now linked to staff supervision, individual learning plans for staff and SSSC registration requirements. We saw a sample of this on the day of the inspection. It was satisfactory. 5) The Manager had identified courses for new staff. Attending these would enhance the induction process. The manager said that attendance at these would provide the service with further evidence of staff awareness and understanding of the service's policies and procedures. New Breaks, page 14 of 19

15 6) We reviewed the service's amended whistle blowing policy. We noted that it now included the telephone numbers of external consultants whom staff could approach with their concerns. 7) At the time of the inspection visit, the manager was working with one of the Directors of CALM (Crisis, Aggression, Limitation and Management) on a review of the services challenging behaviour policy. The changes would mean that the policy was linked more effectively with the services de-briefing policy, staff safety and CALM principles. The manager discussed the areas were changes were made with us. 8) The manager was continuing to revise and develop further the services positive behaviour policy. This work would link it to the challenging behaviour policy. The manager is working with the Director from CALM on this too. The manager outlined the areas were changes were made to us. 9) The manager confirmed that she was, at the time of our visit, waiting for further feedback from the Director of CALM on both these policies. 10) The manager confirmed that she was continuing to develop a trauma-informed care approach. This would be linked to the well-being web (based on the principles of Getting It Right For Every Child and SHANARRI - Safe, Healthy, Achieving, Nurtured, Active, Respected, Responsible and Included) to evidence outcomes for young people. The manager is currently identifying future training opportunities for developing these different approaches. Other areas of the action plan which were still being developed included - a) Further developing the service's protocol for de-briefing staff after an incident, and reviewing the recording of incidents. b) The manager had sourced risk management guidance to assist in further development of behavioural risk assessments. We saw samples of these. The guidance was appropriate to further developing behavioural risk assessments. c) The manager was developing a violence against staff policy and protocol. d) Further development of the service's policy and procedure for external visitors to the service was continuing. The manager told us that where appropriate, she was making effective use of external consultants to support her in developing the areas identified in the action plan eg the service's original consultant, the Human Resources Consultant and the Director of CALM. New Breaks, page 15 of 19

16 The following areas of the action plan were completed or well under way to completion - 1) Screening interviews, in line with Scottish Government's Safer Recruitment Guidance were completed for 3 members of staff. Further screening interviews were scheduled to take place with the other 2 members of the staff team, including the manager. 2) The manager had now strengthened the management structure by working with external consultants, as detailed above. We found that the manager had made significant progress in the completion of the action plan. We discussed with the manager the service once again accepting placements for service users. The manager told us that one of the local authorities who used the service asked the service to make some minor amendments to 3 of their policies, eg to bring the services child protection policy in line with the local authority one, to review the services complaints procedure, and smoking policy. We suggested that the service should now proceed with these amendments. The manager confirmed that she would now be completing this work and resubmitting her service's policies and procedures. This would mean that the service was considered for approved provider status with the local authority in question. Once these reviews were completed, it was agreed with the manager that she would notify local authorities that the service was accepting placements for service users. We also considered concerns raised with us by a former member of staff. We looked at the issues and relevant information and documents. On balance, we found no information giving rise to concern. The grade awarded at the previous inspection - grade 4 - good, was therefore confirmed. Areas for improvement To continue to work on the service's action plan, in order to finalise the suggested amendments to the service's policies and procedures, as detailed above (items 1-10). Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued New Breaks, page 16 of 19

17 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 noted. 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 SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1). New Breaks, page 17 of 19

18 5 Summary of grades Quality of Care and Support - Not Assessed Quality of Environment - Not Assessed Quality of Staffing - Not Assessed Quality of Management and Leadership Good Statement 1 Statement Very Good 4 - Good 6 Inspection and grading history Date Type Gradings 16 May 2012 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 4 - Good 18 Jan 2012 Unannounced Care and support Not Assessed Environment Not Assessed Staffing 4 - Good Management and Leadership 4 - Good 24 Aug 2011 Unannounced Care and support 4 - Good Environment 5 - Very Good Staffing 4 - Good Management and Leadership 4 - Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. New Breaks, page 18 of 19

19 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 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: or by telephoning Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: enquiries@careinspectorate.com Web: New Breaks, page 19 of 19