Fairbairn Street Young People's Unit Care Home Service Children and Young People 7 Fairbairn Street Dundee DD3 7JH Telephone:

Transcription

1 Fairbairn Street Young People's Unit Care Home Service Children and Young People 7 Fairbairn Street Dundee DD3 7JH Telephone: Inspected by: Linda Paterson Type of inspection: Unannounced Inspection completed on: 16 January 2012

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 10 4 Other information 19 5 Summary of grades 20 6 Inspection and grading history 20 Service provided by: Dundee City Council Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Linda Paterson Telephone enquiries@scswis.com Fairbairn Street Young People's Unit, page 2 of 22

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 5 Very Good Quality of Environment 5 Very Good Quality of Staffing Quality of Management and Leadership N/A N/A What the service does well The service provides a very good standard of care and support for young people. Staff listen well to young people's views and take these into account when making plans. They make every effort to make sure that young people are safe, healthy and supported to reach their potential. What the service could do better In conjunction with the local authority and other agencies, the service should review and develop its approach to helping young people to use the internet safely. What the service has done since the last inspection The service has continued to develop and provide a consistently high quality of care for young people. Conclusion This service provides young people with a very high standard of care and support. The acting manager and staff team work effectively with young people, families and other agencies to achieve positive outcomes. They use their skills and knowledge of current good practice guidance to evaluate and improve the quality of the service. Fairbairn Street Young People's Unit, page 3 of 22

4 Who did this inspection Linda Paterson Lay assessor: Not applicable Fairbairn Street Young People's Unit, page 4 of 22

5 1 About the service we inspected Fairbairn Street is a modern purpose-built residential care home for children and young people located in the Dens Road area of Dundee. The service is provided by Dundee City Council's Social Work Department. Before 1 April 2011 this service was registered with the Care Commission. On this date the new scrutiny body, Social Care and Social Work Improvement Scotland (the Care Inspectorate), took over the work of the Care Commission, including the registration of care services. This means that from 1 April 2011 this service continued its registration under the new body, the Care Inspectorate. The service is registered to care for up to five children. The statement of aims and objectives says that the service is to be provided to children between the ages of 13 and 16+ years, most of who will be supported towards living independently when they leave. At the time of the inspection, there were four young people living at Fairbairn Street. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 5 - Very Good Quality of Environment - Grade 5 - Very Good Quality of Staffing - N/A Quality of Management and Leadership - N/A 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. Fairbairn Street Young People's Unit, page 5 of 22

6 2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care. What we did during the inspection We wrote this report following an unannounced visit to the service on 10 January 2012; we made a second visit to the service the following day, 11 January, and had a meeting with the acting manager of the service on 16 January to give feedback. The inspector was Linda Paterson. The purpose of this inspection was to look at the service's performance in relation to the quality of care and support and the quality of the environment. Before the inspection, the service submitted a self assessment document. We also received three completed pre-inspection questionnaires from young people who use the service. During the inspection, we gathered information from various sources, including: * discussion with the acting manager of the service * discussion with three members of care staff * discussion with three young people * observation of interaction between staff and young people * sample of three care plans * sample of minutes of young people's meetings * sample of evaluation forms from young people, parents, social work and education * sample of team meeting minutes * records of accidents, incidents and complaints * staff training records We took this evidence into account when deciding the grades for each quality statement. Fairbairn Street Young People's Unit, page 6 of 22

7 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 Fairbairn Street Young People's Unit, page 7 of 22

8 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. We received a fully completed self assessment document from the service provider. We were satisfied with the way the service provider had completed this and with the relevant information they had given us for each of headings that we grade them under. The service provider identified what they thought they did well, some areas for development and any changes they had planned. The service provider told us how the people who used the care service were involved in the evaluation process. Taking the views of people using the care service into account We spoke to three of the young people who are currently living in Fairbairn Street. Two of them told us that they are very happy with the quality of the service, and commented positively about the accommodation, the food and the efforts which staff make to support and guide them. Both said that they are treated fairly and that their privacy is respected. The third person we spoke to had some issues about some aspects of her care, and we have noted her comments about the accommodation under QS 2.3. With regard to other issues, we noted during the inspection that the young person was able to raise issues confidently with staff, and that staff responded appropriately and consistently. Some of the comments made by young people were: "Staff are fair and they really listen to you. They give you good advice." "The staff encourage you to be healthy. They have tried to get me to register with a doctor - they couldn't do any more to help." "Staff try to give you a bit more freedom - you can negotiate with them and that makes you want to stay." "The worst thing about being here is having to come in when you're having a brilliant time." "I really like my room - its a brilliant room and the bed's really comfy" "The staff will listen to you" Fairbairn Street Young People's Unit, page 8 of 22

9 "I don't like going into the bathroom after the boys as they always leave it messy. I would rather have an en-suite." In addition, we received three pre-inspection questionnaires from young people. Of these, one "agreed" and two "strongly agreed" that they were happy overall with the quality of care they received. One young person had made a humerous comment which he asked us not to include as he felt he was "more mature now". Taking carers' views into account We did not have the opportunity to speak to parents during this inspection: however, we received written feedback from social workers who have case responsibility for three of the young people who currently use the service. All three said that they were satisfied with the quality of care and support provided by Fairbairn Street. They felt that young people were safe and their health needs were identified and met. They confirmed that staff worked in partnership with them to take forward care plans for young people, and said that communication was good. The following comments were made: "My experience of working with staff from Fairbairn Street has been positive. Everyone is child focused and wants the best possible outcome for young people" "Through my observations and communications with staff and with X, I would say that he is respected and treated in a non-judgemental way by staff. Staff have also demonstrated a great deal of "stickability" in providing X with ongoing advice, guidance and support in sometimes difficult circumstances." Fairbairn Street Young People's Unit, page 9 of 22

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 Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths The service has very good arrangements in place to encourage young people and their parents or carers to participate in assessing and improving the quality of care and support they receive. From the self assessment form, and from evidence gathered during the inspection, we found the following strengths: * young people are closely involved in the care planning process. Both they and significant family members are involved in regular planning meetings with their key worker and social worker, during which the details of day-to-day care and future plans are worked out. * in discussion, staff gave examples of how they have worked in partnership with young people and their families to develop a shared approach to caring for young people: we could see that effective partnership working has helped to promote the safety of some young people; * staff within the service encourage young people to write in their own files: although there wasn't a lot of evidence to show that young people had taken up this opportunity, it was another example of the commitment of the service to creating a sense of openness and ownership of of care plans; * in discussion, young people confirmed that staff involved them in discussions about all aspects of their care; * young people could also have their say about the service at house meetings: we saw that these had not been held very often, due to the current group of young people being older and spending more time out of the unit. When they were held, we saw that young people did feel empowered to put items on the agenda, and raise issues which are important to them, such as behaviour in the group, and fairness. Fairbairn Street Young People's Unit, page 10 of 22

11 * some meetings had involved the Who Cares support worker as an independent facilitator; * the service uses questionnaires to seek the views of young people, parents and other stakeholders about all aspects of the service: a new, pictorial format designed by one of the previous users of the service has been piloted and will be used in future consultations; * the format of staff team meetings has been arranged to include issues raised by young people; * young people have been consulted about the development of key policies within residential services, e.g. the Clear Expectations policy, which helps young people to take more responsibility for their own behaviour and to understand the consequences of this; * one young person from Fairbairn Street has been involved in the development of Dundee City Council's corporate parenting initiative, the Champion's Board. Overall, we found that this service has a genuine commitment to enabling young people, their familes and other agencies to participate in improving the quality of care and support they receive. They use a variety of both informal and formal methods to encourage participation, and have sought the input of independent advocacy services to support young people to express their views. All of the young people we spoke to during the inspection confirmed that staff listen to their views and take them into account. Areas for improvement none noted at this inspection. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 We ensure that service user's health and wellbeing needs are met. Service strengths Inspection report continued We found that there are very good arrangements in place to make sure that the health and wellbeing needs of young people are met. From the self assessment form and during the inspection, we noted the following strengths: - young people's health needs are identified and recorded in their care plans; Fairbairn Street Young People's Unit, page 11 of 22

12 - the service has very good links with LAAC nurse who is notified by staff when a young person is admitted to the service, and who visits and assesses needs within first few days; - very good attention is paid to following up on health issues including referring for medical treatment, first aid, and contact with specialist agencies when needed; - there was good evidence in care plans of staff responding to young peoples' requests for help with health-related issues, and encouraging them to attend appointments eg GP, dental, counselling; two of the young people we spoke to during the inspection told us that staff had given them every encouragement to seek appropriate medical help; - we saw evidence in 1:1 notes about discussions about women's health and sexual health issues which was noted as being "reassuring" for young person; - we also saw evidence of sensitive discussion with young people about feelings and concerns; - in discussion with staff, they showed that they knew and understood the young people and their behaviour well; they showed how this had helped young people to engage in the care plan and make progress; - there is a clear medication policy and procedure in place: staff have received training in this; - young people are encouraged to self-medicate appropriately: we saw that risk assessments are in place to support this; - the service has an appropriate range of policies to promote a healthy lifestyle for young people: in particular, the nutritional policy sets out clear guidance for staff about the provision of a balanced diet: menus are devised with young people in line with the guidance; - the LAAC nurse will provide smoking cessation support: this has been taken up on more than one occasion by young people at Fairbairn Street; - staff encourage young people to be active, eg they are encouraged to walk to school where possible, and are supplied with gym and swimming passes as required; in better weather, staff make good use of back garden for football and other activities; Fairbairn Street Young People's Unit, page 12 of 22

13 - staff have good knowledge and information about national and local resources which are focused on health and wellbeing needs of young people; in addition, we found examples of staff using their own contacts to link young people into sports activities. In summary, we found that the service is very good at meeting the health and wellbeing needs of young people, and the strengths noted during this inspection have a positive impact on the quality of care and support the young people receive. Areas for improvement none noted at this inspection. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Fairbairn Street Young People's Unit, page 13 of 22

14 Quality Theme 2: Quality of Environment Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the environment within the service. Service strengths The service has very good arrangements in place to enable young people to participate in assessing and improving the quality of the service. The range of methods, which we have described under QS 1.1, include 1:1 meetings, planning meetings and house meetings, some of which are chaired by an independent advocate. The service has an ethos of asking for and valuing the views of young people, so both informal and formal methods of involving young people are used effectively. In relation to the environment, we found the following strengths: - young people were allowed/encouraged to personalise their own rooms with soft furnishings, posters, pictures, and even some graffiti art in places; young people told us that staff actively encouraged them to do this, and that money was available to help them to make their rooms their own; - some former users of the service had decorated the games room, making it bright, modern and definitely "theirs"; -young people were involved in choosing books, DVDs and furniture for the house following a suggestion at a house meeting; -some young people had asked to go camping during the school holidays: equipment had been purchased and a successful holiday had resulted, with young people asking (and being allowed) to stay on longer than planned - a new, positive experience for all; - young people had been involved in fire safety training (including the use of fire extinguishers) with staff; while there had no doubt been an element of adventure in this experience, it was nonetheless an opportunity for young people to work alongside staff to help to develop an understanding of the risks associated with fire. Areas for improvement none noted at this inspection. Fairbairn Street Young People's Unit, page 14 of 22

15 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Statement 3 The environment allows service users to have as positive a quality of life as possible. Service strengths Inspection report continued We found that the environment at Fairbairn Street allowed young people to enjoy a positive quality of life. All of the young people were generally happy with the quality of their accommodation, although one or two suggestions for improvement are included under "areas for development" below. We noted the following strengths: - the premises are clean, comfortable and homely throughout; there is space for social interaction, games, study and quiet times if needed; - young people have access to the internet, and a policy and staff training support its safe use; - young people confirmed that staff respect their privacy, and privacy generally was not an issue; - young people told us that they feel safe; they said that the atmosphere within the house is generally good, and there is little or no disruption from other young people; - very good attention is paid to health and safety within the building: the manager has recently completed the accredited Institute of Occupational Safety and Health training, and staff have a range of training within their first year of employment which is focused on safety: fire safety, first aid, food hygiene; - we saw that staffing levels have been consistently maintained, contributing to the stability and safety of the environment; - two of the young people we spoke to were very happy with the quality of their accommodation in terms of comfort, privacy and degree of personalisation. - young people are given opportunities for different experiences during holidays: the camping holiday last year had been requested by young people and had proved to be a great success. Fairbairn Street Young People's Unit, page 15 of 22

16 Overall, we found that Fairbairn Street provides young people with a comfortable, safe and homely environment, which by and large meets their needs. Areas for improvement One young person mentioned that she didn't like sharing a bathroom with boys and would have preferred en-suite facilities. While it is difficult to see how this might be managed within the constraints of the current building, we suggest that this aspect of the accommodation should be considered if the opportunity arises as it would represent an improvement in the quality of the environment for some young people. At the time of the inspection, there has been a ban on the use of social networking sites: while we recognise that the safe use of these sites can be problematic for care providers, they are inescapably part of life for young people and a preferred option would be to find a way of minimising the risks and promoting safe and responsible use. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Fairbairn Street Young People's Unit, page 16 of 22

17 Quality Theme 3: Quality of Staffing - NOT ASSESSED Fairbairn Street Young People's Unit, page 17 of 22

18 Quality Theme 4: Quality of Management and Leadership - NOT ASSESSED Fairbairn Street Young People's Unit, page 18 of 22

19 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 No additional information. Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in 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). Fairbairn Street Young People's Unit, page 19 of 22

20 5 Summary of grades Quality of Care and Support Very Good Statement 1 Statement Very Good 5 - Very Good Quality of Environment Very Good Statement 1 Statement Very Good 5 - Very Good Quality of Staffing - Not Assessed Quality of Management and Leadership - Not Assessed 6 Inspection and grading history Date Type Gradings 25 Nov 2010 Unannounced Care and support 6 - Excellent Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed 16 Jun 2010 Announced Care and support 6 - Excellent Environment Not Assessed Staffing Not Assessed Management and Leadership 6 - Excellent 19 Mar 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing 5 - Very Good Management and Leadership Not Assessed 9 Jun 2009 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good Fairbairn Street Young People's Unit, page 20 of 22

21 27 Jan 2009 Unannounced Care and support Not Assessed Environment Not Assessed Staffing 5 - Very Good Management and Leadership 4 - Good 10 Jul 2008 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very 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. Fairbairn Street Young People's Unit, page 21 of 22

22 To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on This inspection report is published by SCSWIS. 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@scswis.com Web: Fairbairn Street Young People's Unit, page 22 of 22