Crawford Street Young Person's Unit Care Home Service Children and Young People 31 Crawford Street Hyndland Glasgow G11 6TT Telephone:

Transcription

1 Crawford Street Young Person's Unit Care Home Service Children and Young People 31 Crawford Street Hyndland Glasgow G11 6TT Telephone: Inspected by: Anne Borland Type of inspection: Unannounced Inspection completed on: 29 November 2012

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 9 4 Other information 21 5 Summary of grades 22 6 Inspection and grading history 22 Service provided by: Glasgow City Council Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Anne Borland Telephone enquiries@careinspectorate.com Crawford Street Young Person's Unit, page 2 of 24

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 4 Good Quality of Environment 4 Good Quality of Staffing 4 Good Quality of Management and Leadership 3 Adequate What the service does well The staff members at the service know and understand the needs and preferences of the young people living in the home. There was good evidence that staff strive to provided care and support based on these preferences and support needs. What the service could do better The service provider requires ensuring the home is adequately staffed. The staff should receive training on GIRFEC. The service should improve the quality of risk assessments and risk management plans. The service should ensure the outside area is free from cigarette ends. The service should ensure the security of the office is not compromised. The service should review the locking of communal areas. The staff and management should review the times when staff members require to be based in the office. What the service has done since the last inspection The home has improved the physical environment. Staff supervision is now taking place. Crawford Street Young Person's Unit, page 3 of 24

4 Conclusion Inspection report continued This service continues to provide a good level of care and support to young people. Who did this inspection Anne Borland Crawford Street Young Person's Unit, page 4 of 24

5 1 About the service we inspected Crawford Street is run by Glasgow City Council Social Work Services and is located in the Partick area of Glasgow. The Care Inspectorate regulates care services in Scotland. Prior to 1 April 2011, this function was carried out by the Care Commission. Information in relation to 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 Crawford Street provides 24-hour care and support to 8 young people who require to be looked after away from home. The service is in a purpose-built premises where young people have their own private rooms. There are also three lounge areas where young people meet with family, friends or each other. The service offers young people a safe and secure home in a homely and comfortable environment. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 4 - Good Quality of Environment - Grade 4 - Good Quality of Staffing - Grade 4 - Good Quality of Management and Leadership - Grade 3 - Adequate 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. Crawford Street Young Person's Unit, page 5 of 24

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 This unannounced inspection was carried out over two days commencing on the 12th October During the course of the inspection the Inspector spoke with six young people, three residential workers, a nightshift residential worker, the senior practitioner and the manager. The condition of the physical environment was examined. Relevant records were examined, some of which included: The support plans for three young people, Complaints log, Medication Records, Violent incident recordings, Young people meeting minutes, Team meeting minutes, Health and Safety Records, Unit Development Plan, Monthly manager reports. Monthly care plan audits. Verbal feedback was provided to the manager and service manager on the 29th November Crawford Street Young Person's Unit, page 6 of 24

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 Crawford Street Young Person's Unit, page 7 of 24

8 What the service has done to meet any recommendations we made at our last inspection Following the last inspection the service received five recommendations. These are detailed below and an update on progress made. The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The service provided a self assessment which detailed the strengths of the service and areas for improvement. Taking the views of people using the care service into account The Inspector spoke with six young people. The views expressed varied, regarding the service. Young people confirmed involvement in the choice of decoration, menu planning and in care reviews. Some comments are listed below: "I like it here staff are good and nice" "I can see childrens rights officer and get help before meetings" "I was moved here with no notice but like it anyway." "Some times I go out with my key worker for shopping and a meal, it is good" "I say what I want at my meetings and I am listened too" "Staff should spend less time in the office and stop treating work like social event" "Staff should listen better and the home should be cleaner" Taking carers' views into account The Inspector did not meet with any parents or carer during this inspection. Crawford Street Young Person's Unit, page 8 of 24

9 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: 4 - 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 staff at the service used a number of ways to gather the views of the young people. This included asking young people to complete questionnaires about the care and support provided, encouraging young people to attend house meetings and involving young people in formal care review processes. Two questionnaires about the admission process had been completed by young people. Comments included, "staff were helpful and nice" and "the information pack was good". There were questionnaires which asked relevant questions to young people about their overall experience of living in Crawford Street. Two were completed and included positive comments about staff approachability and ability to listen to young people. Both young people agreed that they were supported with their health needs as indicated in the questionnaire 'Your stay'. An exit questionnaire had been completed and this young person thought that support had been provided in the pathway to moving on. One social worker had completed a questionnaire and was positive about the care and support provided. Young people attended formal care reviews and some choose to submit their own report. Young people who spoke with the Inspector stated feeling able to contribute fully to these meetings. Crawford Street Young Person's Unit, page 9 of 24

10 Young people meetings took place and discussion and agreement took place regarding activities, menu planning and household items to be replaced. This forum was also used to praise young people for improved behaviour and achievements and to give advise about safe care. A copy was pinned to the notice board in the recreational room and each young person was also provided with an individual copy. Young people had been involved in previous staff recruitment and had participated in the city wide childrens' reference group. Young people had been involved in recent decoration of the communal areas and their bedrooms and bathrooms. Areas for improvement The minute of the young peoples' meeting, would benefit from an action plan to ensure that issues are pursued. Similarly the service could collate the findings of the questionnaires and identify areas for improvement, e.g. one social worker stated the hall was bare and could do with being more homely. A young person had stated a need for young people to show more respect to one another and for young people meeting to be more regular. The guidance rules for young peoples' meetings were written by the young people in Given the length of time elapsed, consideration could be given to reviewing this with current young people living in the home. The manager advised a parent and carers questionnaire was in the process of being devised. Two of three communal rooms are routinely locked. The need for this practice should be kept under review. This will form a recommendation. (See Recommendation below). Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. Recommendation with reference to Theme 1, Statement 1: The need for locking two of the communal areas should be reviewed. This is to meet with Standard 5. Your Environment. National Care Standards for Care Homes for Children and Young people. Crawford Street Young Person's Unit, page 10 of 24

11 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths The young people had their health needs assessed by the Looked After and Accommodated Children's Nurse (LAAC Nurse). Following the assessment the LAAC nurse could make referrals for specialised services. There was evidence that young people had made use of the Sandyford sexual health services and the Child and Adolescent Mental Health services and counselling services. The LAAC nurse had also provided immunisations and advised to young people on a number of matters relating to good health. Staff kept a detailed account of all health appointments which were attended by young people. The blue BAAF health books were kept up to date. Young people were supported and encouraged to attend health appointments. There was evidence of young people attending dentists and opticians for routine checkups in addition to attendance for treatment. Medication records were kept up-to-date and administered as prescribed. Arrangements made for medications to be disposed of which were no longer in use and the medication storage was well managed. The medication folder held a copy of the service's medication policy and procedures. Young people were positive about the meals provided and confirmed menus reflected their food preferences. Meals included healthy options with fresh fruit, vegetables and salad provided daily. Most of the young people ate well, joining the staff for meals at the table. Physical exercise was promoted and most young people had been given the opportunity to participate in trying out new experiences by trying out sporting and outdoor activities such as fishing, camping, attending the gym, dance exercise classes and football. There was evidence of excellent support being provided to young people who were suffering from mental health problems. Areas for improvement The service should continue to support young people to have active lifestyles. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Inspection report continued Crawford Street Young Person's Unit, page 11 of 24

12 Quality Theme 2: Quality of Environment 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 environment within the service. Service strengths Please refer to Quality Theme 1, Statement 1. Areas for improvement Please refer to Quality Theme 1, Statement 1. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Crawford Street Young Person's Unit, page 12 of 24

13 Statement 2 We make sure that the environment is safe and service users are protected. Service strengths Inspection report continued On the days of inspection the home was clean, tidy and attractively decorated. There had been improvements to the decoration within the service. This included upgrading of the bathrooms and en-suites, decoration to the bedrooms and communal areas. The hall had been painted and was now brighter. The home complied with safe health and safety practices. The cook followed safe food handling and hygiene practices. Cooked food and fridge temperatures were monitored. Electrical equipment testing was carried out routinely and gas equipment was serviced annually. Recent certificates indicated that all was in order. The service had regular water safety checks to ensure the water was safe for use. The service has a visitor's sign in book and visitors were asked to show identification when appropriate. There was an oncall system in place for staff to contact management in an emergency outwith office hours. Staff at the service could also contact the West of Scotland Social Work Standby Service if necessary. An out of hours team comprising peripatetic residential workers were based in the city for the purpose of responding to emergency additional staffing needs. The service also held contact details for emergency services such as, NHS 24, Police and Fire Service. The property was maintained by City Building Repairs team who could also be contacted to attend to urgent repairs to the fabric of the building. There was evidence of the staff making contact to these services as needed. There was a prompt response for non-urgent repairs by the City Building team and the house was in a good state of repair. Staff members completed Violent Incident forms (VI1) to record any incident which involved the young person showing aggression, violence, verbal abuse, or threat of aggression towards a staff member or other young person. This included an account of how the situation arose, what happened and the action which was taken to manage the situation. These were signed by the manager. Procedures were in place to alert RIDDOR of serious incidents. Staff members undertake Therapeutic Crisis Intervention training to develop skills in intervention techniques to use in managing behaviour. This training had been regularly updated. Crawford Street Young Person's Unit, page 13 of 24

14 Risk assessments were in place for young people identifying a number of potential risks to themselves and others. The service had 'Substance Misuse' procedures which made clear the action to be taken in the event of young people returning to the service under the influence of drugs and/or alcohol. There were records of the monitoring of young people during the period of time in which they were under the influence of substances. Individual Crisis management plans were in place and identified the circumstance in which a young person may become distressed and exhibit challenging behaviours. These included the intervention to use to diffuse the situation and offer reassurance to the young person. Staff members were trained in Child Protection and were aware of the procedures to follow in the event of a young person being at risk of danger and when to report allegations of abuse. Staff members followed the provider 'Missing from Placement' procedures when young people failed to return to the place. This involved notifying parents and the police. The home operated a traffic light system in partnership with the police in the event of a young person being missing from the placement. This code system allowed for a level of priority to be given in seeking out the young person dependent on the assessed level of vulnerability. Areas for improvement The risk assessment and management plans did not accurately reflect the risk to young people and how this would be managed. This will form a recommendation. (See recommendation 1 below). The service does not have a door bell and the front door security could be improved. This will form a recommendation. (See recommendation 2 below). The staff should seek ways to prevent the build up of cigarette ends at the shrubbery to the side of the front door. This will form a recommendation. (See recommendation 3 below). Crawford Street Young Person's Unit, page 14 of 24

15 Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 3 Recommendations 1. Recommendation with reference to Theme 2, Statement 2: Risk assessment and management plans should contain relevant information and contain clear protocols to manage, reduce or eliminate risk. This may include the involvement of external agencies, i.e. services specialising in domestic violence. This is to meet with Standards 6.3 Feeling Safe and Secure and Standard 9.1 Making Choices. National Care Standards for Care Homes for Children and Young People. 2. Recommendation with reference to Theme 2, Statement 2: The service should have a door bell and the front door security should be improved. This is to meet with Standard 6.4 Feeling Safe and Secure. National Care Standards for Care Homes for Children and Young People. 3. Recommendation with reference to Theme 2, Statement 2: The entrance way to the building should be free of cigarette ends. This is to meet with Standard 5.1 Your Environment. Feeling Safe and Secure. National Care Standards for Care Homes for Children and Young People. Crawford Street Young Person's Unit, page 15 of 24

16 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 4 - Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service strengths Please refer to Quality Theme 1, Statement 1. Areas for improvement Please refer to Quality Theme 1, Statement 1. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Crawford Street Young Person's Unit, page 16 of 24

17 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Regular team meetings were held and formal supervision was taking place. The staff team demonstrated great commitment to the young people by being extremely flexible in changing shifts and working additional hours to accommodated ongoing staffing shortage. The majority of staff members were qualified to SVQ level 3 and HNC or above. Mandatory refresher training was made available and staff could access the Glasgow Online training resource (GOLD) for further training. Staff members stated that over the last year training opportunities had improved. As a result some has attended additional non-mandatory training events. Staff members were registered with the Scottish Social Service Council (SSSC). Areas for improvement The manager was in the process of rolling out professional development plans with the staff team. Young people were of the view that some staff members spent too much time being based in the office. The Inspector observed discussions taking place between young people and staff at the office door. This will form a recommendation. (See recommendation below). Staff identified a need to have training regarding 'Getting it Right for Every Child'. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 1 Recommendations Inspection report continued 1. Recommendation with reference to Theme 3, Statement 3: Staff and managment should clarify when staff require to be based in the office. This is to met with Standard 7.9 Management and Staffing. National Care Standards for Care Homes for Children and Young People. Crawford Street Young Person's Unit, page 17 of 24

18 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 3 - Adequate 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 Please refer to Quality Theme 1, Statement 1. Areas for improvement Please refer to Quality Theme 1, Statement 1. Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0 Crawford Street Young Person's Unit, page 18 of 24

19 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 The unit has a development plan which was updated in April The external manager was a regular visitor to the home and met with the manager regularly to discuss issues and progress made in the service. The external manager also attended senior management meetings. The senior night workers carried out record sampling to monitor practice. Prompts were given to staff to update records or carryout outstanding tasks. The management team provided the external manager with a monthly report, which reported on all aspects of the service performance. This included examination of complaints, violent incidents, staff attendance, Health and Safety, staff training and the progress of the young people. Arrangements were in place for the manager to meet with the head of residential services and service manager to discuss operational issues and progress of the young people. Meetings also took place with Personnel to discuss any staffing issues and the Finance section to discuss budget management. Weekly reports were sent to case managers regarding the progress of young people. Monthly care plan audits were sent to external management to ensure appropriate progress was being made. The organisation used electronic survey monkeys to gather staff views on a range of subjects, with the latest being regarding training for residential child care workers. The results are to be used to inform the future training programme. Areas for improvement The manager advised that the planned update of the development plan had been delayed. There was an issue of the service failing to notify the Care Inspectorate of incidents. This has since been resolved. The home was routinely operating outwith the staffing agreement. This had an impact on the individual time which could be spent with young people. It also impacted on staff carrying out administrational tasks. This will form a requirement. (See requirement 1 below). Grade awarded for this statement: 3 - Adequate Number of requirements: 1 Number of recommendations: 0 Inspection report continued Crawford Street Young Person's Unit, page 19 of 24

20 Requirements Inspection report continued 1. Requirement with reference to Theme 4, Statement 4: The service requires to comply with the staffing schedule. This is required to comply with SSI/210 Regulation 15(a) -Staffing: Timescale 3 months from the publication of this report. Crawford Street Young Person's Unit, page 20 of 24

21 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 N/A. Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in the Care Inspectorate re-grading a Quality Statement within the Quality of Management and Leadership Theme (or for childminders, Quality of Staffing Theme) as unsatisfactory (1). This will result in the Quality Theme being re-graded as unsatisfactory (1). Crawford Street Young Person's Unit, page 21 of 24

22 5 Summary of grades Quality of Care and Support Good Statement 1 Statement Good 5 - Very Good Quality of Environment Good Statement 1 Statement Good 4 - Good Quality of Staffing Good Statement 1 Statement Good 4 - Good Quality of Management and Leadership Adequate Statement 1 Statement Good 3 - Adequate 6 Inspection and grading history Date Type Gradings 19 Sep 2011 Unannounced Care and support 4 - Good Environment Not Assessed Staffing Not Assessed Management and Leadership 4 - Good 9 Nov 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed 19 Jul 2010 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing Not Assessed Management and Leadership Not Assessed Crawford Street Young Person's Unit, page 22 of 24

23 9 Mar 2010 Unannounced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership Not Assessed 12 Oct 2009 Announced Care and support 4 - Good Environment Not Assessed Staffing 4 - Good Management and Leadership Not Assessed 24 Mar 2009 Care and support 5 - Very Good Environment 4 - Good Staffing Not Assessed Management and Leadership Not Assessed 6 Oct 2008 Announced Care and support 4 - Good Environment 4 - 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. Crawford Street Young Person's Unit, page 23 of 24

24 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: Crawford Street Young Person's Unit, page 24 of 24