Care service inspection report

Transcription

1 Care service inspection report Full inspection The Paddock Care Home Service The Paddock Ochiltree Cumnock Inspection completed on 11 April 2016

2 Service provided by: Radical Services Ltd 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 38

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 4 Good What the service does well The living environment is of a high standard for young people and provides safe and comfortable accommodation. Young people are well supported to maintain good attendance at their education placements and enjoy regular and varied recreational activities. The service has good links with See Me - ' Scotland's Programme to tackle mental health stigma and discrimination' and some young people are currently involved in the redesign See Me's resources in promoting the voice of young people in care who experience stigma or discrimination through mental health difficulties. What the service could do better The Paddock is a new service and this was the first inspection. We found that there was a mix of levels of experience within the staff group and the service should ensure that there is a balance of experienced staff working with newly recruited / less experienced staff on each shift to better meet young people's care needs. page 3 of 38

4 Whilst we recognise that staff record discussions with the young people we found that on occasions there were no clear links between discussions, actions taken and outcomes for the young people. Staff should maintain clear records linking discussions to outcomes. The Paddock staff have continued through a difficult period to support young people with challenging behaviours and levels of need. Given that some staff are new to the residential care work setting Radical Services Limited should monitor and quality assure how staff apply their learning to practice through supervision and continuing professional development. The service has a good internal audit processes in place to evaluate the service however there is a need for the Paddock to develop its participation strategy to further gain the views of carers. Radical Services Limited should continue to monitor the staff registration processes to ensure they are registered with the appropriate registration body within the required timeframe. What the service has done since the last inspection This was the service's first inspection. Conclusion The Paddock staff and young people have experienced some difficulties in recent months. The service has worked with partners to address this and continue to seek to develop their support to achieve good outcomes for the young people in the home. The service is relatively new and there is a continuing development plan in place to improve upon all areas of care the service provides. The external manager, manager and staff present as committed to progressing this plan and should they do so the service has the potential to achieve very good outcomes for the young people they provide care to. page 4 of 38

5 1 About the service we inspected Inspection report The Paddock is managed by Radical Services Limited. The house is located in a rural location in East Ayrshire and provides 24-hour residential care to young people referred by their local authority under "Looked After" and "Accommodated" arrangements. At the time of this inspection visit, there were three young people living at the service. The accommodation comprises four bedrooms, one with en-suite facilities, a large kitchen and dining area, two lounges, separate bathrooms for young people and for staff and office accommodation. 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 at 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. 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. page 5 of 38

6 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 4 - Good Inspection report 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 38

7 2 How we inspected this service The level of inspection we carried out In this service we carried out a medium 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 We wrote this report following an unannounced visit to the service on 4 April A second visit was made on the 7 April Formal feedback was provided to the service on 11 April As part of the inspection we took account of the completed annual return and self-assessment documents submitted by the service. In this inspection we gathered evidence from various sources, including the following: We issued six questionnaires to the manager to distribute to service users. We received three returned questionnaires. We issued questionnaires to the manager to distribute to staff and received 4 returned questionnaires. We spoke with two young people. We also spoke with one social worker, the external manager, the service manager and an assistant manager, a team leader and two residential workers. We had discussions with external partner agency personnel. During the inspection of the service we observed the interactions of young people and staff and inspected the living and external house environment. We looked at service documents including: - The service questionnaires for young people who use the service - Sample of young people's personal files - Evidence of how staff consulted with the young people - Health & safety policies - Risk Assessments page 7 of 38

8 - Medication procedures and records - Records of staff meetings - Staff training information - Complaints procedure and documents - Quality assurance documents - Insurance certificates - Certificate of registration 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 38

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. 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 us with a self-assessment within which they identified what it thought they did well, areas for development and actions it had planned for improvement. Taking the views of people using the care service into account The young people we consulted had mixed views about the service. One young person told us they were not happy there and wanted moved closer to home and that they liked some staff but not others. They also told us that they did like the food as it was healthy and that they did feel safe within the service. Taking carers' views into account We spoke with one carer for this inspection. The comments overall were positive and staff were considered to be 'very good'. page 9 of 38

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: 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 At this inspection, we found that the performance of the service was good for this statement. We looked at participation of young people through a review of case files, speaking to young people, staff, managers and stakeholders to assess this statement. The management and staff engaged the young people in decision-making in a number of ways. Residents meetings were held on a three weekly basis and young people's views regarding group issues were sought, for example, on changes to the house décor and furniture, ideas to develop the garden area and social activities. This gave young people the opportunity to have their views heard and respected on the environment and allowed them to feel a sense of connection to the home. The service also operated a key worker system wherein young people were encouraged to discuss issues with nominated key workers. This meant young people were able to discuss concerns, reflect on experiences and incidents, express their views on a one to one basis and plan ahead for preferred activities with the full attention of the staff member. page 10 of 38

11 One young person told us of their preference for using this meeting rather than residents' meetings to express their views. Following arrival at the Paddock young people were given an allowance to help them to personalise their room and we saw good evidence that young people's individual choice had been promoted. Menu choices took very good account of young people's preferences and promoted a healthy diet, young people told us that they liked the food at the Paddock and it was 'very healthy'. Information was available to young people to help them make positive choices in a wide variety of issues including health and recreational activities. Staff members were very well aware of local social and recreational amenities and opportunities had been provided for young people to use these. During the inspection we observed one young person plan a day trip with their key worker to a museum which supported their curiosity in particular subjects as well as giving them an opportunity to spend one to one time with staff. We learned that young people are included in the recruitment of staff and we saw evidence of their participation in interviewing staff and examples of questions they asked of interviewees. The service had sought the views of young people and placing social workers with one young person stating that the best thing about the service was 'getting listened to and learning new things about keeping myself safe'. One social worker commented that, '(x) has only been in placement a couple of weeks but so far it has been a positive experience for them.' Another stakeholder is recorded to have commented that the Paddock, 'appears to be an excellent placement; a good match to young people'. We were not able to contact carers for this inspection however we did note that a parent of a young person who had recently moved out the service had commented that the time at the Paddock had been a 'really good experience for (x). The staff were really helpful. No concerns at all.' page 11 of 38

12 Areas for improvement There is good evidence of effective participation from young people in assessing and improving the quality of care in the Paddock. The service should continue to promote this participation and the involvement of young people within these processes. However, the views of the young people's parents was limited and therefore not to so clear. The service should continue develop the processes to attempt to gather the views of parents and carers also. (See recommendation 1 of Quality Statement 4.4) Grade 4 - Good Number of requirements - 0 Number of recommendations - 0 page 12 of 38

13 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 We found the service had achieved a good standard of performance for this statement at this inspection. We looked at young people's care plans, key time records and service audit documentation and we spoke with young people, staff and external partners. We found good evidence of the services promotion of education for young people. Staff supported young people to attend their education placement both in mainstream school and in the education facility linked to the service provider. In discussion with staff and young people we were told of one young person's difficulty in managing their education attendance due to their emotional vulnerability. After speaking with the young person staff had advocated for an alternative timetable for this young person and, since having this agreed, the young person has maintained full attendance. We heard of one young person accessing a place in mainstream education with the support of the Paddock staff. This young person spoke of being happy with their education and we found that they attended daily. One young person's social worker confirmed the support the young person received in attending and maintaining school and of the support staff provided with homework. This young person was considered to be making progress in their education placement. The young people we spoke with had expressed an interest in working with animals and told us of the support they had received in accessing activities such as dog walking, horse riding and assisting at local stables. These activities had encouraged and promoted young people's interest and for one young person provided a relaxing activity. page 13 of 38

14 We also heard from young people about day trips to visitor attractions such as Blair Drummond and museums and of visits to the cinema that they had enjoyed. Young people told us that the selection of activity is agreed between them and staff and that they therefore have a good deal of choice in what activities to participate in. On arrival at the Paddock staff discuss the young people's preferences and later in discussions in key working sessions and residents meetings. One young person told us of their preference for talking about their views in one to one key work sessions and not in residents' meeting groups. From the one to one sessions this young person felt listened to was able to what they wanted such as agreeing their choice of decorative items for their room. Weekly meal planners are agreed between staff and young people and we were told of both the healthy options that were promoted and the choice of meals chosen from various countries and cultures for the once weekly 'theme night's. There were once weekly 'life skills' sessions where young people select a meal, purchase the ingredients and cook the meal with the support of staff. We heard from young people and staff of the skills in budgeting, planning and cooking that young people develop through this process. We found that staff members actively encourage young people to develop selfcare and wellbeing skills through the incentive to earn additional money to their pocket money allowance. Targets are discussed with young people, such as keeping tidy rooms and positive behaviour and attitudes, and additional money provided if these targets are achieved. Areas for improvement We found that some young people were uncertain as to how to access independent advocacy. Staff we spoke with and one young person's social worker were clear that on arrival at the service, young people were informed of their right to independent advocacy and how to access this. We were made aware of a poster within the service signposting young people to an independent advocate. However, the young people we spoke with were less clear on the process. (See recommendation 1 of this Quality Statement) page 14 of 38

15 We saw evidence from records that a complaint had been submitted and dealt with by the service manager. However the young person stated that they did not feel the complaint had been taken seriously and from our discussion with them they were not clear on the procedure. We have made a recommendation in relation to this matter also. (See recommendation 2 of this Quality Statement) Grade 4 - Good Number of requirements - 0 Recommendations Number of recommendations - 2 Inspection report 1. The service should continue to ensure that young people are aware of, and understand, the process through which they can access an independent advocate. National Care Standards for care homes for children and young people; 19 Advocacy 2. The service should continue to ensure that young people are aware of, and fully understand, the complaints procedures. This will ensure children's rights are adhered to and promote a sense of respect in the young people and evidence that their views are valued. National Care Standards for care homes for children and young people; 18 Concerns, comments and complaints. page 15 of 38

16 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths We found the service had achieved a good level of performance for this statement at this inspection. We looked at personal plans, medication and health records and risk assessments. We also met with young people, staff and spoke with external professionals. Staff had a comprehensive knowledge of the children and young people's needs and the risk factors that were recorded in their care plans. The care plans were consistent with the Getting It Right For Every Child (GIRFEC) principles. The service had also incorporated the well-being indicators of Safe, Healthy, Achieving, Nurtured, Active, Responsible, Respected and Included (SHANARRI) into the care plans to set targets and record outcomes against the well-being web. On inspecting care plans we found, for example, that young people's sense of feeling safe had increased or remained consistent. We confirmed with the Looked After and Accommodated nurse who visits the service that staff are pro-active in registering young people with medical services such as GP, dentist and opticians. We also learned that staff were efficient at supporting young people to make and keep health appointments. The service places a significant emphasis on encouraging healthy physical activity and we found that young people were supported to access activities of their choice. One young person regularly attended a gym and swimming sessions and spoke to us of her increased fitness level and weight reduction. A further example was a young person's request being met for a bike; which provided their preferred physical activity to enjoy and increased fitness levels. During our observations of practice and in discussions with staff we found that staff interacted with young people in a manner that was sensitive to their needs. We observed young people responding positively to these interactions with staff. page 16 of 38

17 We also observed staff appropriately manage challenging behaviours that had the potential to escalate. Staff responses were in accordance with the young people's care plans and risk assessments and on one occasion we observed staff redirecting one young person to other activities and positive behaviours and observed an improvement in the young person's mood and presentation. We gathered views of one young person's social worker on this quality statement and they stated that the service manager and staff 'displayed genuine affection and very good levels of care.' During this inspection one young person was preparing for a birthday celebration. We observed the warm interaction between staff and the young person in preparing for this celebration whilst baking a birthday cake. The young person told us of their plans to meet with friends and have them visit and the very good support from staff in regard to making these arrangements. We noted the young person's excitement and joy at these plans and recognised how well staff promoted the young person's social interaction and integration with their community. In discussion with young people and staff we heard of the arrangements for young people to meet with their family who lived a significant distance from the service. When appropriate, young people were supported to travel independently to meet with family thereby maintaining positive family and community connections for the young people. Where such arrangements were not possible or appropriate, due to assessed risk for example, we found that young people's family members met with them through the support of staff; either in the home community or in the service. In speaking with young people it was clear that they benefitted from this contact. The service supported one young person to individual sessions with an external service in relation to their emotional health and well-being. This young person told us of these sessions and the positive impact they had on their mood and ability to manage strong negative emotions. We reviewed policies and procedures and found that the service has clear child protection procedures that all staff had been trained in. We noted that child protection procedures had been adhered to and saw evidence of appropriate responses to concerns. page 17 of 38

18 The service has strong links to the See Me initiative which aims to address young people's mental health stigma and discrimination. Young people from the Paddock had been actively involved in designing information cards for others. Being involved in this also encouraged young people to talk about and communicate mental health concerns. In the 2016/17 inspecting year the Care Inspectorate is scoping child sexual exploitation (CSE) practice in children and young people's services. This is part of our contribution to 'Scotland's National Action Plan to tackle Child Sexual Exploitation' and focusses on frameworks of CSE practice, staff understanding and care planning outcomes. The service's child protection policy included a section relating to child sexual exploitation (CSE). All staff were given introductory training in child protection and child sexual exploitation during the service induction training. Further training on child protection and child sexual exploitation was planned for all staff. Managers and the majority of staff spoken with demonstrated good knowledge of the risk and vulnerability indicators of CSE and evidenced a clear understanding of the actions required of them in order to protect young people from potential or further harm. From inspection of care plans, key working sessions and daily records there was clear evidence of staff effectively implementing the procedure to protect young people in their care. We saw clear evidence that young people at risk had been appropriately identified. There were care plans in place to maximise the safety of those young people, and the service regularly reviewed planning strategies in conjunction with other agencies. page 18 of 38

19 Areas for improvement During the inspection we noted that some young people's information provided by the referring agency was incomplete or limited. Whilst it was recognised that staff from the Paddock had attempted to obtain this information it continues to be required. This lack of information is contrary to the service statement of aims document. (See recommendation 1 of this Quality Statement Grade 4 - Good Number of requirements - 0 Recommendations Number of recommendations Radical Services Limited should ensure that managers and staff are given sufficient information about prospective referrals prior to admission to ensure consistency of the care plan. National Care Standards for care homes for children and young people; 2 First meetings. page 19 of 38

20 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 Based on our findings in relation to Quality Theme 1, Statement 1, we accept that a good standard had been achieved in relation to this Quality Statement. Areas for improvement Grade 4 - Good Number of requirements - 0 Number of recommendations - 0 page 20 of 38

21 Statement 2 We make sure that the environment is safe and service users are protected. Service strengths We found the service had achieved a good level of performance for this statement at this inspection. We looked at the quality of the living environment and how the service supported young people's safety. We also reviewed risk assessments, maintenance procedures and records, staff training and accident records and documentation. Visitors to the house were required to identify themselves and sign a visitors book ensuring that staff were aware of all who were present in the house and the purpose of their visit. We found that risk assessments included comprehensive details of risks and triggers. The recording of this information informed staff of appropriate responses to challenging or problematic behaviours and, if required, alternative responses to these to maintain the safety of the young people. Every member of staff had access to appropriate training such as child protection and Crisis Aggression Limitation Management (CALM). This equipped staff to support young people in crisis and included the use of restraint in the most extreme circumstances. All incidents of CALM intervention were evaluated by a service trainer and suggested improvements in practice fed back to staff. The outcome of this practice was a reduction in some young people's challenging behaviours. Staff members confirmed that the evaluations led to increased confidence in how they managed challenging behaviour. To support school homework, and for recreational purposes, young people have access to a computer with internet access. On-line safety is assured by internet blocking and filtering software. In accordance with care plans, reviews and risk management plans, young people's internet and social media communications are closely monitored with their consent. page 21 of 38

22 We noted agreed protocols with Police Scotland for occasions when young people failed to return when expected. The service had developed good links with local police officers and young people were reported as missing in accordance with these protocols. We noted good evidence relating to how young people were kept safe through the joint action of staff and police. Due to the location of the service detailed maps had been provided to Fire Scotland to ensure that any required response is as efficient and effective as possible. The service has an anti-bullying policy and all young people were encouraged to report all incidents. The service audit had identified a need to remain vigilant to the potential for bullying in relation to one young person and their social worker confirmed that staff had taken appropriate action in addressing concerns. Through our discussions with young people and staff, we found that the service had responded to the needs of young people and increased staffing levels during periods of heightened risk thus maintaining the safety of young people during such times. We saw evidence that managers and staff conducted appropriate audits to ensure that high standards of safety were maintained within the service. This included health and safety checks of the environment, of electrical equipment and fire safety equipment, vehicles checks and accident and incident reports. Staff members we spoke with described how the young people's personal safety was discussed at staff meetings and shift handovers to minimise any miscommunication and any identified concerns were thoroughly addressed in individual risk assessments. Areas for improvement We noted that the staff group consisted of a mixture of experienced and less experienced support workers. page 22 of 38

23 One young person had made reference to this also in relation to how challenging behaviour was dealt with by staff. In recognising that the service is relatively new and continuing to develop we recommend that the service manager continues to review and evaluate the staff rotas and pairings to ensure a mix of experienced and less qualified workers. (See recommendation 1 of this Quality statement) We noted that managers took appropriate action in regard to concerns expressed by young people, but one young person did not appear to fully understand the procedure and actions on how such issues were resolved. Staff should ensure that young people are fully informed and debriefed following any concerns raised by them to ensure their feeling of safety and wellbeing. (See recommendation 2 of this Quality statement) Grade 4 - Good Number of requirements - 0 Recommendations Number of recommendations The manager should continue to ensure that staffing rotas include experienced staff on each shift. National Care Standards for care homes for children and young people; 7 Management and staffing. Inspection report 2. The service should ensure that young people are aware of the outcomes of any action taken following any concerns they have raised. National care standards for care homes for children and young people; 6 Feeling safe and secure. page 23 of 38

24 Statement 3 The environment allows service users to have as positive a quality of life as possible. Service strengths At this inspection we found the performance of the service was good for this statement. We spoke with young people, social workers, staff and the service manager. The building is a warm, generally comfortable, very clean and tidy environment. We inspected the kitchen, dining room, the lounge, kitchen, bedrooms and toilets and inspected the garden area. Young people were encouraged to personalise their rooms and we saw that their bedroom walls had posters and pictures relating to their hobbies and interests and each room was decorated to the young person's preferences and liking. During discussion with managers we learned that good attention had been given to attempts at avoiding an institutional appearance. The service felt that these efforts were constrained by fire and health and safety regulations however they had endeavoured to prevent the home from appearing institutional. The large, well equipped, kitchen contained a good supply of various food stuffs to meet young people's preferences and dietary needs. The kitchen contains a large dining table which young people are encouraged to use to nurture positive group living experiences. We observed safe practices within the kitchen area. Young people confirmed that The Paddock was a nice environment to stay in. The friends of young people are encouraged to visit if appropriate and there is a second sitting room that can be used for this purpose. This room has a good variety of dvds, games, books and arts and crafts materials for the young people to enjoy. The rear garden is a large area for the young people to enjoy outdoor activities in good weather. The garden has areas that are being considered for development; for example creating a vegetable patch. page 24 of 38

25 Areas for improvement As reported above, the environment was generally clean, comfortable and tidy. There were however two broken windows, one of which had remained unrepaired for a considerable time. The service should continue to ensure that all maintenance and repairs are done as speedily as possible as this will ensure a homely environment for the young people living at The Paddock. Grade 4 - Good Number of requirements - 0 Number of recommendations - 0 Inspection report page 25 of 38

26 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 Based on our findings in relation to Quality Theme 1, Statement 1, we accept that a good standard had been achieved in relation to this Quality Statement Areas for improvement Grade 4 - Good Number of requirements - 0 Number of recommendations - 0 page 26 of 38

27 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 The majority of staff were registered appropriately with the Scottish Social Services Council (SSSC). At the time of the inspection one member of staff was having their registration processed. To prevent any delay in registration occurring the service requires staff to register within two months of joining. Prior to joining the service staff are required to join the PVG scheme and we saw records confirming that all were members of the scheme. Following membership any staff member disclosing a conviction was assessed for suitability for employment and, if appropriate, risk assessments conducted to address any issue. We saw evidence of appropriate actions taken by the service in respect of PVG membership. All newly appointed staff members are required to attend an induction programme and we noted a good programme of training provided by both external training providers and the organisation's own training system. The induction training programme included fire safety, food safety, equality and diversity, CALM, Health & Safety, child protection, Child Sexual Exploitation medication recording and first aid. To support and monitor their progress through the initial induction period, new staff members receive supervision at two weekly intervals. All new staff completed a two week shadowing opportunity with an experienced staff mentor to assist them and support them to develop confidence in their role. Areas for improvement Whilst recognising that the service had identified a difficulty with staff SSSC registration and acted accordingly, Radical Services Limited should ensure that all staff register with the relevant bodies within the services required time frame. (See recommendation 1 of this Quality Statement.) page 27 of 38

28 Grade 4 - Good Number of requirements - 0 Recommendations Number of recommendations Radical Services Limited should ensure that all staff are registered with the relevant authorities within the required time frame. National Care Standards for care homes for children and young people; 7 Management and staffing. page 28 of 38

29 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths At this inspection we found the performance of the service was good for this statement. We looked at staff registration and qualification records, team meeting minutes and supervision records. We spoke with young people, social workers, staff and the service manager. We found that staff were knowledgeable of the particular needs of the young people they work with and applied their learning to practice. The majority of staff knowledge and experience was relevant to the support needs of the young people they provide care for and those staff members spoken with showed clear evidence of this. Staff evidenced a good knowledge of the National Care standards and what they meant in practice. We observed positive interaction between the staff and young people and witnessed examples of young people clearly enjoying the time they were spending with staff. As reported in Quality statement 1.3 the majority of staff we spoke with had a very good understanding of issues relating to child protection and more specifically Child Sexual Exploitation. We noted that the manager took a considered approach to planning the staff rota in relation to staff to child ratios. These ratios were increased at times of greater need and risk to ensure young people had the support they required to take part in a range of activities and by being accompanied to appointments and meetings. page 29 of 38

30 Review of training records showed that all staff were qualified in, or working towards, their SVQ III and HNC in childcare. Radical Services Limited provided staff with suitable training and development opportunities and an external SVQ trainer had been sourced to complete training in SVQ III. We look forward to reviewing the progress of this training at the next inspection. In discussions with staff we heard that supervision was held regularly. Records indicated that supervision occurred approximately every six weeks and staff described this frequency as supportive and useful for reflection on practice. Supervision records evidenced that SSSC Code of Conduct had been discussed with staff. Further to the induction and SVQ / HNC training good training opportunities were available for staff in accordance with their own Continuing Professional Development. An example of this was one member of staff who had expressed an interest in developing their learning in the area of mental health and mental health first aid training being accessed for the staff and young people. page 30 of 38

31 Areas for improvement Whilst staff had a good knowledge of child protection procedures and national standards some staff new to the service were continuing to develop this knowledge. The manager should continue to review staff's understanding of child protection procedures and ensure refresher training is completed at appropriate and effective time intervals. (See recommendation 1 of this Quality Statement) Grade 4 - Good Number of requirements - 0 Recommendations Number of recommendations Radical Services Limited should ensure that refresher courses in mandatory training are completed at regular intervals. National Care Standards for care homes for children and young people; 7 Management and staffing. page 31 of 38

32 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 Based on our findings in relation to Quality Theme 1, Statement 1, we accept that a good standard had been achieved in relation to this Quality Statement. See also Quality statement 4.4 Areas for improvement Grade 4 - Good Number of requirements - 0 Number of recommendations - 0 page 32 of 38

33 Statement 3 To encourage good quality care, we promote leadership values throughout the workforce. Service strengths At this inspection we found that the performance of the service was good for this statement. In assessing this quality statement, we spoke with the external manager, the manager and staff. We looked at supervision, training and service audit records and team meeting minutes. During the inspection we observed staff acting appropriately with autonomy whilst seeking appropriate guidance and support from senior colleagues. In discussion with the external manager and manager we learned that leadership values within the service were promoted through identifying areas for development for staff and allocating particular tasks. Evidence of this was suggested through the promotion of key workers to team leader posts and subsequently to assistant manager and manager posts. We also learned from staff and team meeting minutes of discussions and subsequent actions of suggestions by staff members. There were examples of suggestions for activities and events for young people that were promoted and arranged. Staff confirmed that managers actively gave praise for appropriate actions taken autonomously that were in line with the best interests of the young people's wellbeing. Areas for improvement We recognise that the staff team at the Paddock is relatively new and the service is continuing to develop. The external manager informed us of the service plans to develop the key worker role to offer workers greater opportunity for autonomy work whilst being supported by line managers. page 33 of 38

34 The service should continue to develop its promotion of leadership values for the staff team at the Paddock and we look forward to inspecting this at the next inspection. Grade 4 - Good Number of requirements - 0 Number of recommendations - 0 Inspection report page 34 of 38

35 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 At this inspection we found that the performance of the service was good for this statement. We spoke with one young person, one social worker, external partners and staff in assessing this quality statement. We looked at the services systems for auditing records and practice. We looked at various documentation including audits of safety checks, case files, team meeting minutes, young person's review meeting minutes and risk assessments. One example of this was a quality assurance process with the CALM instructor in relation to a physical restraint. The views of staff and young people involved in incidents of restraint are gathered and improvements suggested. Young people were included in this process to assist them in understanding their behaviours and the subsequent staff actions in supporting them through a difficult situation. The service provider had an efficient quality management system in place which involves auditing by the external manager at bi monthly intervals with the service manager internally auditing at monthly intervals. This process aims to identify any areas for improvement and actions to be taken and we saw evidence of some of the actions having been taken; for example car safety, staff being vigilant for indicators of bullying and new staff shadowing periods being extended. We were informed of the plans to reintroduce the Youth Board for young people to participate in evaluating the service. It is suggested that once developed the Youth Board will create more autonomy for young people. We look forward to inspecting the progress of this plan at the next inspection. page 35 of 38

36 Areas for improvement During feedback with the service external manager and manager we discussed limited information relating to carers and young people's involvement and participation in evaluating the service. This limited involvement was recognised and agreed that this process could be improved upon; particularly in relation to carer's involvement. (See recommendation 1 of this Quality Statement). Grade 4 - Good Number of requirements - 0 Recommendations Number of recommendations The service should continue to develop a framework of participation that gathers the views of carers and stakeholders in addition to the young people in the care of the service. National Care Standards for care homes for children and young people; 7 Management and staffing. Inspection report 4 What the service has done to meet any requirements we made at our last inspection Previous requirements There are no outstanding requirements. page 36 of 38

37 5 What the service has done to meet any recommendations we made at our last inspection Previous recommendations There are no outstanding recommendations. Inspection report 6 Complaints No complaints have been upheld, or partially upheld, since the last inspection. 7 Enforcements We have taken no enforcement action against this care service since the last inspection. 8 Additional Information There is no additional information. 9 Inspection and grading history This service does not have any prior inspection history or grades. page 37 of 38

38 To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. You can also read more about our work online. Contact Us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY Other languages and formats This report is available in other languages and formats on request. Inspection report Tha am foillseachadh seo ri fhaighinn ann an cruthannan is c?nain eile ma nithear iarrtas. page 38 of 38