Apple Tree Nursery Day Care of Children 46 Balhousie Street Perth PH1 5HW

Transcription

1 Apple Tree Nursery Day Care of Children 46 Balhousie Street Perth PH1 5HW Inspected by: Audrey Donnan Type of inspection: Unannounced Inspection completed on: 19 July 2013

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 12 4 Other information 25 5 Summary of grades 26 6 Inspection and grading history 26 Service provided by: Laura Geekie and Joanne Machray a partnership Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Audrey Donnan Telephone enquiries@careinspectorate.com Apple Tree Nursery, page 2 of 27

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 4 Good Quality of Staffing 4 Good Quality of Management and Leadership 4 Good What the service does well The service routinely encouraged participation from parents and children to provide feedback to improve the overall standard of care. Staff supported the children to be active, healthy and independent learners. Staff had established good relationships with the children and their families and were responsive to their needs. What the service could do better We identified the following aspects of practice which need to be improved: * Ensure safe recruitment processes are in place when appointing new staff * Develop and implement a review system of children's registration information for example, who to contact in an emergency * Review the daily risk assessment checklist to ensure it identifies any potential risk to children and the action taken to keep children safe * Support staff with evaluation processes Apple Tree Nursery, page 3 of 27

4 What the service has done since the last inspection We found that the service had made sound progress with the opportunities provided to parents and children to provide feedback. The service kept parents and children informed about the impact their suggestions had made on the service. The service had met the three requirements made at the last inspection. One recommendation had been implemented and one recommendation was outstanding. We discuss these more fully in the body of the report. Conclusion We found that the service provided a high standard of care and that children were happy, confident and active learners. Who did this inspection Audrey Donnan Apple Tree Nursery, page 4 of 27

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at This service registered with the Care Inspectorate on 11 November Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve, we may make a recommendation or requirement. - A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service, but where failure to do so will not directly result in enforcement. Recommendations are based on the National Care Standards, relevant codes of practice and recognised good practice. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reform (Scotland) Act 2010 and Regulations or Orders made under the Act or a condition of registration. Where there are breaches of Regulations, Orders or Conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. Apple Tree Nursery is a day care of children service and is registered to provide care to a maximum of 23 children aged 0 to an age to attend primary school, at any one time. The service operates from a semi detached property in central Perth. Children have access to a large fully enclosed garden. The aims of the service include to provide a range of challenging, educational and stimulating quality experiences which are relevant to each individual child. Provide a safe, warm and welcoming environment for children to play, learn and develop in. 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 4 - Good Quality of Staffing - Grade 4 - Good Quality of Management and Leadership - Grade 4 - Good This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Apple Tree Nursery, page 5 of 27

6 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. Apple Tree Nursery, page 6 of 27

7 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 after an unannounced inspection. Inspector, Audrey Donnan carried this out. The inspection took place on Monday 15 July 2013 and continued on Friday 19 July. Feedback took place with the providers/manager on Friday 19 July. As part of the inspection, we took account of the completed annual return and self - assessment forms that we asked the provider to complete and submit to us. We sent eight care standard questionnaires to the manager to distribute to parents/ carers who used the service. Six parents sent us completed questionnaires. During this inspection process, we gathered evidence from various sources, including the following: We spoke with: * children * the manager * the providers * staff We looked at: * medication policy and procedure * risk assessments * infection control procedures * meal time experiences * newsletters * talking and thinking books/mindmaps * evaluations from parents * registers * quality assurance documentation * care plans * accident and incident records * the environment and equipment Apple Tree Nursery, page 7 of 27

8 Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection report continued Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at Apple Tree Nursery, page 8 of 27

9 What the service has done to meet any requirements we made at our last inspection The requirement The provider must ensure that the premises are clean and suitable for use at all times. Appropriate procedures for the prevention and control of infection must be put in place. This is in order to comply with regulation 4 (1)(a) & (d) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) Timescale: within 7 days of receipt of this report. What the service did to meet the requirement We found that the premises were clean throughout the inspection. Appropriate measures were in place for the infection prevention and control of infection. The requirement is: Met The requirement The provider must keep an accurate record of the numbers of children attending the service at any one time. This is in order to comply with regulation 4 (1)(a) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/ 210) Timescale:within 24 hours of receipt of this report. What the service did to meet the requirement We found that the service had reviewed the registration method however; this required further developing. We have discussed this further under Quality Theme 2, statement 2. The requirement is: Not Met The requirement The provider must develop and implement an effective written system of monitoring and evaluation which supports the improvement of the service. This needs to include monitoring the quality of work of each staff member and the service as a whole. Apple Tree Nursery, page 9 of 27

10 This is in order to comply with regulation 4 (1)(a) and regulation 15(a) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) Timescale: within 2 months of receipt of this report. What the service did to meet the requirement The service had developed and implemented a written system for monitoring and evaluating the service. We have discussed this further under Quality Theme 4, statement 4. The requirement is: Met Inspection report continued What the service has done to meet any recommendations we made at our last inspection One recommendation had been implemented and one recommendation was outstanding. The service had clearly displayed a complaints procedure for the service. A recommendation to review the written risk assessments remains outstanding and has been discussed further under Quality Theme 2, statement 2. 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 Care Inspectorate 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 provider identified what they thought they did well, some areas for development and any changes it had planned. Taking the views of people using the care service into account There were five children attending the 0-2 year olds room and ten children attending the 2-5 year olds room. We found that the children were happy and settled and were involved in a variety of activities indoors and outdoors. Apple Tree Nursery, page 10 of 27

11 Comments included: 'We're having some Gruffalo and banana' (for snack) 'I'm having a drink of milk' 'What are you doing? I have fun at nursery. I'm going swimming with my dad' 'My snack is in my tummy' 'I can write my name. I can write the 'O' can I show you?' 'We've got bubbles. Look, I've filled my bottle with bubbles. They feel soft' 'I'm squirting water. It's on your legs' Taking carers' views into account We received six Care Standard Questionnaires from parents who used the service. All parents strongly agreed that they were overall happy with the quality of care their children received from the service. Comments included: 'Having worked in childcare I knew exactly what I wanted from a childcare setting and Apple Tree Nursery, Perth has met those expectations. The staff understand the fears of parents leaving their child at nursery but strive to help both the child and parents to settle in quickly. I find staff and management professional, knowledgeable and approachable and my child's development is going from strength to strength. It was also reassuring through recent parents' night how well staff know my child and the development is recorded.' 'Support has been fantastic. When we had concerns, the keyworker happily made an appointment to see us - after her working day - and came up with a plan for how we at home and nursery could work together. Always willing to help and have increased my child's skills and confidence in abundance' 'I am really pleased with the nursery. It's like a home from home for my little girl, she is settling well.' 'Apple Tree Nursery have created a lovely setting that my child loves. They are wonderful at looking for feedback from the parents to see where we feel they can do something differently or when purchasing new resources. We are kept up to date weekly with what has been happening in nursery. Overall, the providers and their lovely team have created a nursery that has helped shape my child into a very confident, capable and happy little boy who is ready for school. I cannot praise them all enough' Apple Tree Nursery, page 11 of 27

12 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 was very good at involving the children and parents. At this inspection, we looked at feedback from parents, newsletters, noticeboards, mind maps, talking and thinking books and direct discussion with children and their families. We saw evidence that the service asked parents to complete regular questionnaires about the quality of the service and the staff. We found that the responses in the questionnaires were positive and that the service acted on any suggestions or comments. The service used the noticeboards to post a particular question for example; 'I think our nursery garden should have...' was displayed on the day of the inspection. One parent had responded so far and had suggested a trampoline. We found very good evidence that the service responded to parents suggestions through weekly newsletters. We noted that the newsletters were a very good communication method with parents. A parents' working group was in place and the manager told us that the group had helped to organise fund raising events. The service had involved parents when recruiting new staff and had asked them to contribute to the self-assessment document. As a result of the methods used by the service, we evidenced effective communication with parents. Apple Tree Nursery, page 12 of 27

13 Children had opportunities to influence their learning in a variety of ways including; small group time discussions, one to one discussions and the use of talking and thinking books and mindmaps. We found that staff responded well to children's interests and ideas and used this to plan. We saw that staff listened to the children and responded to their requests and questions immediately. This meant that children felt valued by the staff. Areas for improvement We discussed with the service further developing the talking and thinking books with the children. Developing age appropriate ways to support very young children to evaluate the service would mean that all children were included in the process. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Apple Tree Nursery, page 13 of 27

14 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths We found that children were cared for in a nurturing and supportive environment. We saw that children were happy and busy throughout our inspection and that children's learning was encouraged by staff. We looked at personal learning plans (PLP's), medication records, outdoor play, and observed the snack and lunch time experience to assess this statement. We sampled four PLP's in the 0-2 year olds and six PLP's in the 2-5 year olds rooms. We found that they were easily accessible to both the children and their parents in the 2-5 year olds room and parents could access them in the 0-2 year olds room. We found that they were informative and had observations of the children's development, next steps in their learning, and photographs of their progress. We looked at children's care routines. We found that they were comprehensive and ensured that staff maintained the children's routines whilst attending the service. This meant that the individual needs of the children were met. Children had opportunities to be healthy and active and we saw that the children had free choice to play indoors or outdoors during the inspection. In the afternoon of the inspection, staff took the children aged 0-2 years for a walk to the park in buggies and this ensured the children had fresh air. The service promoted healthy eating with the children and we found that the children had fresh fruit daily and a variety of healthy snacks. We observed staff encouraging the children to drink plenty of fresh water throughout the hot days. This ensured that the children remained alert and hydrated throughout the day. We looked at the administration of medication records and found that there were safe processes in place to administer medication. We found that all medication was stored securely and out of children's reach. Areas for improvement Inspection report continued Whilst we saw that the service carried out six monthly reviews in consultation with parents to ensure children's care plans were up to date and accurate, we found that children's registration information for example; emergency contact information, telephone numbers and home address were reviewed annually. See recommendation 1. Apple Tree Nursery, page 14 of 27

15 We noted that not all staff encouraged children's independence at all times for example, we observed snack time in the 2-5 year olds room and we found that staff did not encourage the children to serve the snack or pour their own drinks. We found that the snack and lunch times for the children aged 0-2 years was not a social experience. During feedback, we asked the service to review the snack and lunch experiences for the children. Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1 Recommendations 1. It is recommended that the service develops and implements a system to review and update children's individual files within a minimum period of 6 months. The information should be completed in partnership with parents. National Care Standards early education and childcare up to the age of 16, Standard 14: Well - managed service Apple Tree Nursery, page 15 of 27

16 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 We have considered the evidence gathered for the grade awarded in this Quality Statement under Quality Theme 1, statement 1. Areas for improvement Please refer to Quality Theme 1, statement 1 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Apple Tree Nursery, page 16 of 27

17 Statement 2 We make sure that the environment is safe and service users are protected. Service strengths During the inspection, we found that the children were cared for in a clean, safe and secure environment. The service was warm, bright and nurturing. We found children's work attractively displayed and photographs showed children's progress in learning. We found that the service had installed a new secure entry system. This meant that parents could be reassured that no unauthorised person had access to the service. The service managed all accident and incident reports appropriately and parents received a copy of the report. As a result, parents were kept up to date about their children's health and wellbeing. The service completed daily risk assessment checklists and we found that all toys and equipment were clean and in a good state of repair. Areas for improvement Inspection report continued We found that the service had reviewed the registers however; we noted that on the day of the inspection, staff did not have an accurate number of children present at any one time. A requirement was made during the previous inspection and remains. See requirement 1. Apple Tree Nursery, page 17 of 27

18 The service had not reviewed the general risk assessment for the service since 2011 and therefore had not included new potential risks to the children for example; slabs had been lifted in the garden and no risk assessment had been completed. We acknowledge that the service acted quickly and had reviewed the risk assessments for the service, garden and outings by the following inspection day. We found that the risk assessment checklist did not fully identify the potential risks to children and the action needed to keep children safe. See recommendation 1. Grade awarded for this statement: 4 - Good Number of requirements: 1 Number of recommendations: 1 Requirements 1. The provider must keep an accurate record of the numbers of children attending the service at any one time. This is in order to comply with regulation 4 (1)(a) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) Timescale: within 24 hours of receipt of this report. Recommendations 1. It is recommended that the service review the risk assessment checklist for the health and safety of the children. National Care Standards early education and childcare up to the age of 16, Standard 2: A safe environment Apple Tree Nursery, page 18 of 27

19 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 We have considered the evidence gathered for the grade awarded in this Quality Statement under Quality Theme 1, statement 1. Areas for improvement Please refer to Quality Theme 1, statement 1 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Apple Tree Nursery, page 19 of 27

20 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths We found that staff were caring, nurturing and enthusiastic throughout the inspection. We evidenced that the staff knew the children and their families well and had worked hard to build good working relationships with them. One parent commented 'The staff are amazing and know exactly how to achieve the best from my child. They provide a safe and stimulating environment in which the children are nurtured and encouraged to reach their potential' As a result, we observed happy and confident children. Staff had a range of qualifications and had registered with the Scottish Social Service's Council (SSSC) as required. The service encouraged staff to undertake additional training courses appropriate to the work that they perform. This further developed their skills and knowledge and improved outcomes for the children. Staff attended regular staff meetings and staff told us that the meetings provided opportunities to discuss planning and keep up to date with relevant information. We found that staff benefited from having opportunities to reflect on their practice and share recent training courses. Staff had quarterly 1:1 supervision meetings with the manager. Staff told us that the meetings provided them with an opportunity to discuss their strengths and identify future training and development. Areas for improvement Inspection report continued We looked at two new staff files. We found that whilst both members of staff had clear PVG (protecting vulnerable groups) checks, the service received the PVG updates after the staff had started work with the children. Both files contained two references however; we noted that one of the references had arrived after one of the new staff had begun work in the nursery. The manager told us that procedures were in place to keep the children safe. This had included ensuring that new staff were not left alone with the children. We discussed with the service the importance of ensuring that all safe recruitment checks are carried out at all times. See requirement 1. Apple Tree Nursery, page 20 of 27

21 During feedback, we discussed supporting staff with their understanding of the evaluation processes used within the service. Grade awarded for this statement: 3 - Adequate Number of requirements: 1 Number of recommendations: 0 Requirements 1. The provider must ensure that all staff are fit to be employed and have the qualifications, skills, and experience necessary for the work that is to be performed. This is in order to comply with regulation 9 (1)(2)(a)(b)(c) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/210) Timescale: on receipt of this report. Apple Tree Nursery, page 21 of 27

22 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 We have considered the evidence gathered for the grade awarded in this Quality Statement under Quality Theme 1, statement 1. Areas for improvement Please refer to Quality Theme 1, statement 1 Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0 Apple Tree Nursery, page 22 of 27

23 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 looked at the audit systems used to monitor health and safety and staff practice. The service had given staff questionnaires about the quality of the service. We found evidence that the service used the feedback from staff to influence the improvement plan and self-assessment document. We noted that the service had also used parent feedback about the self-assessment document when developing the improvement plan. Staff told us that the manager monitored their practice and provided written and verbal feedback. We found evidence that the monitoring identified the strengths of staff and areas for improvement. We found evidence that the manager carried out regular auditing of a variety of aspects of the service including; accidents and incidents, personal learning plans and medication. We found that the service acted on suggestions from parents and children. Parents confirmed this in our care standard questionnaires and on the day of the inspection. Areas for improvement Whilst we recognise that the service had laid the foundations for effective quality assurance processes, we had identified areas of concern during the inspection. We have confidence however; that the service will put in place the necessary procedures to recruit staff safely. The service reassured us that procedures were in place to keep the children safe for example, new staff did not carry out personal care with the children. We discussed with the service continuing to embed the quality assurance systems. This would strengthen and further enhance the quality of care provided. See recommendation 1. The service told us that they were going to introduce peer observations with the staff. This would mean that staff would have a greater understanding of quality assurance processes and further enhance their practice. Grade awarded for this statement: 3 - Adequate Number of requirements: 0 Number of recommendations: 1 Inspection report continued Apple Tree Nursery, page 23 of 27

24 Recommendations Inspection report continued 1. It is recommended that the service further develop and implement quality assurance systems to evaluate the effectiveness of staff practice and the service as a whole to ensure the health, welfare and safety of children. National Care Standards early education and childcare up to the age of 16, Standard 14: Well-managed service Apple Tree Nursery, page 24 of 27

25 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 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). Apple Tree Nursery, page 25 of 27

26 5 Summary of grades Quality of Care and Support Very Good Statement 1 Statement Very Good 5 - Very Good Quality of Environment Good Statement 1 Statement Very Good 4 - Good Quality of Staffing Good Statement 1 Statement Very Good 3 - Adequate Quality of Management and Leadership Good Statement 1 Statement Very Good 3 - Adequate 6 Inspection and grading history Date Type Gradings 19 Jul 2012 Unannounced Care and support 4 - Good Environment 3 - Adequate Staffing 4 - Good Management and Leadership 3 - Adequate All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Apple Tree Nursery, page 26 of 27

27 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: Apple Tree Nursery, page 27 of 27