Milne, Denise Westhill Inspection completed on 05 August 2015
Service provided by: Milne, Denise Service provider number: SP2014985743 Care service number: CS2014324257 Inspection Type: Unannounced Care services in Scotland, including childminders, 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 0345 600 9527 www.careinspectorate.com @careinspect page 2 of 17
1 Introduction The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at www.careinspectorate.com. This service was registered with the Care Inspectorate on 15 July 2014. The Care Inspectorate is committed to improving the health and wellbeing of all children receiving a care service. We want to ensure they have the best start in life, are ready to succeed and live longer, healthier lives. We check services are meeting the principles of Getting it right for every child (also known as GIRFEC). Set up by Scottish Government, GIRFEC is a national approach to working in a consistent way with all children and young people. It is underpinned by the principles of prevention and early intervention. The approach helps services focus on what makes a positive difference for children and young people - and what they can do to improve. Getting it right for every child is being woven into all policy, practice, strategy and legislation that affect children, young people and their families. There are eight wellbeing indicators at the heart of Getting it right for every child. They are, safe, healthy, achieving, nurtured, active, respected, responsible and included. They are often referred to as the SHANARRI indicators. We use these indicators at inspection, to assess how services are making a positive difference for children. The service is registered to provide a care service to a maximum of 7 children at any one time under the age of 16, of whom no more than 6 are under the age of 12 and under, and of whom no more than 3 are not yet attending primary school and of whom no more than 1 is under 12 months. Numbers are inclusive of children of the childminder's family. The service is provided in a detached bungalow in the Aberdeen suburb of Westhill, to the west of Aberdeen. The childminder's home is close to local schools, parks and amenities. The aims of the service include: page 3 of 17
- To create a stimulating, caring and safe environment for all children in my care. - To work in partnership with parents/carers in an open, honest way. - To provide a valuable service for my local community contributing to children's development and learning in a safe, welcoming, homely environment. What we did during our inspection We wrote this report following an unannounced inspection, which took place between 8:15am and 1:45pm on Tuesday 4 August 2015. One inspector carried out the inspection. We gave feedback to the childminder on 4 August. The Care Inspectorate received fully completed annual return and selfassessment documents from the provider. We were satisfied with the way the provider completed this and with the relevant information included for each heading that we grade services under. We sent six Care Standards Questionnaires (CSQs) to the childminder to distribute to the parents. Three parents returned completed questionnaires. We spoke with two parents by telephone following inspection. During the inspection process, we gathered evidence from various sources, including the following: We spoke with: - two minded children - the childminder's children - the childminder. We looked at: - parent questionnaires returned to the Care Inspectorate before the inspection - health and safety records - accident and incident records - medication records - service policies and procedures - parent information booklet page 4 of 17
- six children's records - equipment and the environment - certificates of the training undertaken by the childminder. and: - observation and discussion with two minded children and the childminder's children - discussion with the childminder - observing interactions between the childminder and the children - observation of the environment, including available resources. Views of people using the service There were two minded child present during the earlier part of the inspection, the childminder transported the older child to a gymnastics club before 10am. We observed the children to be comfortable in the childminder's home and when interacting with her children. The childminder knew the children well and interacted with each in a manner appropriate to their stages of development. The older child was happy to chat with us about the club she would be attending that day and tell us about her gymnastics. During the course of the morning the younger child was happy to interact with us and include us in his activities. We observed the child to be familiar with the available activities and for him to take the childminder to the toy cupboard when he wanted to swap some of the resources with which he was playing. We sent out six CSQs to the childminder to distribute to parents. We received three questionnaires before inspection. The childminder currently had nine children from seven families using her service. The parents indicated that they were very happy with the quality of care their children received in the service. Parent comment included: - "Denise is a fabulous childminder. This allows me to concentrate at work with absolutely no concerns at all. Denise does a superb job". page 5 of 17
- "I cannot think of one negative comment to make about Denise. My child loves attending and is delighted when dropped off at Denise's. My child's development has come on in leaps and bounds since starting with Denise. She is brilliant". We were unable to speak with parents during the inspection. We spoke with three parents by telephone following inspection. Parent comment has been included in the body of the report. Self assessment Every year all care services complete a 'self assessment' telling us how their service is performing. We check to make sure this is accurate. We received a completed self-assessment document from the childminder. We were satisfied with the way the childminder completed this and with the relevant information included for each heading that we grade services under. What the service did well We observed the childminder and the children to have relaxed and comfortable relationships. The childminder supported the children to explore the resources, using appropriate praise and encouragement. What the service could do better The childminder to ensure the accurate, comprehensive recording of the administration of medication to children. 2 The grades we awarded We grade the quality of care and support, the quality of the environment and the quality of management and leadership. If the childminder employs an assistant, we also grade the quality of staffing. In each case, we award a grade on a scale from 1 to 6, where 1 is unsatisfactory and 6 is excellent. Quality of care and support Quality of environment Quality of staffing Quality of management and leadership 5 - Very Good 5 - Very Good 4 - Good page 6 of 17
3 Quality of care and support Findings from the inspection The childminder had nine children from seven families registered with her service. On the morning of inspection there was one pre-school child and one primary school aged child attending the service. The childminder's three children were also present. During the earlier part of the morning the childminder transported the older minded child to a gymnastics club. We observed the minded children to be comfortable in the home and familiar with the environment. Whilst there was around eight years difference in the ages of the two minded children we observed the childminder to interact with both children in a manner which was appropriate to each child's stage of development. The childminder included both children in conversation and supported them to choose from the activities available. The childminder's children engaged with both of the minded children in a friendly manner and we observed all of the children to be relaxed in each other's company. The minded children had warm and nurturing relationships with the childminder and her family. All of the children played companionably together and the childminder anticipated and responded appropriately when supporting each child's individual needs. We observed the childminder to know the children well and to show awareness of each child's individual personality, likes and dislikes. She supported the toddler to participate in the activities and used distraction effectively when managing their behaviour. Parents indicated to us in the CSQs that they received clear information about the service before their children started and that they were able to visit the service before using it. This supported a relaxed start for the children and the parents. The childminder and parents told us that they fully discussed the care and support needs of each child before they started with the service, and thereafter page 7 of 17
on an ongoing basis. This promoted parental involvement and influence in the care and support of their child. Parents told us that the childminder kept them well-informed about their child's day and was responsive and supportive of their child's changing needs. A parent commented, 'since starting with Denise my child's development has come on in leaps and bounds'. However, the childminder did not maintain a written record of the ongoing individual, care and support she provided in order to meet the health, welfare and safety needs of each child (please see recommendation 1). Lunches and most snacks were provided by the parents and we observed were mainly healthy options. We discussed the current early years nutritional guidance, Setting the Table, which was now available at: http://www.healthscotland.com/documents/21130.aspx, of which the childminder had a copy. The childminder told us that she was in the process of reviewing the guidance and we discussed the benefits of sharing this with her parents which would further promote healthy options for the children. Documentation reviewed and discussion with the childminder indicated that she administered medication safely. However, records indicated that, in one instance, medication had been administered without the appropriate signed parental permission or accurate reasons for the administration of the medication (symptoms). (Please see recommendation 2). Discussion with the older minded child confirmed that the childminder recognised the importance of fresh air and exercise in promoting an active lifestyle for the children. The children regularly visited local parks and shops and, taking into account children's preferences, the childminder organised outings during the holiday periods. The parents who returned the CSQs agreed that the childminder was flexible and responsive to their child's individual needs and that the childminder helped support their child with changes in their family life. Please also refer to Quality of Environment and Quality of Management and Leadership for further information relative to this section. Grade page 8 of 17
The quality of care and support is graded 5 - Very Good Requirements Number of requirements - 0 Recommendations Number of recommendations - 2 1. The childminder to ensure that she maintains a written record (Personal Plan) for each child, detailing the ongoing, changing, care and support provided to ensure the health, welfare and safety needs of each child are being met. This record to be reviewed with parents at least every six months, when requested to do so by the parent or when there is a change in a child's health, welfare or safety needs. National Care Standards Early Education and Childcare up to the age of 16 - Standard 3: Health and wellbeing; Standard 6: Support and development. 2. In order to meet the health, welfare and safety needs of children, the childminder to ensure the accurate, comprehensive recording of the administration of medication to children. This to include, but not exclusively: - signed parental permission for each medication administered; - accurate description of reasons for the administration of the medication (symptoms). National Care Standards Early Education and Childcare up to the age of 16 - Standard 3: Health and wellbeing; Standard 14: Well-managed service. Reference: Healthcare Guidance. The Management of Medication in Daycare and Childminding Services. Publication code: HCR-0412-061. Available online: www.scswis.com/index.php?option=com_docman&task=doc 4 Quality of environment page 9 of 17
Findings from the inspection The childminder provided a welcoming and homely environment for children and their families. We observed the minded children to be relaxed and familiar with the layout of the home. The children had independent access to a good selection of resources in the playrooms which were appropriate to their individual stages of development. We observed the home and garden to be well maintained, safe and secure. Parents who returned the CSQs all strongly agreed that the childminder's home was a safe, secure, hygienic, smoke free, pleasant and stimulating environment. The resources inside the home and in the garden appeared clean and well maintained and the childminder described effective cleaning routines. We discussed effective prevention and control of infection which included effective hand washing before eating and after toileting, outside play and petting the dog. This was appropriately detailed in the childminder's policies and procedures. During the inspection we did not have the opportunity to observe the childminder changing a child's nappy. In discussion the childminder described appropriate practice which included effective use of disposable gloves and apron. Infection prevention and control guidance may be downloaded from Health Protection Scotland: Infection Prevention and Control in Day Childcare Settings. http://www.documents.hps.scot.nhs.uk/hai/infection-control/guidelines/ infection-prevention-control-childcare.pdf This guidance is currently under review. The minded children could play in the sun room, the kitchen/family area and the secure garden area. The layout of the rooms provided the children with easy access to their chosen activity and space to move around safely. The children had supervised access to additional resources stored in a hall cupboard and we observed the childminder to respond to children's requests for different toys and activities. The childminder demonstrated awareness of the importance of regular fresh air and exercise for the children. A child told us that they regularly played outside in page 10 of 17
the garden and in the local parks, and that during the holidays the childminder took them on outings. On return from holiday, the previous day, one of the younger children was now walking. The childminder demonstrated an awareness of the increased hazards to be considered now that the child was more mobile. This included securing the doors to the sun room in order that the child did not trap fingers. The childminder demonstrated an appropriate knowledge of the safeguards required when in her home, on outings with the children or when travelling by car. However, the childminder did not have recorded risk/benefit assessments which identified these hazards and recorded how she appropriately minimised risk (please see recommendation 1). We observed the childminder to support the young child to be safe, taking into account his individual stage of development. This promoted the child's selfconfidence and decision making skills. We observed the childminder to undertake appropriate, safe practice whilst preparing snack and to store children's packed lunch items in a safe and appropriate manner. The parents who returned the CSQs strongly agreed that the childminder ensured regular access to fresh air and energetic physical play for the children and that there was enough space for the children to play and get involved in a range of activities. Please also refer to the Quality of Care and Support and the Quality of Management and Leadership for further information. Grade The quality of environment is graded 5 - Very Good Requirements Number of requirements - 0 page 11 of 17
Recommendations Number of recommendations - 1 1. The childminder to ensure that she maintains comprehensive and effective, recorded risk/benefit assessment for all areas of her service. This to include, but not exclusively, the home (including household pets and the garden), outings and transport of the children by car. All recorded risk/benefit assessments to be shared with parents and, where appropriate, the children and to be regularly reviewed. National Care Standards Early Education and Childcare up to the age of 16 - Standard 2: A safe environment; Standard 14: Well-managed service. 5 Quality of staffing We only assess this where the childminder employs an assistant. 6 Quality of management and leadership Findings from the inspection The childminder was a member of the Scottish Childminding Association (SCMA) where she also purchased her business insurance. She advised that she found their regular communications informative and that they were helpful should she require to phone for advice. We discussed other sources of information including Scottish Social Services Council (SSSC): www.sssc.uk.com/ and the Care Inspectorate: www.careinspectorate.com and www.hub.careinspectorate.com The childminder told us that she kept her practice up-to-date in a number of ways which included: - regular contact with the SCMA should she have a query - regular newsletters from the SCMA which she found informative page 12 of 17
- she had undertaken an induction course with the SCMA before she began childminding. She found the training comprehensive, covering child related knowledge and also how to administer the business - meeting with other childminders in the area, sharing practice and knowledge. The childminder had undertaken training in first aid in March 2015 and training in child protection in April 2015. Discussion with the childminder indicated that she had appropriate knowledge of first aid and child protection in relation to keeping children safe. During the registration process the childminder was advised that, during the first year of registration, we expected her to attend child protection, infection control, first aid and food hygiene training. The childminder was registered with us 15 July 2014. Current best practice indicates that this core training be undertaken at least every three years. The childminder to also ensure that she has an effective system for identifying and monitoring her development needs and that training is carefully planned and evaluated in accordance with national and local guidelines and the needs of the children in her care (please see recommendation 1). We discussed the Scottish Government initiative Getting it Right for Every Child (GIRFEC) and the SHANARRI indicators (please see relevant information in the Introduction) of which the childminder was aware. During this inspection we observed that the childminder's practice supported areas of SHANARRI. Our comments in respect of this can be viewed throughout the report. We observed the childminder's practice to be appropriate during inspection; she treated the child in her care in a warm and nurturing manner and knew them well as individuals. She praised them appropriately and celebrated their successes. In relation to the younger child, the childminder employed effective distraction when appropriate, actively listened to the children and supported them to offer their views and opinions. Parents told us that: - "Denise is just great. XXXX loves going and would go every day if possible". page 13 of 17
- "Denise takes them out a lot and also meets with other childminders and their children". - "Denise is fantastic, I cannot fault her. We are very lucky to have her as our childminder". - "Denise knows XXX really well and takes on board my comments and provides activities that XXX likes to do". - "XXXXX absolutely loves Denise and her family. She knows XXXXX as well as we do." - "Denise makes me feel very comfortable, I can discuss anything with her". Parents told us that they had good daily dialogue with the childminder and that children's preferences influenced the activities offered (please see recommendation 2). The parents who returned the CSQs strongly agreed that, overall, they were happy with the quality of care their child received in the service. Please also refer to Quality of Care and Support and Quality of the Environment. Grade The quality of management and leadership is graded 4 - Good Requirements Number of requirements - 0 Recommendations Number of recommendations - 2 1. The childminder to ensure that she undertakes regular, comprehensive, training and development in accordance with current legislation and good practice guidance. This to include, but not exclusively, food hygiene and infection control. This is in order to regularly update her knowledge and influence her practice, promoting good outcomes for the children in her care. National Care Standards Early Education and Childcare up to the age of 16 - page 14 of 17
Standard 12: Confidence in staff; Standard 15: Well-managed service. 2. The childminder to development strategies which ensure the involvement of children and parents in regularly assessing and improving the quality of the overall service. National Care Standards Early Education and Childcare up to the age of 16 - Standard 13: Improving the service; Standard 14: Well-managed service. 7 What the service has done to meet any recommendations or requirements we made at our last inspection Previous requirements There are no outstanding requirements. Previous recommendations There are no outstanding recommendations. 8 Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. page 15 of 17
9 Enforcements No enforcement action has been taken against this care service since the last inspection 10 Other issues There were no other issues identified during the inspection. 11 Inspection and grading history This service does not have any prior inspection history or grades. page 16 of 17
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 enquiries@careinspectorate.com 0345 600 9527 www.careinspectorate.com @careinspect Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is c?nain eile ma nithear iarrtas. page 17 of 17