Hunters Crescent Care Home Service Children and Young People 29 Hunter's Crescent G74 3HY Telephone: 01355 270839

Inspected by: Alan Paterson Jan Strain Type of inspection: Unannounced Inspection completed on: 5 October 2012 Inspection report continued

Contents

Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 6 3 The inspection 9 4 Other information 20 5 Summary of grades 21 6 Inspection and grading history 21

Service provided by: South Council

Service provider number: SP2003003481

Care service number: CS2003051275

Contact details for the inspector who inspected this service: Alan Paterson Telephone 01698 897800 Email [email protected]

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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 Hunter Crescent is a Local Authority facility for Looked After and Accommodated Children. It provides its services in a purpose built, home-like setting. Service users are supported to personalise their own bedrooms and are supported to comment on and influence their care and support arrangements.

What the service could do better The service could improve its record keeping by ensuring young people's personal files are accurate, kept up to date and older paperwork archived.

What the service has done since the last inspection The service is now settled after a period of upheaval as Hunter Crescent and Arran House services amalgamated in the Hunter Crescent location.

Conclusion Hunters Crescent is a good unit which is now settling down after a period of transition. It has in place policies, procedures and practices which lead to good outcomes for young people.

Hunters Crescent, page 3 of 23 Inspection report continued Who did this inspection Alan Paterson Jan Strain

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1 About the service we inspected

Hunters Crescent is owned and managed by Council. It was registered with the Care Commission in March 2004 to provide a care home for a maximum of eight young people. There were five young people living in the service at the time of this inspection.

The service is provided from a purpose built house in a residential area in East Kilbride. It blends well with other houses in the area. The service aims to "provide care for children in South Lanarkshire who require a safe environment."

Based on the findings of this inspection this service has been awarded the following grades:

Quality of Care and Support - Grade 4 - Good Quality of Environment - Grade 4 - Good Quality of Staffing - Grade 4 - Good Quality of Management and Leadership - Grade 4 - Good

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 www.careinspectorate.com or by calling us on 0845 600 9527 or visiting one of our offices.

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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 the report following an unannounced inspection. The inspection was carried out by Alan Paterson and Jan Strain between the 4th and 5th October.

In this inspection we gathered evidence from various sources, including the relevant sections of policies, procedures, records and other documents including:

Certificate of Registration Accident log Incident log Complaints/suggestions log Medication records Quality Assurance Audits Questionnaires Care plans of people who use this service Personal Activity Plans Staff training records Staff meeting minutes Staff supervision notes Self assessment document

We spoke with two service users, two members of staff and the service manager.

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

Hunters Crescent, page 6 of 23 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 www.firelawscotland.org

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The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic

Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. We received this electronically

Taking the views of people using the care service into account We spoke to two service users who expressed the opinion that they liked being in the service

Taking carers' views into account NA

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3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found.

Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 4 - Good

Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths

The service is part of the overall provision of social work services by South Lanarkshire Council and therefore operates under the providers participation policies which promote service users participating in the development and provision of their own services. This shows that the provider has made provision for service user participation.

In the individual files we noted that prior to reviews the service user was asked to comment on the reports and this response was recorded. The service had other systems in place where the service user was encouraged to countersign the document and make comment. This showed that the service users were being afforded opportunities to make comments on their care.

Service users' meetings were held regularly and were facilitated by a member of staff. Issues were recorded in a book and fed into the staff meeting agenda and the results of discussion fed back to the service users. To facilitate this the service users meeting always took place the day before the staff meeting. This meant that the service users concerns were dealt with in a short time frame.

The manager had arranged for a service user to attend staff meetings. However, the service users frequently failed to attend. This showed the service continued to make efforts to involve the service users in decisions about their care even though the opportunity was not always taken up.

Hunters Crescent, page 9 of 23 Inspection report continued A 'Who Cares' (an independent, young person's advocacy organisation) worker regularly comes to the unit and spent time with the service users. This helps to ensure that service users can make their views known.

The unit operates a key worker system where each service user has a named worker who is tasked with being the main contact with the service user. This is good practice which helps the service user to make their needs and wishes known through having developed a good relationship with a member of staff.

Daily notes are consistently made and these are compiled into the service users file. The format of recording requires staff to match the recording to Getting it Right For Every Child outcomes. This promotes good care outcomes for the service user.

Care reviews involving all involved parties are held within required timescales and recordings of these meetings are held in the service user's individual file. Decisions from reviews were summarised in clear action plans which enabled participants to ensure they were acted upon.

We found evidence that there was collaboration with schools and health services to achieve good outcomes for the service users.

Service users were involved in the planning, shopping for and cooking of meals. They also are given money to buy their own toiletries.

The service had used questionnaires for parents, teachers and social workers regarding the service. This is good practice as it allows these important people in the service users lives to make comments about the service. Areas for improvement We noted that there was some confusion and contradiction in the information held in individual files. For example one service user had three different dates of birth. Some of the information we saw was out of date and could have been risky for the service user if dealing with someone who did not know their case well. For example in one part of a service users file there was information regarding visits to members of family being discontinued but appeared to be still ongoing in another. We also found references to people in contact with the service users in daily logs but who did not appear in the list of contacts. (see requirement 1)

Individual files were more professional facing than service user friendly in that the reports were contained in sparse pre formatted documents . We also found the use of professional jargon within the files and staff usage which could stigmatise the service users. These included the use of the word 'contact' for visit and DOA for date of admission. This meant that the information contained reflected the professionals viewpoint more that the service users.

Hunters Crescent, page 10 of 23 Inspection report continued Files held more information than was needed for the provision of care would benefit from some of the older information being archived. So much out of date information carries the risk of confusing what action should be taken.

Some of the documents in individual files which equirr ed signatories and counter signatories were not complete. This could lead to confusion as to who can, for example, give permissions for health care. (see requirement 1)

Grade awarded for this statement: 4 - Good Number of requirements: 1 Number of recommendations: 0

Requirements 1. The provider must review the information held in individual files to ensure that all that is held in them is up to date, does not contradict itself, is complete and necessary for the care of service users.

SSI 114 Regulation 5 (1) Personal Plans

timescale 6 weeks from receipt of this report

Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths All service users are registered with a GP and with a local dental practice. There is a Health nurse allocated to the service. Service users have an annual health check. This helps to ensure that the service users receive good health care.

All medication is receipted into the service and stored appropriately. Medicines administered are appropriately recorded Service users have access to health promotion resources such as Leisure passes, advice and guidance about drugs and alcohol and eating well.

Staff have attended training to enable them to help the service users with a range of health and wellbeing matters. Examples of these are given in section 3.3. This enables them to provide support to the service users in the area of health and wellbeing

Service users have their own bedrooms which they are supported to decorate and maintain for themselves. This ensures that the service users has their own private space that they can relax in.

The service staff liaise with the schools the service users attend which helps to ensure that issues and difficulties are known and support offered.

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The service users are supported to go on holiday by the staff. The service users are involved in the choosing, planning and preparation of the holidays.

The service has in place appropriate absconding protocols and work in collaboration with the community police when required.

Areas for improvement Crisis management and risk assessment plans lacked detail especially action plans for the minimising of risk. This could lead to inappropriate action being taken in response to an identified risk. (see requirement 1)

Sanctions were mainly the holding back of the service users pocket money. There was little evidence that this worked which is one of the main criteria of a behaviour management strategy. There was also the risk that service users would be made vulnerable when deprived of their money. The manager should look at more imaginative ways of managing service users behaviour (recommendation 1).

The bullying policy we examined was dated 2005 and had no record of being updated.(see recommendation 2)

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0

Requirements 1. The provider must ensure that risk assessment and crisis management assessments have clear action plans.

SSI 114 Regulation 4 (1) Welfare of Users (c)

timescale: 6 weeks from the receipt of this report

Recommendations 1. The provider should review the use of withholding money as a sanction and seek more effective ways of managing behaviour.

NCS 15 Care Homes for Children and Young People - Daily Life (9)

Timescale: 4 weeks from receipt of this report

Hunters Crescent, page 12 of 23 Inspection report continued 2. The provider should ensure that policies and procedure documentation is up to date

NCS 4 Care Homes for Children and Young People - Support Arrangements

timescale: 4 weeks from receipt of this report

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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 The information given under statement 1.1. equally is applied here in the context of environment.

In addition

Service users had been supported in decorating their own bedrooms. This enabled them to directly participate in improving their own immediate environment.

The provider has clearly invested heavily in the environment and the space and furnishings within the service were of very high standard.

We noted and service users and staff commented on the building being similar to the to other buildings in the locality. This reflected good practice in having service locations which did not stand out from other buildings in the local area.

Service users had televisions in their own rooms which made their own personal space more comfortable.

The service users have access to two computers in the lounge areas downstairs.

Service users can make themselves a snack at any time. Areas for improvement We noted that the downstairs area in the service was not as personalised as the upper floor.

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0

Hunters Crescent, page 14 of 23 Inspection report continued Statement 2 We make sure that the environment is safe and service users are protected. Service strengths We noted that the environment was very pleasant, clean and tidy.

The service users bedrooms were decorated in their choice of colours and were individualised.

All staff had undertaken food hygiene training (REHIS). We found evidence of this in that; Food, Fridge and freezer temperatures were recorded, there were appropriate coloured chopping boards and the dishwasher was loaded safely.

There had been a recent fire safety audit with action identified which the manager was implementing. Fire checks are being done appropriately and are recorded.

The repairs log recorded all repairs and is signed off appropriately.

Areas for improvement The upstairs bathrooms had too many items stored in them which could present a risk to service users. These included razors and nail varnish. (see requirement 1)

We noted that fire drills were not being recorded by the service this will be passed on to the fire service who hold responsibility for regulating fire safety.

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0

Requirements 1. The provider must ensure that health and safety systems are enacted. These include; systems for recording who is in the building and appropriate storage of potentially harmful items.

timescale: 2 weeks from receipt of this report.

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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 The information given under statement 1.1 applies equally here in the context of staffing.

The service shows good practice in holding regular staff meetings which are recorded and action taken on points raised. Areas for improvement see statement 1.1

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0

Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths The provider operates a safe recruitment policy which requires competitive interview, two references and Protection of Vulnerable Groups check before the candidate can take up post.

All staff are required to have or be working towards both Scottish Vocational Qualification at level three and a Higher National Certificate in Social Care in order to register with the SSSC.. All staff are registered with the Scottish Social Services Council. Promoted staff have undertaken the appropriate management qualifications. This shows hat all staff have the appropriate training and qualifications to work in residential child care.

Hunters Crescent, page 16 of 23 Inspection report continued All staff undergo induction training, have personal development plans and have a Personal Development Review twice a year. The provider operates a staff development website on the intra-net which all staff have access to which enables staff to identify and engage with training opportunities.

The manager maintains individual records of staff training. Training accessed includes: child protection (mandatory), Therapeutic Crisis Intervention (behaviour management;mandatory), Substance Abuse, REHIS (food hygiene), ASIST (suicide prevention), Assessment Planning and Report writing.

We were confident that this evidence shows that the staff in the service are well trained.

Staff interviewed were positive about working in the service and particularly commented on the access to training. Areas for improvement We noted that supervision did not happen as regularly as it should. This is an important system which checks whether staff are maintaining their personal development.

We noted that some staff had not had recent TCI updates or child protection training.

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0

Requirements 1. The provider should ensure that staff undertake relevant training and updates

SSI 114 Regulation 13 Staffing (a)

timescale 6 weeks from receipt of this report.

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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 The information given in statement 1.1 apply to this statement in the context of management and leadership Areas for improvement see statement 1.1

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 0

Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide Service strengths The provider operates a continual audit of the services it provides through external quality management groups. This involves the manager of the service providing monthly and bi-annual reports to external management.

Care plans are updated monthly and daily notes summarised identifying Getting It Right For Every Child outcomes.

The service users are involved in providing information on their views on the service through house meetings, service users meetings and are invited to attend staff meetings. The service users are supported to do so by their key workers and external 'Who Cares' workers. In discussion with a service user the service user confirmed he was aware of and had used these supports.

The Provider has a complaints procedure part of which informs the potential complainer of their right to complain to the Care inspectorate.

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Areas for improvement The care plan audits are not effective (see previous comments and requirements about out of date information).

We did not find evidence of ongoing management audits for example spot checks or records that checks had been made.(recommendation 1)

More use could be made of opportunities to gather the views of families and others through more frequent use of questionnaires. (recommendation 2)

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 2

Recommendations 1. The provider should make more use internal audits to ensure that systems in place are working appropriately

NCS 7 Care Homes for Children and Young People - Management and Staffing

timescale: ongoing 2. The provider should make more use of questionnaires to gather information n the views other people involved in the care of the service users have.

NCS 7 Care Homes for Children and Young People - Management and Staffing

timescale: ongoing

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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 SCSWIS re-grading the Quality Statement within the Management and Leadership Theme as unsatisfactory (1). This will result in the Quality Theme for Management and Leadership being re-graded as Unsatisfactory (1).

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5 Summary of grades

Quality of Care and Support - 4 - Good

Statement 1 4 - Good

Statement 3 4 - Good

Quality of Environment - 4 - Good

Statement 1 4 - Good

Statement 2 4 - Good

Quality of Staffing - 4 - Good

Statement 1 4 - Good

Statement 3 4 - Good

Quality of Management and Leadership - 4 - Good

Statement 1 4 - Good

Statement 4 4 - Good

6 Inspection and grading history

Date Type Gradings

18 Nov 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed

3 Aug 2010 Announced Care and support 5 - Very Good Environment 4 - Good Staffing 5 - Very Good Management and Leadership Not Assessed

8 Feb 2010 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 4 - Good Management and Leadership 4 - Good

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27 Aug 2009 Announced Care and support 4 - Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good

30 Apr 2009 Announced Care and support 4 - Good Environment 3 - Adequate Staffing 3 - Adequate Management and Leadership 3 - Adequate

30 Apr 2009 Announced Care and support 4 - Good Environment 3 - Adequate Staffing 3 - Adequate Management and Leadership 3 - Adequate

28 Dec 2008 Announced Care and support 4 - Good Environment 3 - Adequate Staffing 3 - Adequate 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.

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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 0845 600 9527.

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: www.careinspectorate.com or by telephoning 0845 600 9527.

Translations and alternative formats This inspection report is available in other languages and formats on request.

Telephone: 0845 600 9527 Email: [email protected] Web: www.careinspectorate.com

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