Cambusnethan Residential Children's House Care Home Service Children and Young People 239 Cambusnethan Street Cambusnethan ML2 8BS Telephone: 01698 403737/8

Inspected by: Howard Armstrong Pauline Davidson Type of inspection: Unannounced Inspection completed on: 5 July 2012 Inspection report continued

Contents

Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 14 4 Other information 31 5 Summary of grades 32 6 Inspection and grading history 32

Service provided by: North Council

Service provider number: SP2003000237

Care service number: CS2005113322

Contact details for the inspector who inspected this service: Howard Armstrong Telephone 01896 664400 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 3 Adequate Quality of Environment 4 Good Quality of Staffing 4 Good Quality of Management and Leadership 4 Good

What the service does well The service provides very good support to a wide range of young people with differing needs. The staff team is well supported by the manager. The provider is knowledgeable and involved with service issues, and committed to ongoing improvements. Young people told us that it was a good place to stay and that they were generally happy with the way that staff supported them. Referring social workers confirmed that the service worked closely with them to meet young people's needs.

What the service could do better The service and provider needed to continue to work on ways of involving young people and other stakeholders more fully in providing feedback and making improvements. The service should make further improvements to its record-keeping and filing systems.

What the service has done since the last inspection The building has been completely renovated to a very high standard within the past six months. The staff team is much more settled and confident. Staff feel supported by management, and have been provided with developmental training to improve overall relationships and working practices. Improvements have been made to the accuracy of personal planning for young people.

Cambusnethan Residential Children's House, page 3 of 34 Inspection report continued Conclusion We found that the young people at Cambusnethan Children's House were much happier with the service than at the previous inspection. We observed that staff and young people worked well together and respected one another. There was a very good atmosphere in the house and staff seemed to be genuinely committed to the involvement of young people in improving the service, even though they had not yet created appropriate methods of fully achieving this.

Who did this inspection Howard Armstrong Pauline Davidson

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1 About the service we inspected

The Care Inspectorate regulates care services in . Prior to 1 April 2011, this function was carried out by the Care Commission. Information in relation to all care services is available on our website at: www.careinspectorate.com

This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April 2011.

Requirements and recommendations If we are concerned about some aspect of a service, or think it could do more to improve its service, 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. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reforms (Scotland) Act 2010 and Regulations or Orders made under the Act, or a condition of registration. Where there are breaches of the Regulations, Orders or conditions, a requirement must be made. Requirements are legally enforceable at the discretion of the Inspectorate.

Cambusnethan Residential Children's House is provided and managed by Council. It is based in a purpose built single storey building in Wishaw.

It is normally registered to provide a care home service to a maximum of 6 children between the ages of 8 and 18 years. From 25 May 2012 until 30 November 2012 it can provide a care service to a maximum of 7 children between the ages of 8 and 18 years. This number includes one child from Buchanan Street Children's House.

The unit has six bedrooms, each of which has en-suite facilities, and one further bedroom in use at present. There is a large open plan sitting room/dining area, an education/activity/computer room, a meeting room and an additional open plan sitting area.

At the time of inspection there were seven young people accommodated in the service.

The service aims state that they commit to a child centred approach and strive to promote the best interests of the young people.

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

Quality of Care and Support - Grade 3 - Adequate 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 high 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 This report was written following an unannounced inspection which started on 13 June 2012 between 10:15am and 5:30pm. We finished the inspection on 05 July 2012 between 10:15am and 3:50pm. We gave feedback to the provider and manager at the end of the inspection. The inspection was carried out by Howie Armstrong and Pauline Davidson, Inspectors, the Care Inspectorate.

We sent seven Care Service Questionnaires (CSQs) to the service for distribution to young people so that they could give us their views about the service. Five completed forms were returned to us.

Evidence was gathered from a variety of areas including:

• The most recent annual return and self assessment document • Discussion with the children and young people • Lunch with care staff and domestic workers • Discussion with Residential Childcare Workers, Seniors and the Manager • Observation of the property • Observation of staff interaction with the young people • Feedback from referring social workers and the advocacy service. • Examination of records including: Case tracking several young people and examination of: care plans, personal outcome plans, incidents, complaints, medication, risk assessment, health & safety checks, menus, minutes of young people's meetings, staff meetings and senior staff meetings.

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.

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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 www.firelawscotland.org

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What the service has done to meet any requirements we made at our last inspection

The requirement Requirement 1 The Provider must ensure that an ethos of respect is established. In order to do this consideration should be given to the following:

Identify training needs in relation to teamwork and respect. Deliver appropriate training. Ensure a balanced skill mix on each shift. Develop systems to improve communication which are closely monitored. Issues of inconsistency should be closely monitored and appropriate action taken to address these. This is in order to comply with SSI 2002/114 Regulation 4(1) a) - a requirement that the service makes proper provision for service users' health and welfare.

Timescale for implementation: Within three months of the publication of this report.

What the service did to meet the requirement The provider had arranged a developmental training programme for all staff and had appointed to the vacant depute manager post.

The requirement is: Met

Cambusnethan Residential Children's House, page 9 of 34 Inspection report continued The requirement Requirement 2 The following requirement is to comply with: SSI 2002/ 114 Regulation 13(a) Staffing. A regulation intended to ensure suitable staffing levels at all times. A provider shall, having regard to the size and nature of the service, the statement of aims and objectives and the number and needs of service users- (a) ensure that at all times suitably qualified and competent persons are working in the care service in such numbers as are appropriate for the health and welfare of service users; (c) ensure that persons employed in the provision of the care service receive (i) training appropriate to the work they are to perform; and (ii) suitable assistance, including time off work, for the purpose of obtaining further qualifications appropriate to such work.

Timescale: Within 4 weeks of receipt of this report.

What the service did to meet the requirement The provider had appointed additional staff and had organised a developmental training programme for all staff.

The requirement is: Met

What the service has done to meet any recommendations we made at our last inspection We made a recommendation at our inspection of 20 January 2011, which was carried over into the last inspection report:

Steps should be taken to ensure that matters raised by young people are reported back to the staff group as a whole and that matters arising from previous young people's meetings are followed up. National Care Standards 9.2: Making Choices

Progress: We noted that staff meetings mentioned some issues raised by young people. However, we have carried this recommendation into this report because feedback systems for young people remain insufficiently developed. For example, young people's meetings were not held regularly, the Youth Forum had not yet been established, and there was no structured system for gathering young people's informal comments. See recommendation 2 in Quality Statement 1.1.

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The following recommendations were made at the last inspection:

Recommendation 1 The service should actively seek to meaningfully involve the children and young people in assessing the quality of care and support, environment, staffing and management and leadership. The children and young people have a right to receive, and be supported to complete, the Care Standard Questionnaires provided by SCSWIS. National Care Standards Care Homes for Children and Young People Standard 8 - Exercising Your Rights.

The service had planned to progress this through the independent advocacy service and a Youth Forum. We have carried the recommendation over into this report because the external advocacy service has transferred to a new provider which had not yet established group meetings with the young people. Also, the Youth Forum has not yet been established. See recommendation 3 in Quality Statement 1.1.

Recommendation 2 The progress made in ensuring care plans for the children and young people identify clear targets that have been agreed with young people should now be completed for each of the young people. These should ensure risks from substance misuse and risks in the community are fully assessed and action taken to reduce the identified risks. National Care Standards Care Homes for Children and Young People, Standard 4 - Support Arrangements. We found that this recommendation had been met.

Recommendation 3 The service should review its policy on confidentiality and ensure working practices are in line with the principles of this policy and related procedures and of good quality child care practice. National Care Standards, Care Homes for Children and Young People, Standard 6 - Feeling Safe and Secure We found that this recommendation had been met.

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Recommendation 4 Quality auditing systems should fully involve the children and young people and all those with an interest in the service. Young people should in particular be supported to use any internal and external systems for evaluating the service if they wish to do so. National Care Standards Care Homes for Children and Young People Standard 18 - Concerns, Comments and Complaints.

While the service had made demonstrable progress in this area, further improvements needed to be made. The recommendation is carried forward into this report as recommendation 1 in Quality Statement 4.4.

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 heading that we grade them under.

The service provider identified what they thought they did well, some areas for development and any changes they had planned.

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Taking the views of people using the care service into account We sent seven Care Service Questionnaires (CSQs) to the service for distribution to young people so that they could give us their views about the service. Five completed forms were returned to us. These indicated that three young people agreed strongly, and two agreed that they were happy with the quality of care that they received.

During the inspection visits we talked with four young people. We found that generally they were very happy with the service and the way that staff related to them. Although they had concerns (arguably typical for adolescents) about food and bedtimes, they had no major issues about their care. They felt that staff were responsive to their needs and that they intervened appropriately and robustly to deal with incidents like bullying and discrimination.

Taking carers' views into account We did not contact any relatives of service users during this inspection.

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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: 3 - Adequate

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 This section includes evidence from Quality Theme 1, Quality Statements 1.1, 1.3 and 1.4.

We found that the service was operating well in the areas covered by this statement. This represents an improvement on the position at the last inspection.

It was clear from discussion with staff and young people that there was a commitment to involve them in improving the service. We found good evidence that informal suggestions from young people were often taken up and progressed by staff.

Young people were involved in choosing the decor for their rooms as well as common areas in the home. Also, they were involved in suggesting and choosing equipment and resources. This had resulted in improvements to the young people's environment and available resources.

The service had tried out a range of ways to gather young people's views, including questionnaires, house meetings, a comments book and an interactive poster in the computer room.

The local authority planned to set up a Youth Forum with representation from all the children's homes in the area. The self assessment told us that young people had been involved in an awareness-raising exercise with Elected Members.

Two young people who completed questionnaires for us agreed strongly, and three agreed that the manager and staff asked them for their ideas and used them to make things better.

Cambusnethan Residential Children's House, page 14 of 34 Inspection report continued As a whole the feedback we received from talking with young people and from their questionnaires indicated that they were happy with the service and the way that they were treated by staff. Areas for improvement Staff saw house meetings as the key way of gathering young people's ideas for improvement. However, although these meetings were planned regularly, they often did not take place because young people did not want to meet. One young person told us that the meetings were usually planned when he was not able to attend. Staff should work with young people to maximise attendance, both through the timings of meetings and by stressing their importance. Innovative solutions should be considered. For example, if the house meeting controlled a small budget, this might encourage more involvement.

Staff should consider developing a wider range of ways of capturing young people's ideas and feedback. In a group living situation, informal discussion is likely to lead to ideas and suggestions. It was important that staff try to record these, for example in the comments book. See recommendation 1.

We carried over a recommendation last year about staff making sure that matters raised by young people were reported back to the staff group as a whole and that matters raised at young people's meetings were followed up. Some progress had been made with this, but we could not find evidence of sustained improvement. We have carried this into this report as recommendation 2 below.

We have also carried forward recommendation 3 from the last inspection.

Grade awarded for this statement: 4 - Good Number of requirements: 0 Number of recommendations: 3

Recommendations 1. Staff should consider using a range of ways to encourage young people's participation, feedback and ideas for improvement. They should record suggestions and action taken whenever possible, and feedback the results to the young people. National Care Standards, Care Homes for Children and Young People, Standard 9 - Making choices.

Cambusnethan Residential Children's House, page 15 of 34 Inspection report continued 2. Steps should be taken to ensure that matters raised by young people are reported back to the staff group as a whole and that matters arising from previous young people's meetings are followed up. National Care Standards, Care Homes for Children and Young People, Standard 9.2 - Making choices

3. The service should actively seek to meaningfully involve the children and young people in assessing the quality of care and support, environment, staffing and management and leadership. The children and young people have a right to receive, and be supported to complete, the Care Standard Questionnaires provided by SCSWIS. National Care Standards Care Homes for Children and Young People Standard 8 - Exercising Your Rights.

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Statement 3 We ensure that service user's health and wellbeing needs are met. Service strengths We found that the service was operating adequately in the areas covered by this statement.

We confirmed that care plans dealt properly with young people's health and wellbeing needs. Exercise-type equipment had been purchased for general use, and sometimes for specific young people in relation to their own care plans and needs.

We talked with the Health Liaison Officer, who helped to co-ordinate health services for the young people. It was clear that a range of useful resources were provided for the young people.

The service had involved young people in devising new menus which contained more healthy food choices. We discussed the new menu with two of the young people. One told us that he would be happy to eat, or at least try, most of the items. The service had supported one young person to gain access to appropriate ethnic food, and agreed that more work would be done on this.

Four young people who completed questionnaires for us agreed strongly, and one agreed, that staff tried to get them to choose healthy food. Areas for improvement We had concerns about the way that some records were filed, kept and signed off. Several care plans had documents filed in the wrong place. This could suggest that the documents did not exist. Although we recognised that the service used both paper and electronic recording systems, our view was that where paper systems existed, they should be accurate. We found that this was not the case. For example we could find only 58 paper records of incidents during 2011, although we had been informed in the annual return that there had been 83. This made it difficult to track the recordings in relation to specific young people.

Also, the most recent recording of a restraint incident had not been signed off by young person and staff. We noted that individual Crisis Management Plans for two young people involved in serious incidents had not been updated. This could lead to staff (for example temporary or agency staff) not being fully aware of how to manage some young people. See recommendation 1.

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Similarly, care plans and reviews of care plans were not always properly signed off by young person, staff and social worker. This made it difficult to confirm that the young person in particular had been fully involved in these processes. See recommendation 2.

The service used both paper and electronic methods of recording medication and its administration. We confirmed that the paper system was the master system and that it was accurate and up-to-date. There was a clear audit trail and running total of medication, and the night staff double-checked these totals. However, staff had not always recorded the reasons for prescribing medication to young people. See recommendation 3.

The service needed to make sure that care plans linked properly with the personal outcome plans. For example, in one case significant risks noted in the care plan were not dealt with in the personal outcome plan.

Grade awarded for this statement: 3 - Adequate Number of requirements: 0 Number of recommendations: 3

Recommendations 1. The service should review its filing procedures to make sure that records - both electronic and paper, were accurate and up-to-date. National Care Standards, Care Homes for Children and Young People, Standard 7.1 - Management and staffing.

2. The service should make sure that it can evidence that all relevant people, and particularly young people, have agreed and signed care plans and reviews of care plans. National Care Standards, Care Homes for Children and Young People, Standard 4 - Support arrangements

3. The service should make sure that the reason for medicine being prescribed to a young person was always recorded. National Care Standards, Care Homes for Children and Young People, Standard 12.6 - Keeping well - medication.

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Statement 4 We use a range of communication methods to ensure we meet the needs of service users. Service strengths We found that the service was operating well in the areas covered by this statement.

The children's home used an advocacy service that met regularly with the young people to support them. We contacted the head of the advocacy service who confirmed that they were not aware of any issues about communication in the home.

The service told us that parents and friends were actively encouraged to visit young people and were made to feel welcome, for example by being invited to eat with young people or participate in activities.

Young people were able to keep in touch with friends and family using mobile phones, and also had access to landlines within the building for private conversations. Previous residents were able to visit and keep in touch with staff and young people that they knew.

Social workers who completed questionnaires for us confirmed that the service kept them regularly updated through phone calls, e-mails, review meetings and personal contact. We confirmed that the service supported young people's needs using an appropriate range of methods, including reviews of personal plans, young people's meetings, staff team meetings and individual staff supervision.

Young people who completed questionnaires for us agreed strongly that staff talked to them about the future and helped them to think about what they wanted to do when they left school. Three agreed, and two agreed strongly that staff had enough time for them. Areas for improvement The provider was planning to establish a Youth Forum which would be open to the young people in all of its children's homes. We agreed with this area for improvement and will monitor it at future inspections.

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

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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 This section includes evidence from Quality Theme 2, Quality Statements 2.1 and 2.2.

We found that the service was operating well in the areas covered by this statement. This represents an improvement on the position at the last inspection.

See Quality Theme 1, Quality Statement 1.1 for information about participation and involvement that also applies to this statement. We have given this statement the same grade as Quality Statement 1.1. Areas for improvement The service should continue to develop its good practice in this area.

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

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Statement 2 We make sure that the environment is safe and service users are protected. Service strengths We found that the service was operating very well in the areas covered by this statement.

The building had been renovated to a very high standard within the past six months. Young people had been involved in choosing the colour schemes for their bedrooms as well as the common areas. We noted that the building was bright and welcoming. A very good range of resources was available for young people to use. This included a computer room with several terminals. The provider used an external contractor to install software that supported young people to use the Internet safely.

We confirmed that there were sufficient staff to support young people's activities and develop relationships with them and their parents. A check of staff rotas confirmed that the service was typically staffed above the minimum levels required by the staffing schedule.

We confirmed that young people's health and safety was supported by a range of regular checks of equipment and working practices.

Discussion with the manager and staff confirmed that there were good relationships with the local police, who often visited the home on an informal basis. Generally, the behaviour of the young people had improved over the past six months as a result of additional training and support that had been provided for staff. This had resulted in fewer young people needing to be held safely, and a reduction in vandalism to the building. Young people's safety was supported by all staff being trained in Therapeutic Crisis Intervention (TCI). This system helped staff to 'de-escalate' difficult situations, and to hold young people safely when necessary.

We noted that issues about noise, that had been raised by neighbours, had been dealt with sensitively by staff. Arrangements were in place to erect a soundproofing barrier in the garden area as a response.

All five young people who completed questionnaires for us agreed strongly that they could use computers with Internet access. Three agreed strongly, and two agreed that they thought that the children's house was a nice place to stay.

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Areas for improvement Staff reported that some young people thought that the open plan design of some areas, for example the main lounge and dining area, was too large and impersonal. Young people tended to use a smaller lounge at the rear of the building instead.

Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 0

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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 This section includes evidence from Quality Theme 3, Quality Statements 3.1, 3.3 and 3.4.

We found that the service was operating well in the areas covered by this statement. This represents an improvement on the position at the last inspection.

See Quality Theme 1, Quality Statement 1.1 for information about participation and involvement that also applies to this statement. We have given this statement the same grade as Quality Statement 1.1. Areas for improvement The service should continue to develop its good practice in this area.

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

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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 the service was operating well in the areas covered by this statement.

We confirmed that young people benefited from staff who had been rigorously recruited and were appropriately qualified, or being supported to obtain qualifications. This was also in relation to meeting the registration requirements of the Scottish Social Services Council (SSSC). We came to this conclusion after talking to the manager and staff, and examining staff files and the relevant recruitment policies and procedures.

We had significant concerns about the proper functioning of the staff team at the last inspection. However, the provider had put in place additional training and support to address this over the past year, and the situation had improved greatly. A depute manager had been appointed. The manager felt that this assistance had helped to support the team and create a more positive ethos.

We confirmed that young people benefited from well informed staff who were able to update their training regularly. Training needs were identified and taken forward through supervision sessions. Staff were able to refer to an on-line internal training course programme and could also request external training opportunities. Training that was available to staff regularly included:

• First aid • TCI • Food hygiene • Sexual health & relationships • Fire warden training • Medication training

The three referring social workers who completed questionnaires for us felt that staff were meeting the needs of the young people, sometimes in difficult circumstances.

Three young people who completed questionnaires for us agreed, and two agreed strongly that staff understood the things that were important to them. They had similar views about the manager and staff asking them for ideas and using them to make things better.

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Areas for improvement Discussion with staff and an examination of records demonstrated that supervision was not provided consistently to all staff. Although the manager and provider suggested reasons why this had been the case for specific individuals, these reasons were not recorded as part of supervision planning. See recommendation 1.

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

Recommendations 1. The service should review its supervision arrangements to make sure that all staff receive regular supervision. Reasons for supervision sessions not taking place should be recorded, and the manager should monitor the regularity of supervision. National Care Standards, Standard 7.2 - Management and staffing.

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Statement 4 We ensure that everyone working in the service has an ethos of respect towards service users and each other. Service strengths We found that the service was operating well in the areas covered by this statement. This represents an improvement on the position at the last inspection.

The provider had organised a 'development training programme' for the staff team and this had helped to improve teamwork and the ethos of respect within the home. We came to this conclusion after talking with the manager, staff and young people, and observing practice. We considered that staff motivation was generally high and that staff engaged with the young people enthusiastically.

We noted that the referring social workers who completed questionnaires for us felt that staff were working well and delivering an effective service to young people. The advocacy organisation used by the home told us that young people had not raised any issues in relation to their treatment by staff or about the way staff treated each other.

Staff had opportunities to discuss and raise issues through staff meetings and supervision sessions. They were also able to discuss issues with young people at the young people's meetings. Staff that we met with told us that communication between the shift teams had improved, that they had 'pulled together' and that they found that the managers were supportive.

Three young people who completed questionnaires for us agreed strongly, one agreed, and one disagreed that staff treated them fairly and with respect. All of the young people agreed strongly that they got to choose things about how they looked, what clothes they wore and how they did their hair. Areas for improvement The self assessment told us that staff would continue to build a positive profile orf themselves and the house. We agreed with this area for improvement. The manager should monitor this and make sure that staff had the necessary support to achieve this.

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

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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 This section includes evidence from Quality Theme 4, Quality Statements 4.1, 4.2 and 4.4.

We found that the service was operating well in the areas covered by this statement. This represents an improvement on the position at the last inspection.

See Quality Theme 1, Quality Statement 1.1 for information about participation and involvement that also applies to this statement. We have given this statement the same grade as Quality Statement 1.1. Areas for improvement The service should continue to develop its good practice in this area.

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

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Statement 2 We involve our workforce in determining the direction and future objectives of the service. Service strengths We found that the service was operating well in the areas covered by this statement.

Staff were able to influence the future direction of the service through team meetings, supervision and working groups. The working groups were authority-wide and involved staff from all the children's houses. There were separate working groups looking at nutrition, smoking and inter-house sports. Staff were represented on all of these groups.

The provider has appointed a Senior Officer orf Learning and Educational Development. Their remit was to meet with staff teams to discuss and progress training needs and issues. Senior staff had undertaken a learning and development programme to help them identify ways to ensure that the house operated more effectively.

Two young people agreed strongly, and two agreed that managers and staff asked for their views often enough. One young person marked the question 'don't know'. Areas for improvement The manager and provider confirmed that staff would be involved in producing future development plans for the service.

The service should consider using structured methods to determine staff views about the aims and direction of the service. For example, this could be done through specific slots at team meetings or staff questionnaires.

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

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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 We found that the service was operating very well in the areas covered by this statement. This represents a considerable improvement on the position at the last inspection.

The service had completed a self assessment as requested by us and had distributed Care Service Questionnaires to young people and encouraged them to complete them.

As part of a local authority the service was included in a range of quality assurance initiatives. These included:

• Children's service plan • Customer service survey • Access to independent advocacy • Best value review • Stakeholder questionnaires • Quality assurance and committee reports.

Within the service there was a well-developed quality assurance system. This included monthly review reports that were compiled by the manager and submitted to headquarters.

Every six months the external managers undertook an extensive review of the service. This covered issues in relation to the young people and care plans, as well as environmental and health and safety issues. This process identified shortcomings and actions that needed to be taken to achieve improvements. Generally we thought that this process was very good and had an emphasis on quality. External managers generally met with young people as part of these reviews. Areas for improvement The service should make sure that its quality assurance systems and reports included evidence of the involvement of a range of stakeholders, particularly young people themselves. See recommendation 1, carried over from the last inspection.

Grade awarded for this statement: 5 - Very Good Number of requirements: 0 Number of recommendations: 1

Cambusnethan Residential Children's House, page 29 of 34 Inspection report continued Recommendations 1. Quality auditing systems should fully involve the children and young people and all those with an interest in the service. Young people should in particular be supported to use any internal and external systems for evaluating the service if they wish to do so. National Care Standards Care Homes for Children and Young People Standard 18 - Concerns, Comments and Complaints.

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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 We noted that the service was not displaying a public liability insurance certificate.

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 - 3 - Adequate

Statement 1 4 - Good

Statement 3 3 - Adequate

Statement 4 4 - Good

Quality of Environment - 4 - Good

Statement 1 4 - Good

Statement 2 5 - Very Good

Quality of Staffing - 4 - Good

Statement 1 4 - Good

Statement 3 4 - Good

Statement 4 4 - Good

Quality of Management and Leadership - 4 - Good

Statement 1 4 - Good

Statement 2 4 - Good

Statement 4 5 - Very Good

6 Inspection and grading history

Date Type Gradings

23 May 2011 Unannounced Care and support 3 - Adequate Environment Not Assessed Staffing 3 - Adequate Management and Leadership 2 - Weak

20 Jan 2011 Unannounced Care and support 3 - Adequate Environment Not Assessed Staffing 2 - Weak Management and Leadership Not Assessed

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20 Sep 2010 Announced Care and support 4 - Good Environment 4 - Good Staffing 4 - Good Management and Leadership 4 - Good

8 Dec 2009 Announced Care and support 3 - Adequate Environment 4 - Good Staffing 4 - Good Management and Leadership 3 - Adequate

7 Sep 2009 Announced Care and support 3 - Adequate Environment 3 - Adequate Staffing 3 - Adequate Management and Leadership 3 - Adequate

24 Mar 2009 Unannounced Care and support 3 - Adequate Environment 2 - Weak Staffing 3 - Adequate Management and Leadership 2 - Weak

29 Oct 2008 Announced Care and support 2 - Weak Environment 2 - Weak Staffing 2 - Weak Management and Leadership 2 - Weak

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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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.

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

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