122 Ashton Road - Care Inspectorate

122 Ashton RoadCare Home Service Children and YoungPeopleInvernessInverness-shireIV2 3UXTelephone: 01463 716580

Inspected by: Rod Coltart

Type of inspection: Unannounced

Inspection completed on: 2 March 2012

ContentsPage No

Summary 31 About the service we inspected 52 How we inspected this service 73 The inspection 104 Other information 175 Summary of grades 186 Inspection and grading history 18

Service provided by:Highland Council

Service provider number:SP2003001693

Care service number:CS2003014132

Contact details for the inspector who inspected this service:Rod ColtartTelephone 01463 227630Email [email protected]

Inspection report continued

122 Ashton Road, page 2 of 20

SummaryThis report and grades represent our assessment of the quality of the areas ofperformance which were examined during this inspection.

Grades for this care service may change after this inspection following otherregulatory activity. For example, if we have to take enforcement action to make theservice improve, or if we investigate and agree with a complaint someone makesabout the service.

We gave the service these grades

Quality of Care and Support 5 Very Good

Quality of Environment 5 Very Good

Quality of Staffing N/A

Quality of Management and Leadership N/A

What the service does wellAll staff are focussed on meeting the needs of the young people resident with them.The management and staff constantly review their practice to ensure it continues tosupport the looked after young people.When young people move on staff continue to offer support and advice as required.

What the service could do betterMany providers as a means of improving access to information have engaged in theproduction of small video presentations produced by service users and staff.

The service may wish to develop the information sharing currently done through thewelcome handbook and service user meetings.

What the service has done since the last inspectionThe service has continued to develop and evolve positive relations with the majority ofservice uses /carers and other stakeholders.

The service has recently accessed monies through the local Community Ward fund.The service plan to use the fund to engage young people in creative and educationalactivities.



ConclusionThe manager and staff outlined various developments planned or beingconsidered for the coming. months. The service is proactive in seeking service usersand other stakeholders views linked to the quality of the service.

Who did this inspectionRod Coltart



1 About the service we inspectedThe Care Inspectorate is the new regulatory body for care services in Scotland. It willaward grades for services based on the findings of inspections. The history of gradesthat services have previously been awarded by the Care Commission will also beavailable on the Care Inspectorate's website.

All references in this report will be to The Social Care and Social Work ImprovementScotland (Requirements for Care Services) Regulations 2011 ("the Regulations") (SSI2011/210).

The service was registered by the Care Inspectorate on the 1st April 2012 to provide acare service to a maximum of 5 young people between the ages of 12 to 18 years.This report was written following an unannounced inspection that took place on the 2March 2012, commencing at 10:00 to 16:30.Formal feedback with the depute manager took place the same day.

As requested by us, the service sent us a completed self-assessment form.

We issued 5 SCSWIS care standards questionnaires to the childminder for distributionto parents who use the service, 5 completed questionnaires had been returned beforethe inspection.

This single storey building was situated in a housing scheme close to local facilitiesand a short bus ride from Inverness city centre. The accommodation was in a goodstate of repair and the atmosphere felt welcoming and relaxed. The accommodationcomprised of 5 en-suite bedrooms, two public rooms, kitchen/dining area and staffroom/offices.

The aims of the service were to provide care for young people who were looked afterand accommodated by the Local Authority. Staff hoped to provide a warm, safe andstable environment which provided care and support while meeting the individualneeds of looked after young people.

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

Quality of Care and Support - Grade 5 - Very GoodQuality of Environment - Grade 5 - Very GoodQuality of Staffing - N/AQuality of Management and Leadership - N/A



This report and grades represent our assessment of the quality of the areas ofperformance which were examined during this inspection.

Grades for this care service may change following other regulatory activity. You canfind the most up-to-date grades for this service by visiting our websitewww.scswis.com or by calling us on 0845 600 9527 or visiting one of our offices.



2 How we inspected this service

The level of inspection we carried outIn this service we carried out a low intensity inspection. We carry out theseinspections when we are satisfied that services are working hard to provideconsistently high standards of care.

What we did during the inspectionThis was an unannounced inspection undertaken by Inspector Rod Coltart. Verbalfeedback of the overall inspection findings to the depute manager for the service.

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

Statement of aims and objectivesMinutes from service user and carer meetingsPersonal plans (care plans )Staff meetings minutesHealth and safetyComplaints.

We undertook a tour of the premises and also had discussions with the deputemanager of the service and 3 care staff.

Grading the service against quality themes and statementsWe 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'. Undereach quality theme are 'quality statements' which describe what a service should bedoing well for that theme. We grade how the service performs against the qualitythemes and statements.

Details of what we found are in Section 3: The inspection

Inspection Focus Areas (IFAs)In any year we may decide on specific aspects of care to focus on during ourinspections. These are extra checks we make on top of all the normal ones we makeduring inspection. We do this to gather information about the quality of these aspectsof care on a national basis. Where we have examined an inspection focus area we willclearly identify it under the relevant quality statement.



Fire safety issuesWe do not regulate fire safety. Local fire and rescue services are responsible forchecking services. However, where significant fire safety issues become apparent, wewill alert the relevant fire and rescue services so they may consider what action totake. You can find out more about care services' responsibilities for fire safety atwww.firelawscotland.org



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

Comments on Self AssessmentEvery year all care services must complete a 'self assessment' form telling us howtheir service is performing. We check to make sure this assessment is accurate.The provider had submitted an electronic self assessment that gave relevantinformation for each of the Quality Themes and Statements. The provider identifiedstrengths and made comment as to areas for improvement.

Taking the views of people using the care service into accountWe spoke briefly with two young people on the day of the inspection and we wouldlike to thank them for their comments which are included in the body of the report.

The 5 CSQ's returned indicated service users were happy with the overall quality ofthe service provided.

Taking carers' views into accountNo carers were available on the day of the inspection we did however have sight oftestimonials said to be written by parents/carers of service users .The commentsnoted were very complimentary regarding the care and support received at theservice.



3 The inspectionWe looked at how the service performs against the following quality themes andstatements. Here are the details of what we found.

Quality Theme 1: Quality of Care and SupportGrade awarded for this theme: 5 - Very Good

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

Service strengthsThis Quality Statement had been inspected previously. As part of the ongoing audit ofthis area of service user participation it has been inspected once more .

The staff group remains the same core group as we met on previous inspections.These staff members continue to support the young people and their families toexpress their views regarding the quality of care within the service.

Young people's meetings continue to be held and have been influential inproviding improvements to the facilities.

Service users continue to be consulted regarding planned activities. We sampled anumber of service user's care plans and found them to be up to date and containedrelevant information to assist staff and young people to work together.

We agree with the manager's view that the young person's Welcome Booklet wouldbenefit from updating to reflect changes in policy and staffing.

Areas for improvementWe agree with the manager's view that the young person's Welcome Booklet wouldbenefit from updating to reflect changes in the Regulator and other areas linked topolicy.

Grade awarded for this statement: 5 - Very Good

Number of requirements: 0

Number of recommendations: 0

Statement 3We ensure that service user's health and wellbeing needs are met.



Service strengthsThe staff group and management team remain focussed on ensuring the youngpeople have access to relevant information and services linked to supporting theirhealth and wellbeing. The young people, where possible are supported to maintaincontact with their own General Practioner and Dentist. Where this is not possiblealternative arrangements are made.

The service has made ongoing use of linked to professionals. The staff and youngpeople have met with a nutrition advisor. Advice given has been linked to "RealMeals" an English Department of Children and Schools publication.

The Looked After Children Clinical specialist remains available to staff and youngpeople for additional support and advice. We noted the written feedback from linkedprofessionals were the consistent "child centred practice" within the service wasremarked upon as a ever present feature of Staffs interaction with the young peopleliving in the unit.

Young people's Health Assessments are supported, We were informed that theprovider now uses a nationally recognised assessment documentation. The genericmedical information received following this process included an "emotionaldevelopment profile".

We noted that the staff group continue to work within Highland Councils childprotection guidelines and remain aware of and ascribe to the guidance providedthrough the Children's Charter.

Staff encourage and support the young people to maintain and develop healthy andactive lifestyles.

Many of the young people currently resident have developed links with the localcommunity and make use of the local Community resources to take part in varioussporting activities.

Areas for improvementWe noted that the provider plans to continue to review the practice of staff in linewith National Guidance and ensure ongoing review of this area of their work.

Elements of improvement noted on quality statement 1.1 are also relevant in thisstatement.






Quality Theme 2: Quality of EnvironmentGrade awarded for this theme: 5 - Very Good

Statement 1

We ensure that service users and carers participate in assessing and improving thequality of the environment within the service.

Service strengthsElements of quality statement 1.1 are also relevant to this statement.

We note feedback from various parties who visited the service that they consideredthe environment to be "welcoming "and "calm and relaxed".

The service operates from a purpose built facility which was opened in 2002. Staffand young people have in recent years decided to re configure the use of some of therooms. These changes have reduced the "through traffic" in the corridor leading tothe young peoples bedrooms. These changes have been welcomed by staff and youngpeople.

We discussed with some of the young people present their feelings about the service.

They both indicated that it was important that they got the opportunity to decoratetheir rooms in colours that they liked.

The staff group are very keen to ensure that improvements and upgrades tofurnishings as they occur should be carried out with the involvement of young peopleand staff.

Young people and staff are involved in the undertaking of some of the maintenancetasks linked to the upkeep of the environment eg "looking after the garden".

We noted that during staff change over meeting points linked to the generalhousekeeping and maintenance of the building are discussed.

Areas for improvementWe noted that the service development plan includes upkeep and maintenance of theunit. We were informed that issues pertinent to this area of the plan are discussedteam meetings. We would agree that the continued involvement of service users inthe review of the quality of the environment will lead to improved outcomes.






Statement 2We make sure that the environment is safe and service users are protected.

Service strengthsWe had been made aware that the Highlands and Islands Fire and Rescue Service hadissued a number of recommendations following a visit by one of their officers. Thedepute manager stated that the points raised had been addressed.

On the day of the Care Inspectorate's inspection visit we noted that staffing levelswere well above those expected within the current staffing schedule.

Visitors to the building make themselves known to staff via the door entry system.Staff meet visitors at the door. All visitors are asked to sign a visitor's book.

Staff under take Child protection training on a regular basis. Training and accreditationis also taken by staff to equip them with the knowledge and skills required in deescaltion techniques.

The staff carry out regular risk assessments in a number of areas. We sampled asection of these assessments and found them to be relevant and reviewed asrequired.

The young people spoken with confirmed that they had regular contact with "TheWho Cares" worker who they were aware can support and advocate on their behalf.

The service maintained records of incidents and accidents. Additionally a record iskept of occurrences where young people have left the building for periods withoutstaff permission or failed to return within acceptable timescales.

We noted that "Bullying in any form is actively challenged".

As previously stated earlier in this report staff interaction with young people areconsidered to be client centred.

We noted that a number of positive comments from the young people which werecontained in the CSQ's comments included "I feel safe staying in care" and anotheryoung person stated that "When I want personal space I can in peace ".



Areas for improvementThe manager and staff continue to recognise the importance of ongoing training andaccreditation linked to CALM techniques, this training to continue. We have previouslynoted that incident reports are completed and filed in each young persons care plan.We are not aware of any unaddressed incidents to date. However the manager shouldconsider if there is value in maintaining a central record for both accidents andincidents. The maintenance of such a record would help in the early identification ofany re occurring issues and help maintain a timeous and co-ordinated response tocommon occurrences.






Quality Theme 3: Quality of Staffing - NOT ASSESSED



Quality Theme 4: Quality of Management and Leadership - NOTASSESSED



4 Other information

ComplaintsNo complaints have been upheld, or partially upheld, since the last inspection.

EnforcementsWe have taken no enforcement action against this care service since the lastinspection.

Additional Information

Action PlanFailure to submit an appropriate action plan within the required timescale, includingany agreed extension, where requirements and recommendations have been made,will result in SCSWIS re-grading the Quality Statement within the Management andLeadership Theme as unsatisfactory (1). This will result in the Quality Theme forManagement and Leadership being re-graded as Unsatisfactory (1).



5 Summary of grades

Quality of Care and Support - 5 - Very Good

Statement 1 5 - Very Good


Quality of Environment - 5 - Very Good



Quality of Staffing - Not Assessed

Quality of Management and Leadership - Not Assessed

6 Inspection and grading history

Date Type Gradings

12 Jul 2010 Announced Care and support 5 - Very GoodEnvironment Not AssessedStaffing 5 - Very GoodManagement and Leadership Not Assessed

29 Mar 2010 Unannounced Care and support 5 - Very GoodEnvironment Not AssessedStaffing 5 - Very GoodManagement and Leadership Not Assessed

31 Aug 2009 Announced Care and support 5 - Very GoodEnvironment 5 - Very GoodStaffing 4 - GoodManagement and Leadership 5 - Very Good

31 Mar 2009 Unannounced Care and support 5 - Very GoodEnvironment Not AssessedStaffing Not AssessedManagement and Leadership 5 - Very Good



3 Sep 2008 Announced Care and support 4 - GoodEnvironment 5 - Very GoodStaffing 4 - GoodManagement and Leadership 4 - Good

All inspections and grades before 1 April 2011 are those reported by the formerregulator of care services, the Care Commission.



To find out more about our inspections and inspection reportsRead our leaflet 'How we inspect'. You can download it from our website or ask us tosend you a copy by telephoning us on 0845 600 9527.

This inspection report is published by SCSWIS. You can get more copies of this reportand others by downloading it from our website:www.scswis.com or by telephoning 0845 600 9527.

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

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



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122 Ashton Road - Care Inspectorate