Care service inspection report

50 Pages·2012·0.57 MB·English

Care service inspection report
Full inspection
Little Einstein's Arbroath
Day Care of Children
Abbot Street
Arbroath
Inspection report for Little Einstein's Arbroath
Inspection completed on 16 November 2015
Inspection report
Service provided by: Forth Care Limited
Service provider number: SP2014012365
Care service number: CS2014331857
Inspection Visit Type: Unannounced
Care services in Scotland 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
[email protected]
0345 600 9527
www.careinspectorate.com
@careinspect
Inspection report for Little Einstein's Arbroath
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Inspection report
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 1 Unsatisfactory
Quality of environment 3 Adequate
Quality of staffing 1 Unsatisfactory
Quality of management and leadership 1 Unsatisfactory
What the service does well
- New parents/carers were encouraged to visit the service to meet the staff
and consider the environment. The staff gave parents a welcome booklet, which
provided additional information about how the service operated. When a child
was registered, parents were given appropriate information to complete which
helped staff to meet the children's needs early on. The staff welcomed families
into the setting, the staff wrote short summaries of how younger children's
needs were met.
- The staff and children regularly accessed the garden and community; the staff
encouraged children to participate in activities, which supported their health
and wellbeing.
- The playrooms were found to be clean and tidy. Nappy changing/toilet areas
were also clean and well-maintained.
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- The staff were introducing some natural resources into the playrooms, which
supported the children's learning and development. The children also accessed
arts and crafts and messy play, which stimulated their creativity.
What the service could do better
- Parents were not actively involved in the assessments and improvements in
the service. The staff were not communicating effectively with parents therefore
parents were not always aware of their child's progress or experiences.
- The staff lacked an understanding of nutrition and food preparation. This
meant children were not always able to eat their meals safely. Risks in terms of
dental decay were increased as a result of the staff's lack of knowledge of
infant nutritional guidelines.
- The staff lacked knowledge of best practice in terms of promoting safe sleep
for children. The environment also needed to be developed to ensure children
slept safely.
- During the inspection we observed staff meeting children's needs however,
the staff were unable to establish meaningful relationships with children as a
result of being moved from one playroom to another. This had a negative
impact on the children in relation to nurture and attachment. The staff were not
always aware of each child's needs particularly children who required additional
support. Further evidence highlighted staff were not documenting how the
children's needs were met in the setting or how their progress was evaluated in
terms of their learning and development.
- Although the nursery was found to be clean, the staff needed to act more
responsibly to ensure risk associated with the spread of infection were
minimised.
- The staff were open and honest about the negative culture in the setting and
although the manager stated she was addressing the issues, the lack of staff
meant she did not have time to develop her own leaderships skills or
management of a safe and effective service.
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- The recruitment and induction of new staff did not support best practice.
Previous requirements in relation to this were not met.
- Certain staff were not carrying out the roles they were employed to do, nor
did they have the necessary skills or support from others to promote positive
outcomes for children.
What the service has done since the last inspection
The provider recognised that the leadership needed to be developed in the
setting. After the manager was recruited, the provider met with the staff and
manager to discuss how best to support the children's needs within a positive,
nurturing environment where staff respected each other and worked in
partnership with parents and link professionals. We invited the provider to a
'Support and Improvement' meeting in August 2015 to discuss our concerns
and develop strategies to help staff improve the care in the service. The
provider welcomed our invitation.
Conclusion
The service had experienced a number of challenges recently. There had been
significant changes in staff since the last inspection, which had an impact on
how the children's needs were met and how the staff respected each other. The
manager had difficulties recruiting suitably qualified staff and, coupled with
this, recruitment processes did not support best practice. There was some
evidence to demonstrate that staff wanted to develop the culture in the setting
and they were trying to work as a team to cover staff/child ratios. The staff did
not always feel included in decision-making in the service, which meant they
were unsure of developments or changes in the setting.
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1 About the service we inspected
The Care Inspectorate regulates care services in Scotland. 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.scswis.com.
This service was previously registered with the Care Commission and transferred
its registration to the Care Inspectorate on 1 April 2011. The service has recently
undergone a new registration, having said that, the provider of the service has
not changed.
Little Einsteins Nurseries are part of a group of six nurseries, which are situated
in various of parts Scotland. Little Einsteins Arbroath is located in a quiet area,
close to shops, schools and other areas of recreation. The nursery caters for the
developing needs of children aged from birth to school age. Children are cared
for by staff in various rooms according to their age and stage of development,
latterly children and staff have been moved from one playroom to another to
support safe adult to child ratios. The nursery operates Monday - Friday offering
sessions for full-time and part-time sessions between 7am and 6pm. The
service was registered to:
1. To provide a care service to a maximum of 61 children aged from six weeks of
age to entry to primary school age, of whom no more than 16 can be under 2
years of age, 16 children 0 - under 2 years, 20 children 2 - under 3 years and 25
children 3 - to those not yet attending primary school.
Any other conditions unique to the service:
2. A minimum of two staff to be present in an operating playroom/area at any
time.
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The staff consisted of several early year's practitioners, a modern early years
apprentice, a deputy managers, a cook and domestic staff. A member of staff
based at another location, supported the service training and administration
processes. The service stated the following principles of their service were to:
- To provide a safe, secure and stimulating environment for all-round child
development
- To help children develop intellectually through a balance of directed and free
choice activities
- Continuity of care for all children and flexible care routines
- To create a stimulating and challenging environment, providing opportunities
for learning through play and covering the five key areas
- To encourage children to develop self-control, self-direction and independence
- To develop self-expression through various activities such as drama, music,
story-telling, block building and other forms of play
- To provide a warm and welcome atmosphere with good staff, child and parent
relationships
- To ensure a safe environment which protects children from harm, abuse and
neglect
- Develop respect for individual and cultural differences
- Effective use of assessment information to identify needs and plan the next
steps for learning and evaluating regularly to meet changing needs
- High standard of thoughtful and courteous behaviour
- A good clear concise monitoring and evaluation system and effective use of
policies
Recommendations
A recommendation is a statement that sets out actions that a care service
provider should take to improve or develop the quality of the service, but where
failure to do so would not directly result in enforcement.
Recommendations are based on the National Care Standards, SSSC codes of
practice and recognised good practice. These must also be outcomes-based and
if the provider meets the recommendation this would improve outcomes for
people receiving the service.
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Requirements
A requirement is a statement which sets out what a care service must do to
improve outcomes for people who use services and must be linked to a breach
in the Public Services Reform (Scotland) Act 2010 (the "Act"), its regulations, or
orders made under the Act, or a condition of registration. Requirements are
enforceable in law.
We make requirements where (a) there is evidence of poor outcomes for people
using the service or (b) there is the potential for poor outcomes which would
affect people's health, safety or welfare.
Based on the findings of this inspection this service has been awarded the
following grades:
Quality of care and support - Grade 1 - Unsatisfactory
Quality of environment - Grade 3 - Adequate
Quality of staffing - Grade 1 - Unsatisfactory
Quality of management and leadership - Grade 1 - Unsatisfactory
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 0345 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
The service was inspected in May 2015, however due to increasing concerns
about the quality of staffing and leadership and complaints we received, we
arranged for a follow-up inspection visit as an appropriate course of action. At
the time of the unannounced follow-up inspection which took place between
10.50am and 3.50pm on 11 November 2015 the two Care Inspectorate
inspectors identified children's needs and potential risks in the service were not
being managed effectively. Therefore the inspectors changed the follow-up
inspection to a full inspection, which enabled them to fully assess how the
children's needs were met and how the quality assurance processes had been
developed since the last inspection. The manager and provider attended our
feedback, which took place in the service on 16 November 2015 from 10.40am
and 12.45pm.
This report highlights evidence to support the grades for our key inspection
themes. More detailed evidence supports our findings for the following quality
statements:
1.3 We ensure that service user's health and wellbeing needs are met
3.2 We are confident that our staff have been recruited, and inducted, in a safe
and robust manner to protect service users and staff
3.3 We have a professional, trained and motivated workforce, which operates to
National Care Standards, legislation and best practice
4.4 We use quality assurance systems and processes, which involve service
users, carers, staff and stakeholders to assess the quality of the service we
provide
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As requested by us, the service sent us an annual return. The service did not
submit a self assessment as requested in April 2015. In this inspection, we
gathered evidence from various sources, including the relevant sections of
policies, procedures, records and other documents:
- Evidence from previous self assessments
- Personal plans of the children who use the service
- Children's learning journeys
- Observing how staff work
- Staff recruitment/induction files
- Observation of the environment
- Health and safety records
- Complaints records
- Questionnaires that had been requested, filled in and returned to the Care
Inspectorate
- Discussions with various people, including the manager, the staff and the
children who attend the nursery
- Examining equipment and the environment
Grading the service against quality themes and statements
We inspect and grade elements of care that we call 'quality themes'. For
example, one of the quality themes we might look at is 'Quality of care and
support'. Under each quality theme are 'quality statements' which describe
what a service should be doing well for that theme. We grade how the service
performs against the quality themes and statements.
Details of what we found are in Section 3: The inspection
Inspection 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.
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