Appendix 4 - Barochan
Renfrewshire Council · 19 January 2023
Back to Education and Children's Services Policy Board — 19 January 2023 and its agenda
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220 Bar0 Barocochan Rhan Rooadad Care Home Service Barochan Road Johnstone PA5 8FE Telephone: 01416 185 080 Type of inspection: Unannounced Completed on: 7 October 2022 Service provided by: Service provider number: Renfrewshire Council SP2003003388 Service no: CS2003001265
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About the service 20 Barochan Road is a residential children's house owned and managed by Renfrewshire Council. The house can accommodate up to six young people but at the time of inspection there was only four young people living in the house. The house is a purpose-built property located on the outskirts of Johnstone. It has a large garden and grounds, with local amenities in close proximity. About the inspection This was an unannounced inspection which took place on 20 and 21 September 2022. The inspection was carried out by two inspectors from the Care Inspectorate. To prepare for the inspection, we reviewed information about this service. This included previous inspection findings, registration information, information submitted by the service, and intelligence gathered since the last inspection. In making our evaluations of the service we: • spoke with two people using the service • spoke with three of their family/friends/representatives • spoke with eight staff and management • observed practice and daily life • reviewed documents. Inspection rInspection reporteport Inspection report for 20 Barochan Road page 2 of 8
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Key messages • Following the inspection a serious letter of concern was issued to the service. From this inspection we evaluated this service as: In evaluating quality, we use a six point scale where 1 is unsatisfactory and 6 is excellent How well do we support children and young people's rights and wellbeing? 2 - Weak Further details on the particular areas inspected are provided at the end of this report. Inspection rInspection reporteport Inspection report for 20 Barochan Road page 3 of 8
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How well do we support children and young 2 - Weak people's rights and wellbeing? We made an evaluation of weak for this key question. Whilst some strengths could be identified, these were compromised by significant weaknesses. As these weaknesses concerned the welfare and safety of children and young people, we made several requirements for improvement and issued a serious letter of concern. Whilst inspecting the house there was no dedicated manager to Barochan. We found that, historically, there had been a lack of leadership and this had lead to inconsistencies in practice within the house. Practice was reactive and did not consider the needs of the young people, which impacted on the outcomes for young people. Staff told us how this impacts on the consistency of care provided and the responses from young people to this. The staff had also not been supported with regular debriefs, supervision, or training to help them progress and develop their knowledge. Since the inspection we have been pleased to hear an experienced manager has been appointed and is open to working with the Care Inspectorate to make improvements (see requirement 1). This requirement has a short timescale as it was issued in the letter of serious concern 26 September 2022. During inspection, we found, at times, young people living in the house were not kept safe. We heard from staff that they were unable to respond to the needs of young people, at times, due to the high demands within the service and the lack of staff to support this (see requirement 2). This led to, at times, young people's safety and health being placed at risk and some concerns going unnoticed. The risk assessments in place to support some of the serious risks were not informative of proactive strategies or secondary strategies should the young person need support (see requirement 3). Both of these requirements have a short timescale as they were issued in the letter of serious concern 26 September 2022. At the previous inspection there had been concerns raised about bullying. Whilst reviewing documents we found this was still a concern. Young people had experienced physical and emotional bullying of a period of months. Although there had been attempts to resolve this, the matter was still ongoing and the impact on the young person was detrimental to their health. Therefore, we reinstated this matter as a requirement (see requirement 4). We found, at times, some incidents had involved staff restraining young people. We heard from staff that they had not had refresher training to support this. This led to anxiety at implementing the restraint and, at times, this not being conducted with enough people. Within the young people's individual care plans there was no assessment of restraint to be used to support the young person's safety or how to implement this. This led to young people being at risk of harm. We were reassured to hear that training had been organised in the upcoming weeks and senior management were already reviewing incidents and the risk assessments to support young people following us raising our concerns to them (see requirement 5). This requirement has a short timescale as it was issued in the letter of serious concern 26 September 2022. Following the letter of serious concern being issues to the provider, we were reassured to have a prompt response from them to look at the improvements needed. The provider has been working alongside the Care Inspectorate to ensure improvements are made and young people are kept safe. Inspection rInspection reporteport Inspection report for 20 Barochan Road page 4 of 8
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Requirements 1. By 31 October 2022, the provider must ensure that all staff have structure and support, to develop a consistent approach to the care provided. To do this, the provider must, at a minimum: a) Ensure there is a clear leader within the service to implement structure and a clear approach to support the young people in the service. b) Ensure that staff are debriefed following an incident and receive regular supervision to help them reflect on their practice and best support the young people. c) Ensure that staff are supported to access trauma and care planning training to help them develop their skills and knowledge to best support young people. This is to comply with Regulation 4(1)(a) (Welfare of users) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/ 210). This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'I have confidence in people because they are trained, competent and skilled, are able to reflect on their practice, and follow their professional and organisational codes' (HSCS 3.14). 2. By 1 October 2022, the provider must ensure that there is enough staff to support the young people in their care and support their needs. To do this, the provider must, at a minimum: a) Ensure the emotional and mental health needs of the young people are taken into account when completing the staffing assessment. This is to ensure there is sufficient support to meet their needs and keep them safe. b) Ensure there is the right number of staff on shift to support all young people in the service. This is to comply with Regulation 4(1)(a) (Welfare of users) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/ 210). This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'My care and support meets my needs and is right for me' (HSCS 1.19); and 'My needs are met by the right number of people' (HSCS 3.15). 3. By 10 October 2022, the provider must ensure that the risks young people present within the service are assessed. To do this, the provider must, at a minimum: a) Ensure that the risks young people present are recorded accurately and include proactive strategies, along with primary and secondary strategies to support the young people. b) Ensure that young people are supported and kept safe from the risks other young people may present to them in the service. This is to comply with Regulation 4(1)(a) (Welfare of users) of The Social Care and Social Work Improvement Inspection rInspection reporteport Inspection report for 20 Barochan Road page 5 of 8
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Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/ 210). This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'If I might harm myself or others, I know that people have a duty to protect me and others, which may involve contacting relevant agencies' (HSCS 3.24). 4. By 31 October 2022, the provider must ensure that any bullying which arises within the service is monitored and responded to appropriately. To do this, the provider must, at a minimum, ensure that: a) Risk assessments are updated to reflect the concerns and supports put in place. b) Monitor each incident and review whether further action needs to be implemented. c) Ensure that if the bullying continues, the young person is able to be kept safe and if not ensure action is taken. This is to comply with Regulation 4(1)(a) (Welfare of users) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/ 210). This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'I am protected from harm, neglect, abuse, bullying, and exploitation by people who have a clear understanding of their responsibilities' (HSCS 3.20). 5. By 31 October 2022, the provider must ensure that all staff have had the relevant training in restraint and there is a review of incidents looking at more proactive ways to respond when young people are distressed. To do this, the provider must, at a minimum, ensure that: a) All staff have the relevant training in relation to restraint. b) There is a review of incidents and more proactive responses are considered. c) Staff are given a debrief after any incidents. d) If restraint is identified as a method which may be needed to keep a young person safe, the details of this are specific and recorded within their risk assessment. This is to comply with Regulation 4(1)(a) (Welfare of users) of The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 (SSI 2011/ 210). This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'I have confidence in people because they are trained, competent and skilled, are able to reflect on their practice, and follow their professional and organisational codes' (HSCS 3.14). Inspection rInspection reporteport Inspection report for 20 Barochan Road page 6 of 8
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Areas for improvement Previous area for improvement 1 We found that some young people were experiencing forms of bullying by other young people living at the service. Although the service was very aware and alert to this behaviour, the impact on those affected was consistently negative over a period of some months. We advised that the current situation was not sustainable and asked that decisive action be taken to protect those affected from further instances of intimidation and physical harm as a result of others' behaviours. This is to ensure that care and support is consistent with Health and Social Care Standards (HSCS) which state that: 'I am protected from harm, neglect, abuse, bullying, and exploitation by people who have a clear understanding of their responsibilities' (HSCS 3.20). This area for improvement was made on 23 March 2019. Action taken since then Reinstated as a requirement. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. Detailed evaluations How well do we support children and young people's rights and wellbeing? 2 - Weak 7.1 Children and young people are safe, feel loved and get the most out of life 2 - Weak What the service has done to meet any areas for improvement we made at or since the last inspection Inspection rInspection reporteport Inspection report for 20 Barochan Road page 7 of 8
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To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can 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. You can also read more about our work online at www.careinspectorate.com Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 Find us on Facebook Twitter: @careinspect Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. Inspection rInspection reporteport Inspection report for 20 Barochan Road page 8 of 8