Durham, Alison Aberdeen Inspection completed on 15 March 2016
Service provided by: Durham, Alison Service provider number: SP2014986199 Care service number: CS2014329536 Inspection Type: Unannounced Care services in Scotland, including childminders, 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 enquiries@careinspectorate.com 0345 600 9527 www.careinspectorate.com @careinspect page 2 of 15
1 Introduction Childminder inspection report Alison Durham is registered as a childminder to provide care to children in her own home. Current registration is to provide a care service to a maximum of 6 children at any one time under the age of 16, of whom no more than 3 are not yet attending primary school and of whom no more than 1 is under 12 months. Numbers are inclusive of children of the childminder's family. The childminder cares for her children as well as minded children. The childminder provides her service from her home located in the commuter town of Portlethen. The childminder uses the lounge as a playroom for the children. The kitchen is used for snacks and meals. The childminder's statement of aims includes "... to create a homely environment where children are safe, valued and cared for in a friendly welcoming setting while parents/carers are at work/study etc" and "... to encourage your child to develop confidence and self-esteem (while in my care) by providing opportunities for individual, small and large group activities". The Care Inspectorate is committed to improving the health and wellbeing of all children receiving a care service. We want to ensure they have the best start in life, are ready to succeed and live longer, healthier lives. We check services are meeting the principles of Getting it Right for Every Child (also known as GIRFEC). Set up by Scottish Government, GIRFEC is a national approach to working in a consistent way with all children and young people. It is underpinned by the principles of prevention and early intervention. The approach helps services focus on what makes a positive difference for children and young people - and what they can do to improve. Getting it right for every child is being woven into all policy, practice, strategy and legislation that affect children, young people and their families. There are eight wellbeing indicators at the heart of Getting it right for every child. They are: safe; healthy; achieving; nurtured; active; respected; responsible; and included. They are often referred to as the SHANARRI indicators. We use these indicators at inspection, to assess how services are making a positive difference for children. page 3 of 15
The Care Inspectorate regulates care services in Scotland. Information about all care services is available on our website at www.careinspectorate.com This service was registered with the Care Inspectorate on 08 October 2014. What we did during our inspection We wrote this report after an unannounced inspection. This inspection was carried out by one inspector. The inspection took place on 11 March 2016 between 10.15 am and 1.15 pm. We gave telephone feedback to the childminder on 15 March 2016. We sent care standards questionnaires to the childminder to give to parents and carers of children who use the service. We received two completed questionnaires. As part of the inspection we took account of the completed self assessment and annual return that we asked the childminder to complete and submit to us. During the inspection we gathered evidence from the following sources: We spoke with: - the childminder - the child present during the inspection - a parent. We looked at: - the childminder's practice with the children - the environment for the children - aims and objectives - children's records - training records - risk assessments - public liability insurance certificate - child protection policy - medication policy - complaints policy - infection control policy. page 4 of 15
Views of people using the service Two minded children were present when we arrived to do the inspection. Both children were young. The minded children appeared happy, confident and settled. The children had clearly formed very good relationships with both the childminder and each other and appeared very much at home in the setting. Two questionnaires were returned prior to the inspection. The parents indicated that they strongly agreed that they were happy with the overall care provided and that they were involved in developing the service. We spoke to one parent as part of this inspection. They spoke very highly of the extremely high level of care provided to their child. They commented about the variety of activities their child participated in and the high quality nutritious food. They stated that their child had "great opportunities to develop" and "received 100% care and attention" in Alison's care. They stated that they were "so lucky to have got her" (as a childminder) and "can't grade her highly enough". Self assessment Every year all care services complete a 'self assessment' telling us how their service is performing. We check to make sure this is accurate. The childminder submitted a self assessment before the inspection. The self assessment provided detailed information about the service the she provides and identified areas for development that will have a positive impact on the quality of service. What the service did well The childminder provides a friendly, welcoming environment to children and their families. Children are happy and relaxed and have a very good relationship with the childminder. The children are provided with activities they enjoy including outings to the local park and community groups. The childminder had attended a selection of relevant training to help her better support children. What the service could do better Children's personal plans and information about their care need to be further developed. Better infection prevention and control practices need to be put in place. The systems for managing medication need to be improved. The childminder needs to review sleeping arrangements for young children. page 5 of 15
Better systems should now be developed for evaluating the service provided. This will support the childminder in making the necessary improvements. 2 The grades we awarded We grade the quality of care and support, the quality of the environment and the quality of management and leadership. If the childminder employs an assistant, we also grade the quality of staffing. In each case, we award a grade on a scale from 1 to 6, where 1 is unsatisfactory and 6 is excellent. Quality of care and support Quality of environment Quality of staffing Quality of management and leadership 4 - Good 3 - Adequate not assessed 2 - Weak 3 Quality of care and support Findings from the inspection We found the level of care and support provided by the childminder for the children in her care was good. The childminder had created a homely and friendly environment where the children were included as part of the family. We found the childminder was warm, nurturing and caring in her interactions with the children. As a result we found the children were happy, settled and confident in the service. A parent confirmed this was their experience also. During the inspection we found the childminder was responsive to children's needs and requests. Children requested the dinosaurs to play with. The childminder provided the children with this and interacted with the children during their play, such as talking about the noise made by the dinosaurs and their different sizes. When children became upset, the childminder comforted them in a caring and nurturing manner. This supported children to feel safe and nurtured. page 6 of 15
The childminder had recently attended relevant childcare training events which supported her understanding of child protection, safeguarding of children and supporting development. The childminder had used the knowledge gathered from the training to develop an overview about the minded children. These included information about how the children were progressing and developing. These showed that the childminder knew the children well and understood their individual development needs. A parent commented that the childminder knew their child well and understood their care needs. The childminder gathered information about children before they started at the service. Basic information such as GP contact details, allergies and medical needs were recorded. More detailed information about children's routines, stage of development and preferences were gathered however not all of this information was recorded. A daily diary was used to inform parents about what their child had been doing each day. In line with current legislation, we advised the childminder she needed to record more information in order to detail how she would meet children's health, welfare and safety needs. The recorded information needs to be reviewed with parents at least every six months to ensure it is still accurate. (See Recommendation 1) The child protection policy contained basic information about the childminder's responsibilities and the procedure to follow in the event of any concerns including appropriate telephone numbers. The childminder was aware of child protection and Getting It Right For Every Child (GIRFEC) guidance. The childminder's policy should now be further developed to include details of the relevant national guidance. The childminder was aware of the need to closely supervise children whilst they were using the internet to keep them safe. Children's physical wellbeing was actively promoted. The childminder told us that she made good use of the local parks and walked to all local activities. The children also had access to a fully enclosed rear garden. The childminder provided lunch for the children. The childminder was aware of the current guidance for promoting healthy eating 'Setting the Table' and took this into account when menu planning. At lunch time children were provided with a sandwich followed by a selection of fresh fruit and yoghurt. The childminder responded well to children's visual cues when they wanted more page 7 of 15
fruit after their lunch. The childminder had registered as a food business with the Food Standards Agency. The childminder advised us she had developed very good relationships with the children's parents. She exchanged information verbally with parents during drop off and collection times and felt this worked well. A parent confirmed that information was shared regularly and very positive and supportive relationships had been established. Grade The quality of care and support is graded 4 - Good Requirements Number of requirements - 0 Recommendations Number of recommendations - 1 1. To help support children better, personal plans should be regularly reviewed to ensure they reflect the current needs of individual children. National Care Standards for early education and childcare up to the age of 16. Standard 6: support and development. 4 Quality of environment Findings from the inspection The quality of the environment used by the children was found to be adequate. During the inspection we found the childminder's home was clean, tidy and smoke free. Children were cared for in a homely environment and the childminder had created a warm and welcoming atmosphere. This contributed to children being cared for in a pleasant and inviting environment. We found the childminder made good use of the space she had available. The living room was attractively presented with a range of age appropriate toys for page 8 of 15
the children to play with. There was suitable floor space for the children to move around safely. Additional toys were available in storage units within the room and children were able to choose from these. The kitchen was used for arts and crafts activities. As a result we found children had access to a range of activities they were interested and engaged in. The toys were clean and in a good state of repair, this ensured they were safe for the children. There was a fully enclosed garden with a selection of outdoor toys and plenty of space for the children to enjoy energetic play. The childminder advised us she had attended first aid training. This meant she had the necessary skills to deal with children's accidents or a medical emergency, therefore reducing risk to children. The childminder had a policy for excluding children that were ill from the service; this reduced the risk of spreading infection in the service. The childminder provided opportunities for children to sleep and rest. Due to the limited space available, the childminder allowed children to sleep in a double buggy. We found this restricted children's ability to move freely whilst sleeping and did not follow current best practice guidelines for safe sleep practices. Therefore this could not guarantee that children had a comfortable and restful sleep. The childminder may benefit from accessing information about safe sleep practices via the Care Inspectorate website, 'The Hub'. She should use the information available to review children's sleeping arrangements. This will support the childminder to ensure children are provided with a more suitable sleeping environment. (See Recommendation 1) Nappies were changed on a suitable changing unit in the living room. We found the infection prevention and control procedures were inadequate, this increased the risk of spreading infection and put both the children and the childminder at risk. The childminder told us that she used disposable gloves and aprons when changing nappies, however only gloves were changed between nappy changes. Disposable gloves and aprons need to be changed at every nappy change. The childminder's nappy changing practices put children and herself at risk of cross infection. The childminder agreed to rectify this immediately. (See Requirement 1) page 9 of 15
http://hub.careinspectorate.com/media/2558341/shpn-infection-preventionand-control-in-childcare-settings.pdf During the inspection we saw children having lunch. The childminder washed her hands before preparing snack, however the children's hands were not washed before they ate their lunch. After snack the children's hands and faces were cleaned with their own cloth. The childminder did not support children with good hand hygiene, as a shared towel is still used by the children for drying their hands. (See Requirement 1) Grade The quality of environment is graded 3 - Adequate Requirements Number of requirements - 1 1. The childminder must implement appropriate infection prevention and control procedures in order to safeguard and protect children. In order to achieve this the childminder must ensure: a) children do not share towels b) disposable gloves and aprons are removed at the appropriate time when changing nappies c) children are appropriately supported to wash their hands before eating. This is in order to comply with Scottish Statutory Instrument 2011/210 Regulation 4(1)(d) - Welfare of users. National Care Standards early education and childcare up to the age of 16. Standard 2: a safe environment and Standard 3 - health and wellbeing. Timescale: within one week of receipt of this report. Childminder inspection report Recommendations Number of recommendations - 1 1. To support children better during sleep times, the childminder should review sleep arrangements for young children. National Care Standards for early education and childcare up to the age of 16. page 10 of 15
Standard 3: health and wellbeing. 5 Quality of staffing We only assess this where the childminder employs an assistant. 6 Quality of management and leadership Findings from the inspection We found the quality of management and leadership in the service was weak. The childminder told us she was actively involved in a local childminding group and regularly attended group events with minded children. She found the group to be very supportive and helpful when developing her service. She made use of information she received in the post to keep up to date with best practice. For example, the Scottish Childminding Association and the Care Inspectorate magazines. This included information about access to training events and funding available for these. The childminder had attended a selection of appropriate training which helped her to develop her service. She provided examples of how the training had helped her to think about the care she provides and plans to provide. An example of this was following the 'Building the Ambition' training, a summary about children's development and progress had been put in place. A complaints policy was in place and contained the relevant information. The childminder completed and returned a self assessment to us before the inspection. The self assessment contained good information about how the service was developing and some identified areas for improvement. During the inspection it was clear the childminder enjoyed caring for children and had developed good relationships with parents. As a result the children were happy and settled in the service. The childminder was able to give page 11 of 15
examples of how she had been able to accommodate individual requests from parents. This included changing times of attendance and working with parents to support children with planning for toilet training. The childminder told us that she has yet to develop formal opportunities to involve parents in assessing and improving the quality of the service. By putting this in place, it would give parents better opportunities to be involved in developing and improving the service. This was identified as an area for development within the self assessment and recommendation has been made regarding this. (See Recommendation 1) The childminder had an administration of medication policy which contained the relevant information to support the safe use of medication. The childminder's understanding and practice for safe administration of medication did not did not reflect the policy. The medication records were not maintained. We found the permission to administer medication had not been obtained prior to or after medication being administered. The limited information about medication administered did not include the amount given. This meant there were no accurate records to be shared with parents when they collected their child. Consent for the use of medicated creams had not been obtained. This was contrary to the childminder's own medication policy. A medicated cream used for a minded child was part of the family medicine stock. (See Requirement 1) The childminder may find the document 'Management of medication in daycare of children and childminding services' useful to develop her record keeping further. http://www.careinspectorate.com/index.php/news/2227-management-ofmedication-in-daycare-of-children-and-childminding-services Grade The quality of management and leadership is graded 2 - Weak Requirements Number of requirements - 1 Childminder inspection report 1. To ensure the safety and wellbeing of children, the childminder must review and change her administration of medication procedures and practice. This is in order to comply with Scottish Statutory Instrument 2002/114 Regulation 4 (1) (a) - Welfare of users. page 12 of 15
National Care Standards early education and childcare up to the age of 16. Standard 3: health and wellbeing and Standard 14: well-managed service. Timescale: within two weeks of receipt of this report. Recommendations Number of recommendations - 1 1. The childminder should develop formal methods to involve children and families in assessing and improving the quality of care and support, the environment and the management of the service. National Care Standards for early education and childcare up to the age of 16. Standard 13: improving the service. 7 What the service has done to meet any recommendations or requirements we made at our last inspection Previous requirements There are no outstanding requirements. page 13 of 15
Previous recommendations There are no outstanding recommendations. 8 Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. 9 Enforcements No enforcement action has been taken against this care service since the last inspection 10 Other issues No other issues. 11 Inspection and grading history This service does not have any prior inspection history or grades. page 14 of 15
To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. You can also read more about our work online. Contact Us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 www.careinspectorate.com @careinspect Other languages and formats Childminder inspection report This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is c?nain eile ma nithear iarrtas. page 15 of 15