MacIntosh, Stacey Glasgow Inspection completed on 07 September 2015
Service provided by: MacIntosh, Stacey Service provider number: SP2008968661 Care service number: CS2008170034 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 17
1 Introduction Ms MacIntosh was previously registered with the Care Commission and transferred her registration to the Care Inspectorate on 1 April 2011. Ms MacIntosh is registered as a childminder to provide care for a maximum of six children at any one time. Of these, no more than three children are not yet attending primary school, and no more than one is under twelve months. Ms MacIntosh has three named assistants included on her registration certificate, and when an assistant is present, the number of children not attending school can be six, with no more than one under twelve months. The number of children attending cannot exceed six at any one time. Ms MacIntosh is currently minding five children over the week with another three children attending on an occasional flexible basis. Ms MacIntosh provides her service from her home in the Pollockshields area of Glasgow. The service is provided flexibly Monday to Friday to meet the needs of families. Ms MacIntosh aims to, "Provide a safe and secure environment for children to learn structured and free play", and "To ensure that all children leave my care happy and content." What we did during our inspection We wrote this report following an unannounced inspection. The inspection took place on 7 September 2015 from 9.20am until 12pm. We gave feedback to the childminder on 7 September 2015. As part of the inspection, we took account of the annual return and self assessment forms that we asked the childminder to complete and submit to us. We sent four care standards questionnaires to the childminder and asked her to give these to families using her service. We received two completed questionnaires before the inspection. During this inspection process, we gathered evidence from various sources including the following: We spoke with: - the childminder - one childminding assistant - four minded children page 3 of 17
We looked at: - children's personal plans - the environment and resources - record keeping including accidents and attendance - insurance - routines and activities Views of people using the service We saw that the four minded children were happy with the childminder and her assistant. They played together and approached the childminder for comfort and reassurance when we arrived. The older child told us they liked coming and that they had been "playing with the toys" during our visit. Both parents/carers who completed our questionnaires indicated that the childminder encouraged their child to form positive relationships with other children, and that she was flexible and responsive to their child's needs. The views of parents/carers and children are included in this report. 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. This is the first time the childminder had completed our new self assessments that are now based on the SHANARRI (Safe, Healthy, Active, Nurtured, Respected, Responsible, Included) wellbeing indicators. Throughout the assessment, it was clear that the childminder had considered how she was meeting children's needs using the SHANARRI indicators. What the service did well It was clear that the childminder was committed to providing a safe and nurturing service for children. She worked in close partnership with families, and ensured communication was maintained. page 4 of 17
What the service could do better The childminder must complete a personal plan for each child within twenty eight days of them starting the service. The childminder should read new guidance and review her service with this to ensure she continued to provide a service that promoted national best practice. 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 3 Quality of care and support Findings from the inspection We found that care and support in the service was good. The childminder had prepared personal plans for each child, and was using these to review care and support with parents/carers. These contained a general overview from parents/carers about their child, including how they should be reassured while at the service. The childminder also asked parents/carers to complete enrolment forms where health information was recorded. Parents/carers also completed consent forms for outdoor activities. These forms provided parents/carers with opportunities to discuss their child's needs and to agree personalised care for their child while at the service. The childminder told us that she planned to review these plans each year and we saw that one child's plan had not been put in place within twenty eight days of them starting the service. page 5 of 17
We reminded the childminder that it was a requirement that the plans are put in place within twenty eight days of a child starting the service and that they are reviewed at least once every six months. The childminder used a phone application to keep in touch with parents/carers over the day. This meant that parents/carers were informed immediately if there were any concerns, for example if a child became unwell. The childminder ensured medication was not administered without parental consent. Written procedures had not been updated since the last inspection and we have repeated the recommendation made then in this report. (see recommendation 1) Parents/carers who completed our questionnaires indicated that the childminder listened to and acted upon their views about their child's development needs. We spoke with the childminder and an assistant and they described the feedback they received from parents/carers each day. For example, they told us they were able to take account of any changes in the child's life or if they had not slept well, or had an exciting night before they arrived. This information helped the childminder and her assistant to plan care and support in a way that was appropriate for each child. The childminder had received a copy of the new nutritional guidance, "Setting the Table", although she had not yet read this. The childminder agreed to read this guidance and review her menus if necessary. The childminder described healthy meals and snacks and was confident that meals were varied. The childminder had developed a brief policy on child protection and also listed contact telephone numbers to enable her to access these quickly if necessary. She provided a consistent service where children knew the boundaries that would keep them safe. During outings, the childminder helped children gain an understanding of risk and consequences. She used praise to celebrate children's achievements and we saw that children approached her for cuddles and reassurance during our visit. The childminder had information from Scottish Cot Death Trust about safe sleeping and we discussed how children in her care took naps to ensure this was safe. The childminder provided a range of activities. She encouraged free play and use of imagination indoors, and took children to local parks to see animals and birds and to talk about nature and its changes over the year. page 6 of 17
Through discussion it was clear that the childminder was committed to providing a service that met the needs of families, and that care and support was agreed with parents/carers. We assessed care and support as good. Grade The quality of care and support is graded Requirements Number of requirements - 0 Recommendations Number of recommendations - 1 1. The written medication procedures should be improved. Records of consent should include the dose and frequency of the medication as well as the reason for it. There should also be a record of any dose administered by the parent/ carer before the child arrived at the service. The childminder should add that she had checked the consent details with those on the pharmacy/original medication label. The medication procedure should include the action the childminder would take if a child refused their medication. 16, standard 3: Health and wellbeing. 4 Quality of environment Findings from the inspection We found the environment was good. It provided space for children to play with a variety of toys and to take part in various games and physical play activities, for example singing and dancing. Parents/carers who completed our questionnaires indicated that the childminder's home was safe and hygienic and provided a suitable range of equipment, toys and materials for their child to use. page 7 of 17
The childminder was prepared for children arriving at her service. She knew what they enjoyed doing and ensured toys and games were suitable. A good supply of wipes and tissues were available and children were learning about safe handwashing. We saw good infection control procedures around handwashing and wiping children's noses during our visit. Since the last inspection, the childminder had updated information in her infection control policies to include exclusion periods after infectious illnesses. She continually shared information about infectious illnesses with parents/carers. The childminder was using two large rooms, the hallway and the kitchen/dining area for children to play. She discussed using the bedroom for children sleeping and we advised her to apply for a variation to the conditions on her certificate of registration if she wished to do this. The toilet was equipped with a stool to allow children to be supported to wash their hands in the sink under running water. We saw that the space was well used by all children during our visit. The childminder made very good use of the nearby park which provided opportunities to feed squirrels and learn about birds and animals. The childminder used high visibility vests for children when taking them on visits, and risk assessed outdoor activities before they took place. The childminder maintained a diary with children's attendance. However, she was not recording their actual times of arrival and departure. The childminder agreed to record these times immediately. Accident forms were in place although the childminder told us no accidents had taken place since the last inspection. Overall, we assessed the environment as good. Grade The quality of environment is graded Requirements Number of requirements - 0 page 8 of 17
Recommendations Number of recommendations - 0 5 Quality of staffing We only assess this where the childminder employs an assistant. Findings from the inspection The childminder was assisted by three adults. These adults were named on the certificate of registration. We met one assistant during this inspection. It was clear that they had very good relationships with the children, and that children enjoyed spending time with him. The assistant led play experiences for children during the inspection while we spoke with the childminder. No new assistants had been employed since the last inspection. The childminder had developed a policy on recruitment and a brief whistle blowing policy to support staff working in the service. Since the last inspection, she was ensuring that care and support information was shared with assistants as required. As previously stated, during this inspection we saw that the assistant knew children well, and that they were happy to be spending time with him. The childminder worked alongside the assistant at all times, providing advice when needed and monitoring their practice. The childminder had identified that it would be useful for the childminding assistant to attend a course on first aid, and hoped to be able to access this in the near future. Overall, we assessed staffing in the service as good. Grade The quality of staffing is graded Requirements Number of requirements - 0 Recommendations Number of recommendations - 0 page 9 of 17
6 Quality of management and leadership Findings from the inspection The found the service was managed well. The childminder had established very good communication with parents/carers and ensured she provided feedback about her service daily. She also asked parents/carers about their satisfaction of the service generally, as well as more specifically about how care and support should be provided. The childminder focused on parental satisfaction and keeping children safe and happy. Since the last inspection, the childminder had taken positive action about recommendations made and completed an action plan about how she proposed to develop her service. Since the last inspection, the childminder had received copies of new guidance. This included nutritional guidance, "Setting the Table", and guidance on the Children and Young People (Scotland) Act 2014, "Building the Ambition". She told us she had not read these publications yet, but was familiar with the principles of GIRFEC (Getting it Right for Every Child) and the SHANARRI wellbeing indicators. We discussed the importance of these new publications, as well as continuing to access the Care Inspectorate HUB to ensure the childminder was familiar with best practice guidance. (see recommendation 1). Through discussion, it was clear that the childminder carried out research and was committed to providing a service that met the expectations and wishes of parents/carers. Although the childminder had not attended training since the last inspection, she had accessed our website more often to check for any updates to guidance. She had also completed the self assessment form based on the SHANARRI wellbeing indicators in which she had recorded how she met children's needs and how she kept up to date with best practice and legislation. The childminder had developed a procedure for parents/carers to make a complaint. She encouraged feedback and had created an open service where comments and suggestions were welcomed. Overall, we assessed leadership and management as good. Grade The quality of management and leadership is graded Requirements Number of requirements - 0 page 10 of 17
Recommendations Number of recommendations - 1 1. The childminder should update her nutritional policies in line with information in "Setting the Table" guidance. She should also continually review all policies and procedures with new guidance such as "Building the Ambition" as this becomes available. 16, standard 14: Well-managed 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. Previous recommendations 1. The childminder should develop a more formal consultation process to enable children, parents and carers to give their views on the development of the service. 16: Standard 13 - Improving the Service. The childminder had developed more formal methods to consult with parents/ carers and children through personal plan reviews. page 11 of 17
2. The childminder should now introduce a personal/care plan format for all children attending. Profiles should also be introduced giving an overview of children's time at the service. 16: Standard 3 - Health and Wellbeing. The childminder had developed personal plans for each child. These should continue to be developed to ensure they were put in place within twenty eight days of a child starting the service and reviewed at least once in every six months. Reviews should be dated to allow tracking to take place. These points were discussed with the childminder during the inspection. 3. A training programme should now be introduced for childminding assistants and a record retained. 16: Standard 14 - well-managed Service. Although no records of training were available, the childminder was seeking first aid training for her assistant. A record of this would be retained when completed. 4. A clearer system to record children's attendance at the service should now be introduced. 16: Standard 14 - well-managed Service. It was clear that children's attendance was recorded in the diary. However, actual times of arrival and departure were not recorded. The childminder agreed to put this in place immediately. 5. Medication procedures should be improved. Records of consent should include the dose and frequency of the medication as well as the reason for it. There should also be a record of any dose administered by the parent/carer before the child arrived at the service. The childminder should add that she had checked the consent details with those on the pharmacy/original medication label. The medication page 12 of 17
procedure should include the action the childminder would take if a child refused their medication. 16, standard 3: Health and wellbeing. The childminder had not administered medication since the last inspection apart from on an emergency basis. Written medication procedures had not been developed as recommended at the last inspection. We have repeated this recommendation in this report. 6. The childminder should take account of recognised guidance provided by Health Protection Scotland in relation to safe handwashing and allow children to access the toilet to wash their hands after nappy changes, before eating, after touching the pet dog, and after playing outdoors. She should also move the location of the changing mat to prevent airborne infections spreading to the food preparation area. 16, standard 2: A safe environment. The childminder had obtained a stool to allow children to access the wash hand basin in the toilet to wash their hands. 7. The childminder should develop her policy in relation to infection control to include that children should not return to her service and assistants should not work in her service until at least forty eight hours after the last episode of sickness and/or diarrhoea. 16, standard 2: A safe environment. This information had been added to the policy on infection control. 8. A record of assistants present should be recorded with children's attendance each day. 16, standard 2: A safe environment. page 13 of 17
The childminder was recording this information in her diary each day. 9. Assistants should have access to appropriate information about minded children that would help them take an active part in planning care and support, activities, and outings. 16, standard 6: Support and development. Through discussion, it was clear that the assistant present knew minded children well and information had been shared with them to help them provide appropriate care and support. 10. Assistants should be able to access training and be encouraged and supported to update their knowledge about legislation relating to the childminding registration. 16, standard 12: Confidence in staff. The childminder should access the Care Inspectorate website including the HUB and use links to legislation. She should do this regularly to ensure she was up to date with any changes that may affect her registration as well as accessing good practice guidance to help her develop her service. 16, standard 14: Well-managed service. The childminder should continue with her plans to seek training relevant to her role. This should include training on infection control, food hygiene, and child protection as well as any other specific training that would help her support children in her care. 16, standard 14: Well-managed service. The childminder should complete an action plan of how she will take forward recommendations and areas for development in this report. This should include timescales. The childminder should complete the self Inspection report for assessment form when evaluating her service and planning improvements. The views of page 14 of 17
parents/carers and children should be included in any future developments. 16, standard 14: Well-managed service. The childminder had accessed the Care Inspectorate website since the last inspection. She was seeking training and had opened an Individual Learning Account to support her in this. Assistants were also being encouraged to complete relevant training. An action plan was submitted to the Care Inspectorate after the last inspection setting out how the childminder would develop her service and meet the recommendations made. The self assessment had been completed using the SHANARRI wellbeing indicators. 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. page 15 of 17
11 Inspection and grading history Date Type Gradings 23 Oct 2014 Unannounced Care and support Environment Staffing 3 - Adequate Management and Leadership 3 - Adequate 28 Nov 2013 Unannounced Care and support Environment Staffing Management and Leadership Not Assessed 29 Nov 2011 Announced (Short Notice) Care and support Environment Staffing Management and Leadership 5 - Very Good Not Assessed Not Assessed 29 Apr 2010 Announced (Short Notice) Care and support Environment Staffing Management and Leadership Not Assessed Not Assessed 2 Jun 2009 Announced Care and support Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership Not Assessed page 16 of 17
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 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 17 of 17