Overall CCO Theme Grading: 4 - Good

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

Service Strengths
Some methods were used to facilitate service user and carer involvement in the evaluation and development of the quality of care and support provided including;

o questionnaires
o individual consultation meetings
o newsletters
o suggestion box
o complaints procedure

There was evidence that service user, carer and children's views were responded to, resulting in improvements to the quality of care and support. Feedback from parents, carers and children confirmed they were involved in these processes and found them to be useful. One parent who completed a questionnaire stated; "Staff are very attentive and ask for ideas. At the moment they are putting a recipe book together of parents' recipes, which will be a great help". Inspection reports were available to service users.

Most parents/carers who completed questionnaires stated they had a chance to be involved in the service. Staff knowledge of children was used to inform planning. Programmes were flexible and responded to the individual needs and interests of children.

Areas for Development
Identified areas for improvement were to develop home links and a parental participation strategy, as a means of involving service users in the development of the service Consultation on this had commenced, with suggestions of a parents/carers committee, parents/carers being involved in interviewing new staff and visits to the nursery to partake in activities. Some parents who completed questionnaires were keen for more involvement in the service. One suggested they would like parents' afternoons / evenings or regular meetings. The manager confirmed plans for these were in place.

Management and staff should seek further ways in which service users can be involved in the assessment of the quality of care and support provided using the grading system, including developing the questionnaires to be more specific about statements within the quality theme. Consideration should be given to providing more practical support to parents, carers and children to help them participate in the opportunities provided.

Whilst questionnaires had been distributed and returned by parents/carers and staff, and information collated, feedback had not been provided to service users. The manager stated she intended to feed back; views gathered and how and when areas identified for change will be actioned.

CCO Grading
4 - Good

Number of Requirements
0

Number of Recommendations
0

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

Service Strengths
A variety of policies, procedures and programmes were in place to promote the health and safety of children including, medication and risk assessments. A key worker system was in place, which assisted in providing continuity of care. A policy was in place to support this. Staff utilised transition records from home, daily discussions and diaries with parents and carers to ensure information is shared.

Most parents/carers who completed questionnaires stated their children's routine was discussed. Comments included; "Staff fill out a daily diary for parents, this helps to plan the routine I use at home" and "they provide a range of activities designed for her. Each day they tell me what she has played with. All information is recorded and handed to you in slips".

Staff demonstrated an understanding of children's needs and planned appropriately to ensure they were being met. All parents/carers consulted stated they were happy or very happy with the way staff helped their child/children with personal care.

Information about the child, including health and dietary needs was obtained prior to placement. Parents and carers confirmed they were aware of the need to keep information updated and that information on children's needs and preferences were discussed regularly.

All parents/carers consulted stated they were happy/very happy that staff knew their child as an individual.

Staff provided good support and encouragement to children. Parents and carers commented positively on the support and assistance provided to them and their child/children. One commented; "Staff have been very sensitive to all our needs".

Children were provided with daily opportunities for indoor and outdoor play and had opportunities to sleep or rest. Management and staff had a clear understanding of their role and responsibility in protecting children from harm, abuse, bullying and neglect and implemented appropriate procedures in line with the service policy and current guidelines. Parents and carers were provided with copies of this. Feedback from parents and carers supported this. Children were encouraged to express their feelings and experiences. All staff took part in regular Child Protection training.

An infection control policy was in place and regularly reviewed using current guidance. Infection control including, food hygiene was incorporated into staff inductions. Some staff had attended certificated food hygiene training.

A copy of the nutritional guidance for early years: food choice for children aged 1- 5 in early education and childcare settings was available. Staff had used this to confirm practice and encouraged healthy eating through working with parents and children. Account was taken of ethnic, cultural and dietary requirements. A healthy eating policy was in place. A range of meals, snacks and drinks were provided, in line with the guidance. Menus were displayed. Service users confirmed they were involved in menu planning. One parent commented; "they have photographed food so that I could see what my baby was eating and followed all my requests ". Most parents/carers consulted stated they were happy/very happy with the food, drink and snacks provided.

The service participated in the 'Smile Too' national toothbrushing programme.

Areas for Development
An identified area for improvement was to review the lunch time routine to incorporate a more social and relaxing environment for the children. At the time of the visit, changes had been implemented and further improvements planned.

Whilst the range of meals, snacks and drinks provided were in line with the nutritional guidance and menus were displayed, one parent stated he/she was unaware of the nutritional content. The manager stated she would make this information available to service users. Whilst most parents/carers who completed questionnaires stated their children's routine was discussed, one stated; "The routine in the nursery is established but particular discussion about the child's routine in this is not happening". The manager stated plans were in place to meet with parents/carers to discuss children's routine and developmental progress.

Whilst there were no children attending the service who had identified Additional Support for Learning needs, management and staff should become familiar with and implement current legislation to ensure procedures and practice are up to date.

CCO Grading
5 - Very Good

Number of Requirements
0

Number of Recommendations
0

Overall CCO Theme Grading: 4 - Good

Statement 1: We ensure that service users and carers participate in assessing and
improving the quality of the environment within the service.

Service Strengths
Evidence to support the strengths in this quality statement is as detailed under Quality Statement 1.1.

Areas for Development
Evidence to support the areas for improvement in this quality statement is as detailed under Quality Statement 1.1.

CCO Grading
4 - Good

Number of Requirements
0

Number of Recommendations
0

Statement 3: The environment allows service users to have as positive a quality of life
as possible.

Service Strengths
A warm and caring ethos was evident during the inspection visit. The accommodation provided a safe, warm and welcoming environment. A secure door entry system was in place. Parents/carers felt the premises were safe and secure and stated it was as clean as they would like it to be.

Staff had made effective use of available space, providing areas for children to play alone and in small or large groups. Some outings to places in the local community took place. Staff monitored the use of areas and resources.

The nursery had appropriate procedures for ensuring health and safety, fire safety and reporting repairs. Staff carried out appropriate risk assessments for aspects of accommodation and for outings.

Resources were age and stage appropriate, well organised, accessible and provided challenge. Photographs of resources were available to children, which assisted them in selecting them. Staff used observations and assessments to identify the next steps in children's development and learning and inform planning to ensure individual needs were being met. Parents/carers stated their child always had access to a range of materials and equipment to support their development, learning and interests and that their child always found activities stimulating and challenging. Comments included; "Individual programmes of play are discussed. Photos are displayed of different activities."

Areas for Development
Whilst children were taken on regular outings to places in the local community, the garden area was not used, as it was in need of upgrading. Parents commented; "I would be interested to hear when the garden will be completed as I feel it is very important for the babies/children to play outside" and "The lack of a designated outside space means that the children do not get outside regularly to run around. The staff take children on walks in prams but this is not exercise". The manager and service manager confirmed they were seeking funding for the garden to be developed and that they would keep service users informed of progress.

Staff should consider accessing a wider range of local facilities, including the library and increase their knowledge of local facilities and events and share this with service users.

The manager confirmed planning was being further developed in line with the Birth to Three: supporting our youngest children document.

CCO Grading
4 - Good

Number of Requirements
0

Number of Recommendations
0

Quality Theme 3: Quality of Staffing

Overall CCO Theme Grading: 4 - Good

Statement 1: We ensure that service users and carers participate in assessing and
improving the quality of staffing in the service.

Service Strengths
Evidence to support the strengths in this quality statement is as detailed under Quality
Statement 1.1.

Areas for Development
Evidence to support the areas for improvement in this quality statement is as detailed under Quality Statement 1.1.

CCO Grading
4 - Good

Number of Requirements
0

Number of Recommendations
0

Statement 4: We ensure that everyone working in the service has an ethos of respect towards service users and each other.

Service Strengths
A variety of policies and procedures were in place including, Equality and Fairness, Confidentiality and Whistleblowing. All staff were aware of and implemented the service's policies and procedures. Staff had taken part in appropriate training.

Staff worked well as a team and had developed positive relationships with service users. Service users were encouraged to express their views. Parents/carers stated staff always took account of their views and wishes on their children's development needs, interests and personality.

Children were observed to interact well with staff and other children and responded well to the support, praise and encouragement provided by staff. Parents/carers stated information provided was treated appropriately and that staff spoke privately about their child/children. They stated they were very happy that staff treated their child respectfully and fairly and interacted well with their child. Comments included; "Staff are fantastic. My baby loves going to nursery and feels safe in her environment. Staff are warm, friendly and professional at all times. They are a credit to the nursery" and "Staff have been excellent at settling me in as well as my baby. They have allayed all my fears".

Staff implemented programmes which celebrated equality, culture and diversity. Parents and carers stated staff respected and valued their personal beliefs whilst caring for their child.

All staff were appropriately qualified or working towards a qualification and registered or in the process of registering with the Scottish Social Services Council (SSSC). Staff had a good knowledge of the National Care Standards and the SSSC Codes of Practice and ensured their practice was reflective of these.

Staff were clear about lines of communication and accountability and were confident in reporting poor practice. Regular staff and management meetings took place to plan and evaluate practice.

Areas for Development
An identified area for improvement was to seek further ways in providing support to service users whose first language was not English. At the time of the visit, some written documentation was being translated into a number of languages other than English.

Whilst staff photographs, names, qualifications and registration status were available to service users, information about previous staff was displayed in the cloakroom area. The manager stated this was an oversight and that she'd ensure only current staff information was displayed.

CCO Grading
5 - Very Good

Number of Requirements
0

Number of Recommendations
0

Quality Theme 4: Quality of Management and Leadership

Overall CCO Theme Grading: 4 - Good

Statement 1: We ensure that service users and carers participate in assessing and
improving the quality of the management and leadership of the service.

Service Strengths
Evidence to support the strengths in this quality statement is as detailed under Quality
Statement 1.1.

Areas for Development
Evidence to support the areas for improvement in this quality statement is as detailed under Quality Statement 1.1.

CCO Grading
4 - Good

Number of Requirements
0

Number of Recommendations
0

Statement 4: We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide.

Service Strengths
Management and staff were committed to providing a continuously improving service.
Parents/carers who completed questionnaires knew of the service's complaints procedure and were confident that if they had concerns, staff would deal with them appropriately. They were very happy overall with the quality of service.

Regular staff meetings provided opportunities for discussion and consultation. Staff used continuous assessment practices to monitor children's development and the programme of activities available to them.

The management team and staff had a good understanding of national and local priorities.

The provider and management had an understanding of their responsibilities to make notifications to the Care Commission and SSSC.

Areas for Development
Management and staff were aware of and had access to the Scottish Executive document The Child at The Centre and had recently undergone an Investors In People re-assessment.

They intended to use this process in the monitoring and evaluation of the service, using The Child at The Centre and in the creation of a development plan.

Although some informal monitoring and support was available to staff, the formal procedures for supervision were not being fully implemented. The manager and staff confirmed dates were scheduled for these to commence.

The manager confirmed policies and procedures were currently being reviewed, including recruitment and disciplinary, which would reflect checking professional registers such as the SSSC and notification procedures to the SSSC and the Care Commission.

Questionnaires for staff had been developed. The manager confirmed they were soon to be distributed and when returned, they would be used to assess and improve the quality of the service.

CCO Grading
4 - Good

Number of Requirements
0

Number of Recommendations
0