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REPORT OF AN INSPECTION OF ROSSIE SECURE ACCOMMODATION SERVICES
MONTROSE

Joint Report By: Social Work Services Inspectorate and HM Inspectorate of Education assisted by the Scottish Executive Health Department.

FEBRUARY 2004

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SOCIAL WORK SERVICES INSPECTORATE

Purposes and responsibilities

To work with others to continually improve social work services so that:

• they genuinely meet people's needs; and
• the public has confidence in them.

HM INSPECTORATE OF EDUCATION

Purpose and responsibilities

HM Inspectors undertake first-hand, independent evaluations of the quality of education. Their inspections and reviews monitor how well schools, colleges and other providers of education are performing, and promote improvements in standards, quality and attainment in education.

SCOTTISH EXECUTIVE HEALTH DEPARTMENT

Purpose and responsibilities

To work with NHS Scotland to improve health and health services for the people of Scotland:

• to improve, protect and monitor the health of the people of Scotland;
• to develop and deliver modern, person-centred primary care and community care services;
• to provide modern, high quality, responsible hospital and specialist services.

LIST OF CONTENTS

1. Introduction
2. Progress made on recommendations in previous report
3. Summary and conclusions

REPORT ON AN INSPECTION OF ROSSIE SECURE ACCOMMODATION SERVICES
(formerly Rossie School) - OCTOBER 2003

Introduction

1. An inspection of Rossie Secure Accommodation Services was undertaken by the Social Work Services Inspectorate (SWSI) and HM Inspectorate of Education (HMIE), assisted by the Scottish Executive Health Department (SEHD). It took place in October 2003. A main aim was to evaluate progress achieved on the recommendations made in the report on Rossie published in August 2003 ¹. The Care Commission simultaneously undertook a routine, announced, annual inspection in October 2003. There was a high level of collaboration among inspectors. There is a separate report published of the Care Commission inspection.

2. Each recommendation from the 2002 inspection is outlined below with, where necessary, explanation of the context in which it was made. The findings of the 2003 inspection concerning each recommendation follow. Areas for further work are outlined.

3. All inspections of children's services should take account of any new circumstances or problems that have emerged since the last inspection, particularly if they relate to the safety or security of children. This inspection was not, therefore, focussed solely on the previous recommendations. It sought, alongside the Care Commission, to take a holistic view of Rossie's child care and education provision and practice.

Progress made on recommendations in the previous report

Recommendation 1: A clear statement of the Board of Governors' roles and responsibilities should be produced. The Board should continue to be vigilant in ensuring that the school is able to operate to capacity. The temporary de-commissioning of beds should be reported to the Scottish Executive Education Department.

4. There was a clear statement in place of the Board of Governors' roles and responsibilities. Infrequent but regular visits at night were undertaken by Governors. There were regular discussions at Governors' meetings concerning whether or not the service was operating to capacity. In the last year the secure unit had operated at 98% capacity and there had been no de-commissioning of beds. The open unit, which has 4 beds, had only operated at 46% of capacity although there had been no de-commissioning. Rossie was keen that greater use should be made by local authorities and the Scottish Executive of the latter resource. It could be a helpful stepping stone for some young people back into the community, particularly for those who have had a long stay in secure conditions. Rossie should consider with their user group how the open unit might become a more fully used resource.

Recommendation 2: Senior management must ensure more robust arrangements are in place for supporting staff, particularly inexperienced staff, in the management of challenging behaviour.

5. Most staff felt well supported. There was generally good morale and a positive attitude to the changes and developments that were taking place at Rossie. A system of mentoring for new staff was spoken of highly as was the induction programme. Paradoxically, most staff felt safe in spite of the fact a number had been assaulted in the last year, which for some had resulted in a period of sick leave. This feeling of safety seemed to emanate from strong, positive staff relationships and effective teamwork. A number of staff, in different teams, spoke of being in the "best team in Rossie".

6. At the time of the last inspection, there had been a considerable number of new staff, some of whom were found not to be sufficiently confident and competent in handling the young people's challenging behaviour. Inspectors observed little evidence of this difficulty during this inspection and there was considerable evidence of thoughtful, reflective and effective practice. "Zero tolerance" of swearing had been implemented by staff and this was beginning to have some positive results. The inspection, however, coincided with what was described by a number of staff as a relatively calm period which was contrasted with a more turbulent period in the summer. During the last year, there had been a number of incidents of reckless, sometimes para-suicidal, behaviour by young people. Although none of these incidents had serious outcomes, senior managers should review their causes, the robustness of the risk assessments and risk management, and the appropriateness of the immediate actions taken and the medical treatment and therapeutic inputs provided.

7. More experienced and promoted staff recognised that they were role models for newer staff. They tried to explicitly build this into the induction process by, for instance, providing a period of "shadowing". Team leaders, unit managers and more senior staff were perceived to be readily available to provide advice, support and feedback. At times in the last year, however, continuity of staffing and management in the houses had been affected by high sickness levels. This was also a finding at the last inspection. This could be unsettling both for young people and inexperienced staff. It could also mean that the temporarily assembled team working on a particular shift might not have the optimum balance of training and expertise needed to handle all the challenges that emerged on the shift. Senior managers in Rossie were described as sympathetic and supportive to staff on sick leave. More needs to be done by them to try to pre-empt possibly work-related sick leave so that a more consistent service is achieved.

8. Whilst informal support and supervision were usually readily available and valued, formal individual supervision was still not happening for a significant number of staff at the prescribed frequency of 4 weekly. New staff, if they are inexperienced in this area of work, are likely to benefit from supervision that occurs more frequently than 4 weekly. The often "fire fighting" nature of the work was reported to have got in the way of this requirement, as had the level of sickness. A number of supervisory staff had not had the opportunity of training in supervision skills. This might increase both commitment to and effectiveness of formal supervision sessions. Rossie was about to undertake a review of shift patterns and rotas. A feature of this review should be consideration of how regular, dedicated time for supervision can be consistently achieved.

9. In contrast to the above picture, inspectors found morale among night care staff was still considerably lower than among day staff and they had higher anxieties about personal safety. Although they were now receiving supervision at regular intervals from the head of care, this did not appear to have assuaged their sense of isolation and their view that their role was insufficiently understood. At the last inspection, senior managers were asked to consider whether there was a case for having a designated team leader on night shifts. This consideration led to the decision to designate a co-ordinator on each shift. This role appeared to be mainly administrative and had not resolved night staff's concerns. Senior managers should review these concerns with night care staff to see if they can be more successfully resolved. Inspectors remained of the view that team leaders on the night shifts might be helpful.

Recommendation 3: The review of care and control and related procedures at Rossie should be completed and copies of the report forwarded to SWSI and the Care Commission within 6 months of the publication of this report.

10. The inspection took place only 2 months after publication of the report. Consequently, it was not expected that there would be an outcome from this recommendation. Rossie had a staff working party in place to take forward this recommendation. It will be important to consult young people and placing organisations about the procedures prior to them being finalised. The review should also include consideration of when and how the segregation suite will be replaced.

Recommendation 4: The estate manager should ensure that the quality of living accommodation, furnishings and fittings and cleaning arrangements are more consistent.

11. There has been some, albeit insufficient, improvement in response to this recommendation. There were cleaning arrangements in place at weekends and there had been some redecoration. Inspectors noted that the education unit and the open unit were both bright and pleasant and in a good state of repair. It was recognised that there had been a few children in residence recently whose behaviour could at times be very destructive which had made achievement of a higher quality living environment difficult. The design and layout of the secure houses was also not helpful. Nevertheless, it was demoralising for those children and their families who respected and enjoyed pleasant surroundings if the shared living areas and the visitors' rooms had damaged furniture and bare, sometimes graffiti covered, walls. It would be helpful if there were tight time targets for removal of graffiti and repair or replacement of damaged furniture and fittings. Although cleaning has become more frequent, inspectors observed some soiled carpets and upholstery that would have benefited from appropriate cleaning.

Recommendation 5: Senior management should consider how a step-up in availability of focused programmes of work with young people can be achieved. Consideration should be given to the nature and level of psychological input, developing in-house resources and the implications for staff training.

12. All young people were offered the opportunity to take part in focused programmes. There was occasional reluctance to take part. Sometimes the timing of the programme or attributes of the young person meant that the young person was not very responsive to the intended effects of the programme. There was also a number of assessment tools, both psychological and educational, being used at the time young people entered Rossie. Detailed family and social histories were not generally supplied by social workers and this could seriously hamper Rossie staff in their understanding of children's behaviours and in assessing the appropriateness of their interventions. A strength of Rossie over a number of years has been the good relationships that staff have been able to develop with most children and this is the bedrock upon which programme work is most likely to be successful. Some children, however, are likely to have attachment disorders and this is an area where staff would benefit from further training.

13. It was not always clear or clearly recorded why a particular programme was being used with a particular child, how it related to the assessment of the child or its intended outcome. Not all staff had received training in all the programmes being used and some programmes were delivered by outside individuals or organisations. This was appropriate where programmes were not planned to be used universally with all children, for example only some children needed bereavement counselling, or where an outside person or organisation was readily available to deliver a programme to all those children who needed it. However, all care staff require briefing about the aims and methods of all the programmes in order that they can plan appropriately for their key children. Some programmes, for example STAR, were only available for children placed in particular houses. The original rationale for this was to undertake a controlled trial but the programme was not yet being evaluated. All the programmes require careful monitoring. Evaluation, where possible independent, is required to measure the effectiveness of programmes and to make fine judgements about which children would benefit from them, in what combinations and at what stage of their stay in Rossie. If possible, evaluation should continue after young people have left Rossie to gauge the medium and long-term effectiveness of programmes. Some of this work would beneficially take place across all secure units in Scotland rather than each of them "re-inventing the wheel".

14. Rossie had been successful, in conjunction with the Dundee City Council secure unit, the Elms, in obtaining funding for an integrated "Promoting mental health and wellbeing" programme supported by a multi-professional mental health team. It was intended that a 0.5 WTE clinical psychologist would be employed, alongside a full-time psychiatric nurse and with allocated consultant psychiatrist input. The latter 2 were already in post. Unfortunately efforts to recruit the psychologist had not yet been successful. Once all staff are in place, this integrated programme is likely to prove very beneficial for the young people at Rossie.

15. Senior managers and staff had enthusiastically implemented assessment tools and behavioural change programmes. Rossie had recently employed a consultant to develop the "Rossie Model of Change". This was in recognition that tools and programmes:

• were applied somewhat haphazardly;
• should have their quality and effectiveness assured;
• should be tailored to individual children's needs;
• should be a good fit with each other; and
• should be used at the most appropriate times and in the most appropriate "dosages" with those children who were most likely to benefit from them.

It was envisaged that the model would take 6 months to develop and perhaps a further 6 months to a year to become fully embedded in practice. This is likely to necessitate a significant staff development programme and development of clear staff guidance and implementation procedures. It might also require a dedicated programmes manager or programmes team. This is a very important and potentially complex undertaking but one that, if it is successful, should provide tangible benefits for the young people concerned and the communities to which they will return. SWSI and the Care Commission will be interested to review progress when they next visit.

Recommendation 6: Smoking policies for young people and staff need to be reviewed with a view to introducing a non-smoking policy on a staged basis.

16. Rossie had consulted with the pupils, staff, carers and local authorities on the development of a non-smoking policy. This had been accepted by the staff and young people's councils. A very comprehensive incremental approach had been taken with the necessary support built in for staff and young people, and management protocols developed. The whole facility, including the grounds, should be non-smoking by February 2004. Rossie is commended for this thorough and comprehensive approach to a difficult issue.

Recommendation 7: Each living unit requires a designated health lead with responsibility for health provision and assessment, health education and promotion and contributing to health and safety across the school.

17. Each of the 4 living units had a designated health lead, who was a residential social worker of varying seniority. A unit manager continued to take the overall health lead for Rossie, and there was a health committee that met on a regular monthly basis. The unit health leads took responsibility for health and safety and general health issues within each unit. They were responsible for developing the overall approach to holistic healthcare. This framework to address health issues is appropriate and it has addressed the previously identified issues. Hopefully, positive longer term effects will be noted at the next inspection.

Recommendation 8: All health information should be unified into a single health care record.

18. All the health information relating to individual young people was appropriately and satisfactorily held within one loose leaf health folder, stored in the duty room. This allowed easy and appropriate access to all the relevant information.

Recommendation 9: The education department should improve the structure of the curriculum and programmes of study in subject areas, as outlined in this report.

19. The deputy chief executive had established a working party to examine the structure of the curriculum and arrangements for learning and teaching. Staff had developed a wide range of programmes to improve teaching and cross-curricular links and to enhance students' achievements. Curriculum developments included English, mathematics, modern languages, social subjects, information and communications technology, craft and design technology, home economics, physical education and personal and social education, including work experience. The length of the school week had been increased for formal lessons. However, it needed to be extended further in line with that of mainstream secondary schools. Due to staffing shortages, the breadth of the curriculum was restricted and the subjects on offer did not include science and religious and moral education. The education department had devised various contingency plans to cover for staff absence and care staff played an active role in assisting with aspects of the curriculum. Nevertheless, the education department needs to ensure that there is an adequate level of staffing to provide a broad and balanced curriculum throughout the school week.

Recommendation 10: Teaching staff should develop and extend opportunities for students to undertake National Qualifications units across the curriculum.

20. The education department had extended opportunities for young people to achieve national certification. Overall, the number of National Qualifications (NQ) units attained by students had increased significantly from 2002 to 2003. Students mainly undertook NQ units at Access 3 and Intermediate 1 levels. If appropriate, they were able to complete NQ units at higher or lower levels of attainment. Additionally, the education department was in a position to offer young people the opportunity to undertake Standard Grade examinations in some subjects, including English, mathematics, computing and social and vocational skills.

Recommendation 11: Care and teaching staff collectively should continue to develop a more comprehensive and integrated personal and social education programme.

21. The deputy chief executive had led the development of Rossie's personal and social education programme to promote more collaborative work among care and teaching staff. This initiative had included the development of a variety of courses to meet the personal, social and vocational needs of students and to enable them to gain NQ units in personal and social education. Bases for care staff were being developed in the education department to assist them in engaging in young people's education. Staff were making extensive use of services in the wider community to enhance students' knowledge and understanding of social issues. However, there should be more detailed arrangements in place to enable personal and social education to be more fully integrated within the 24-hour curriculum across education, health and care staff. The education department should review its homework policy to facilitate collaborative working across education and care and continue to work collaboratively with care staff in establishing "educationally rich" environments in the living units. For young people reluctant to attend classes, there should be clearer procedures to ensure that appropriate educational provision is available in the houses. The education department also should ensure that parents, care staff and social workers receive regular school reports.

Recommendation 12: The education department should establish and maintain an effective system for supporting students who are experiencing learning difficulties. It also should further develop and extend its use of individualised educational programmes.

22. Teachers were aware of the learning and behavioural difficulties being experienced by students. Due to continuing staffing shortages, the education department had made provisional arrangements for the reorganisation of support for learning. Care staff were assisting in the work of the education department to enable teachers to engage in one-to-one tutorial support or small group teaching with designated students. The department had developed a new format for individualised educational programmes (IEPs) to provide targets for English, mathematics and personal and social development. Half of the students had IEPs, including the 4 students with Records of Needs. Targets for personal and social development focussed on helping students to overcome behavioural difficulties. When reviewing and implementing IEPs, staff should include specific targets relating to national certification in personal and social education.

Recommendation 13: The education department should develop its procedures for improving educational provision through more rigorous approaches to staff review and development, self-evaluation and development planning.

23. The education department had devised an ambitious improvement plan for 2002-03 to 2005-06. It covered key aspects of the work of the department such as curricular development, staff recruitment, raising attainment and achievements, support for pupils and staff development. Development planning had been successful in taking forward the work of the department though not all targets for 2002-03 had been fully achieved. The department had made extensive use of quality indicators within curricular areas and had involved teachers in this process of self-evaluation.

24. The head of education, along with promoted staff, had introduced procedures to monitor aspects of staff's contributions and to offer support if required. A supervision record was kept for all teaching staff, including classroom assistants. The education department had devised new arrangements for staff review and development and was planning to implement them during the current school year.

Recommendation 14: Rossie and placing local authorities should work together better to ensure that existing community-based resources are used to address the reasons for admission and prepare for a successful return to the community.

25. In the last year Rossie had children placed from approximately 75% of Scottish local authorities. As far as children in situ in Rossie are concerned it is unrealistic that services in all these local authorities can be accessed - access to services local to Rossie is the key to meeting this recommendation. Rossie had developed and strengthened a wide range of links with local community-based resources in Angus and Tayside in the past year. Senior managers had agreed a protocol with Tayside police around issues such as absconders and misuse of drugs. There was evidence of the child protection protocol, agreed with Angus Council, being implemented appropriately in a case where a young person had complained of assault by Rossie staff (her complaint was not upheld). The joint mental health initiative with Dundee City Council has been referred to above and Rossie also had an agreement with Angus Counselling Service to provide staff counselling. There were examples, in individual cases, of youth justice social workers implementing offender programmes. There is scope for such work to happen more frequently, particularly where the social worker is reasonably local. There were helpful links with local drug misuse counselling agencies. Local community-based resources were also being well used within the education unit, such as workshops provided by the Angus Mental Health Association, regular contact with the local careers service, use of the Tayside Include Project, and longstanding positive work experience opportunities.

26. Arrangement and maintenance of appropriate types and levels of community-based services when young people were ready to return to their home communities was sometimes problematic and is an area that requires more work both by Rossie and by placing local authorities. This will merit continuing consideration by the user group. These arrangements are likely to become both more complicated and more essential as services and programmes in Rossie are extended. Rossie had been trying to recruit a through care and after-care worker - these efforts should continue as the post holder will have an important and necessary role to play. An issue of concern to local authorities was that they did not always receive details of the programmes that had been undertaken with individual young people at Rossie. This made it hard to plan appropriate programmes for them after they had left.

27. Local authorities described occasional lapses or delays in communication and consultation by Rossie staff. Nevertheless, some local authorities expressed the view that Rossie's communication and consultation with them had improved in the last year. They also acknowledged that staff shortages in their authorities could lead to shortcomings in communication on their parts. Inspectors considered that Rossie's communication and consultation were mainly satisfactory but that there had been a small number of occasions, particularly when Rossie staff acted in ways that contradicted recent review decisions or when serious incidents had occurred, where communication and consultation still required more consistent attention.

Summary and Conclusions

28. Inspectors were pleased to find that considerable and satisfactory progress had been achieved on most of the recommendations. A few recommendations, generally those that were more complex to achieve, still required further action or action had been started but was still ongoing. Recommendations 2-5, 9, 11 and 14 fall into these categories. Suggested actions have been outlined above. Inspectors noted that difficulties in staff recruitment and retention had been a factor that reduced Rossie's ability to fully meet a number of the recommendations. This is an issue that the Board of Governors needs to find new ways to address. With the exception of the report concerning care and control and related procedures, which should be sent to SWSI and the Care Commission by the end of March 2004, progress on the other recommendations will be further reviewed through future routine inspection and registration visits.

How can you contact us?

Copies of this report have been sent to the Board of Governors, senior managers and staff in Rossie School, all local authorities, appropriate local councillors and Members of the Scottish Parliament. Subject to availability, further copies may be obtained free of charge from the office at the address below or by telephoning 0131 244 5423. Copies are also available on our websites:

SWSI - www.scotland.gov.uk/socialwork/swsi
HMIE - www.hmie.gov.uk

Should you wish to comment on or make a complaint about any aspect of the inspection or this report, you should write in the first instance to Gill Ottley, Deputy Chief Inspector, whose address is given below. If you are unhappy with the response you will be told in writing what further steps you may take.

Social Work Services Inspectorate
Scottish Executive Education Department
Area 1-F (South)
Victoria Quay
EDINBURGH
EH6 6QQ

Crown Copyright © 2004
Scottish Executive

This report may be reproduced in whole or in part, except for commercial purposes or in connection with a prospectus or advertisement, provided that the source or date thereof are stated.

Further copies of this report may be obtained from
Social Work Services Inspectorate
Area 1-F(South)
Victoria Quay
EDINBURGH
EH6 6QQ
Tel: 0131 244 5423

1 Inspection of care arrangements and education in Rossie School, Montrose. August 2003