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PL3 5QL
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- NA Notice to the Local Authority under section 47(5) of the Care Standards Act 2000 of failure(s) to satisfy regulatory requirements in their adoption service which are not substantial, and specifying the action the Commission considers the Authority should take to remedy the failure(s), informing the Secretary of State of that Notice: p.12
- The following 4-point scale is used to indicate the extent to which standards have been met or not met by placing the assessed level alongside the phrase "Standard met?" p.2
- Several adopters felt that communication between the adoption workers and the childcare workers was poor. p.10
- NA Report to the Secretary of State under section 47(4)(a) of the Care Standards Act 2000 of a failure by a Local Authority adoption service to satisfy regulatory requirements which is not considered substantial: p.12
- NA Report to the Secretary of State under section 47(1) of the Care Standards Act 2000 of substantial failure to satisfy regulatory requirements by a Local Authority adoption service: p.12
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- Identified below are areas not addressed from the last inspection report which indicate a non-compliance with the Care Standards Act 2000, the Adoption Agencies Regulations 1983 and the Local Authority Adoption Service (England) Regulations 2003. p.13
- Regulation Standard Required actions Timescale for action p.13
- City of Plymouth Adoption Service Page 12 p.13
- Action Plan: The appropriate officer of the Local Authority is requested to provide the Commission with an action plan, which indicates how requirements are to be addressed. p.14
- This action plan is shown in Part D of this report. p.14
- Identified below are areas addressed in the main body of the report which indicate non- compliance with the Care Standards Act 2000, the Adoption Act 1976, the Adoption Agencies Regulations 1983, the Local Authority Adoption Service (England) Regulations 2003 or the National Minimum Standards for Local Authority Adoption Services. p.14
- The Authority is required to comply within the given time scales in order to comply with the Regulatory Requirements for adoption services. p.14
- Regulation Standard * Requirement Timescale for action p.14
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Care & placements12
“to achieve a successful and lasting placement.” p.21
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- Pages
- 44
- Words of findings
- 7,263
- longer than usual (typical 1049)
- Reading level
- Hard
- Flesch 47, typical 45
- Average sentence
- 16 words
- Next steps
- 8
- typical 5
- Hedged sentences
- 2%
- “some”, “not always”, “most”…
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Full report text
City of Plymouth Adoption Service
Gingko House 156 Mannamead Road Plymouth PL3 5QL
p.1
City of Plymouth Adoption Service
15th September 2004 Local Authority Adoption Services
p.1
Commission for Social Care Inspection
Launched in April 2004, the Commission for Social Care Inspection (CSCI) is the single inspectorate for social care in England.
p.2
Commission for Social Care Inspection
The Commission combines the work formerly done by the Social Services Inspectorate (SSI), the SSI/Audit Commission Joint Review Team and the National Care Standards Commission.
p.2
The role of CSCI is to:
• Promote improvement in social care • Inspect all social care - for adults and children - in the public, private and voluntary sectors • Publish annual reports to Parliament on the performance of social care and on the state of the social care market • Inspect and assess ‘Value for Money’ of council social services • Hold performance statistics on social care • Publish the ‘star ratings’ for council social services • Register and inspect services against national standards • Host the Children’s Rights Director role.
p.2
Inspection Methods & Findings
SECTION B of this report summarises key findings and evidence from this inspection. The following 4-point scale is used to indicate the extent to which standards have been met or not met by placing the assessed level alongside the phrase "Standard met?"
p.2
The 4-point scale ranges from:
4 - Standard Exceeded (Commendable) 3 - Standard Met (No Shortfalls) 2 - Standard Almost Met (Minor Shortfalls) 1 - Standard Not Met (Major Shortfalls) 'O' or blank in the 'Standard met?' box denotes standard not assessed on this occasion. '9' in the 'Standard met?' box denotes standard not applicable. 'X' is used where a percentage value or numerical value is not applicable. City of Plymouth Adoption Service Page 1
p.2
Address
Gingko House, 156 Mannamead Road, Plymouth, PL3 5QL
p.3
service
City of Plymouth Adoption Service Page 2 Date of Inspection Visit 15th September 2004 ID Code
p.4
inspections and bring a different
perspective to the inspection process. Name of Specialist (e.g.
p.4
Name of Establishment Representative at
the time of inspection Wendy Van Den Heuvel City of Plymouth Adoption Service Page 3
p.4
D.3. Provider’s agreement
City of Plymouth Adoption Service Page 4
p.6
INTRODUCTION TO REPORT AND INSPECTION
Local authority adoption services are subject to inspection by CSCI, to establish if the service is meeting the National Minimum Standards for Local Authority Adoption Services and the requirements of the Care Standards Act 2000, the Adoption Act 1976 as amended, the Adoption Agencies Regulations 1983 as amended and the Local Authority Adoption Service (England) Regulations 2003.
p.6
INTRODUCTION TO REPORT AND INSPECTION
This document summarises the inspection findings of the CSCI in respect of City of Plymouth Adoption Service. The inspection findings relate to the National Minimum Standards for Local Authority Adoption Services published by the Secretary of State under sections 49 of the Care Standards Act 2000.
p.6
INTRODUCTION TO REPORT AND INSPECTION
The Adoption Agencies Regulations 1983 and the Local Authority Adoption Service (England) Regulations 2003 are secondary legislation, with which a service provider must comply. Service providers are expected to comply fully with the National Minimum Standards. The National Minimum standards will form the basis for judgements by the CSCI regarding notices to the local authority and reports to the Secretary of State under section 47 of the Care Standards Act 2000.
p.6
INTRODUCTION TO REPORT AND INSPECTION
The report follows the format of the National Minimum Standards and the numbering shown in the report corresponds to that of the standards.
p.6
INTRODUCTION TO REPORT AND INSPECTION
The report will show the following: • Inspection methods used • Key findings and evidence • Overall ratings in relation to the standards • Compliance with the Regulations • Notifications to the Local Authority and Reports to the Secretary of State • Required actions on the part of the provider • Recommended good practice • Summary of the findings • Report of the Lay Assessor (where relevant) • Providers response and proposed action plan to address findings
p.6
INSPECTION VISITS
Inspections will be undertaken in line with the regulatory framework with additional visits as required. This is in accordance with the provisions of the Care Standards Act 2000. The inspection methods used in the production of this report are set out in Part B. Pre- inspection information, and the manager’s written self-evaluation of the service, have also been taken into account. The report represents the inspector's findings from the evidence found at the specified inspection dates. City of Plymouth Adoption Service Page 5 BRIEF DESCRIPTION OF THE SERVICES PROVIDED.
p.6
INSPECTION VISITS
Plymouth City Council Adoption Service was re-structured on 1 ST September 2004. At the time of the inspection the agency was in the process of relocating to new premises. The team consists of a recently appointed manager, a team leader, three full-time social workers, five part-time social workers and three clerical staff, one being a manager. The aim of the service is to provide a full and comprehensive range of adoption services. City of Plymouth Adoption Service Page 6
p.7
INSPECTOR’S SUMMARY
(This is an overview of the inspector’s findings, which includes good practice, quality issues, areas to be addressed or developed and any other concerns.) The inspectors inspected the agency over four days in September 2004. The service was reorganised some two weeks earlier. It was evident throughout the inspection that management had a clear view of how they envisaged the agency maturing. Many policies and procedures were in draft format. The agency was in a state of change. Unfortunately the inspection centred around what the current practices were and not what is proposed. During feedback it was agreed that the inspector’s would return to the agency in approximately eighteen months.
p.8
INSPECTOR’S SUMMARY
The inspectors received questionnaires back from;- Four birth parents Three adoption advisors Seven placing social workers Twenty adopters/prospective adopters
p.8
INSPECTOR’S SUMMARY
Overall the questionnaires indicated the agency is acceptable however, birth parents felt uniformed and not supported. Adopter’s raised issues around length of time and lack of support after panel. Many felt the preparation and information was very good. The majority felt they needed more information regarding complaints. Placing social workers stated they had not seen the Statement of purpose or the Children’s Guide.
p.8
Not met
At the time of the inspection, a ‘draft’ statement of purpose was seen. It was approved by Plymouth Social Services Committee but not by the executive side of the council. The statement of purpose gave a good overview of the future of the adoption service mainly identifying what needs to be done. Not all issues in Schedule 1 of the Local Authority Adoption Service (England) Regulation 2003 were addressed. The Agency does have a booklet for children and young people explaining the adoption process. It’s colourful and addresses the process well. This booklet does not reflect Plymouth Adoption Service’s statement of purpose, how to make a complaint or how to contact an independent advocate. City of Plymouth Adoption Service Page 7
p.8
Met
The inspectors found evidence that the adoption process is essentially child-centred. Evidence viewed indicated that a high proportion of matches that reflect the child’s ethnicity, culture, language and religion were made, 97%. 100% of sibling groups needing to be placed together were made.
p.9
3 part met, 1 not met
Positive feedback was given about the first response from the agency and the informative information sent out. The inspectors viewed the information and found it in need of up dating to reflect the recent changes in the agency. Adopters raised, as a constantly theme, the length of time before the initial assessments started and the lack of communication throughout this time. The inspectors found the assessment and preparation process not consistent rigorous. Overall the forms F viewed had very little emphasis on competencies. At the time of the inspection, preparation groups were being reviewed. There was no evidence to suggest that the effectiveness of the preparation groups is evaluated. It is recommended that such a system in introduced. In the questionnaires adopters gave mixed views on whether they felt adequate information was given to then regarding the matching of children. Some felt social workers were very
p.9
3 part met, 1 not met
good at informing them of the procedures and helping them to understand forms E, others felt very much alone after being approved.
p.9
Not met
Four birth parents contributed to the evidence gathering during this inspection. All stated they were not kept informed throughout the process. Three of the replies stated that they were unhappy with the service they received, “I was not offered any counselling, if I was then things would have turned out better for me”. “ After my children were taken I was left to it. I felt betrayed by everyone who was involved. Counselling would have helped but none offered.” The inspector sampled ten forms E that had gone to panel in the last four months. Two indicated that the birth parents had refused to sign the form; eight were left blank with no indication if the birth parents had seen it. The adoption service provides a post- adoption post-box system for birth families to maintain contact with children placed for adoption. Social workers spoken to were unclear regarding face-to-face contact. The system in place to facilitate this service needs to be clear to all
p.9
Not met
social workers. The manager informed the inspector that a contract has been secured with Plymouth Family support Services to offer birth parents on going support throughout and after the adoption process.
p.9
2 met, 2 part met
At the time of the inspection, a draft copy of adoption panel’s policies and procedures was in place. The manager was aware that more work was needed on this document to bring it in line with standard 10 of the Adoption Minimum Standards. The inspector observed a quorate panel that brought diverse experience and qualities. Evidence was viewed of thoughtful consideration in the cases presented, issues identified in forms F & E were commented on tactfully and compliments given to good pieces of work. City of Plymouth Adoption Service Page 8
p.9
1 met, 1 part met
The inspectors spoke with the adoption manager and found her to have a sound knowledge of adoption law and practices. This adoption service has recently been reorganised. The department were in the process of setting up budget and monitoring systems. The adoption manager is aware of her responsibility regarding financial issues.
p.10
2 met 1 part met
The service is in its infancy. The manager and Assistant Director explained the vision they have for the future of the agency. Both were aware of the changes that need to take place and at the time of the inspection were laying down core tasks. The development progress is reported on a monthly basis to the Social Services Improvements Board. Several adopters felt that communication between the adoption workers and the childcare workers was poor. One questionnaire stated-; “lack of communication between individuals in social services caused much unnecessary anxiety”. “Lack of communication and organisation by individuals let us and the process down and continue to do so”. The adoption service monitors its performance in several different ways including supervision of staff, six monthly reports to the management team and the ‘Portfolio Holder’ is updated monthly on the number of adoptions. The Portfolio Holder is also updated six
p.10
2 met 1 part met
monthly on all other aspects of adoption.
p.10
2 met, 1 part met and 2 not met
The personnel files viewed did not clearly state that Criminal Record Bureau (CRB) checks at enhanced level had been carried out. The manager informed the inspectors that all social work staff hold a professional qualification in social work and are experienced social workers. During interviews with the social workers Inspectors found the group to have a good understanding of the legal implications of adoption for children. The recent re-structuring has impacted on the management and organisation of the staff group. Performance management has recently been introduced which staff feel creates more changes to adjust to. Adoption social workers informed the inspectors that they do receive regular supervision and appraisals from their line manager, however no evidence was viewed of case supervision within adopter’s files. Staff informed inspectors that Plymouth Local Authority is a fair and competent employer.
p.10
2 met, 1 part met and 2 not met
The adoption team became operational on 1 st September 2004. Prior to his date the team held large fostering caseloads. This situation has impacted on adoption training in the past. Time restraints and workloads have made training a low priority. The social workers also felt the geographical area has made accessing relevant training difficult.
p.10
1 part met, 3 not met
The children’s files viewed by the inspector’s were in some area’s quite chaotic. The manager acknowledges that the department as a whole has had concerns regarding the childcare files. Adopter’s files were of variable standards. No file monitoring was evident however the manager states a new file audit mechanism was being introduced. Decisions by supervisors were not evident on adopter’s records. A policy on case recording needs to be put in place. City of Plymouth Adoption Service Page 9 Inspectors viewed a very good file system for all panel members. Sections regarding the appointment, induction including observation, training, attendance, checks and appraisals were evident. Unfortunately not all files contained the relevant CRB checks. Adoption staff files had a very good ‘recruitment process administrative checklist’. This indicated at a glance any missing documentation. The application form requested information on any gaps
p.10
Part met
At the time of the inspection the adoption agency was in the process of moving premises. The new premises were light, airy and suitably situated. The manager informed the inspectors that new IT equipment would be installed within the week, and all adoption staff would have laptops or work stations. The Assistant Director confirmed this. Staff informed the inspectors that there are heavy-duty lockable facilities at their old premises that will be moving to the new premises. City of Plymouth Adoption Service Page 10 Reports and Notifications to the Local Authority and Secretary of State
p.11
Part met
The following statutory Reports or Notifications are to be made under the Care Standards Act as a result of the findings of this inspection:
p.12
Part met
NA Report to the Secretary of State under section 47(3) of the Care Standards Act 2000 that the Commission considers the Local Authority's adoption service satisfies the regulatory requirements:
p.12
Part met
NA Notice to the Local Authority under section 47(5) of the Care Standards Act 2000 of failure(s) to satisfy regulatory requirements in their adoption service which are not substantial, and specifying the action the Commission considers the Authority should take to remedy the failure(s), informing the Secretary of State of that Notice:
p.12
Part met
NA Report to the Secretary of State under section 47(4)(a) of the Care Standards Act 2000 of a failure by a Local Authority adoption service to satisfy regulatory requirements which is not considered substantial:
p.12
Part met
NA Report to the Secretary of State under section 47(1) of the Care Standards Act 2000 of substantial failure to satisfy regulatory requirements by a Local Authority adoption service:
p.12
The grounds for the above Report or Notice are:
City of Plymouth Adoption Service Page 11
p.13
(Not relevant at first CSCI inspection)
Requirements from last Inspection visit fully actioned? NA
p.13
STATUTORY REQUIREMENTS
Identified below are areas not addressed from the last inspection report which indicate a non-compliance with the Care Standards Act 2000, the Adoption Agencies Regulations 1983 and the Local Authority Adoption Service (England) Regulations 2003. No. Regulation Standard Required actions Timescale for action
p.13
Action is being taken by the Commission for Social Care Inspection to monitor
compliance with the above requirements. City of Plymouth Adoption Service Page 12
p.13
STATUTORY REQUIREMENTS IDENTIFIED DURING THIS INSPECTION
Action Plan: The appropriate officer of the Local Authority is requested to provide the Commission with an action plan, which indicates how requirements are to be addressed. This action plan is shown in Part D of this report.
p.14
STATUTORY REQUIREMENTS
Identified below are areas addressed in the main body of the report which indicate non- compliance with the Care Standards Act 2000, the Adoption Act 1976, the Adoption Agencies Regulations 1983, the Local Authority Adoption Service (England) Regulations 2003 or the National Minimum Standards for Local Authority Adoption Services. The Authority is required to comply within the given time scales in order to comply with the Regulatory Requirements for adoption services. No. Regulation Standard * Requirement Timescale for action
p.14
STATUTORY REQUIREMENTS
1 2 LA1 The Statement of Purpose must to be reviewed to include what the agency does and all aspects of schedule 1 1 st April
p.14
STATUTORY REQUIREMENTS
2 3 LA1 The children’s guide must to reflect Plymouth City adoption services Statement of Purpose, how to make a complaint and how to contact an advocate. 1 st April
p.14
STATUTORY REQUIREMENTS
3 2 LA1 The Statement of Purpose must to be available to person’s working for the purpose of the adoption service. 1 st April
p.14
STATUTORY REQUIREMENTS
AAR 1983 Reg 8 LA4 The agency must operate a consistent approach to assessments and preparation of prospective adopters. 1 st April
p.14
STATUTORY REQUIREMENTS
5 2 LA6 The agency must support adopters in line with the Statement of Purpose 1 st April
p.14
STATUTORY REQUIREMENTS
AAR 1983 Reg 7 LA7 Birth parents must to be involved where possible and consulted, kept informed and supported. 1 st April
p.14
STATUTORY REQUIREMENTS
7 6 & 11 LA28LA19 LA15 Full and satisfactory information must to be in place in accordance with schedule 3 1 st April
p.14
STATUTORY REQUIREMENTS
8 12 LA23 Staff training must be addressed as a priority 1 st April City of Plymouth Adoption Service Page 13 AAR 1983 Reg 7 LA27LA25 Children’s adoption files must to contain information as directed in schedule 1, parts 1- 4 AAR 1983 1 st April
p.14
STATUTORY REQUIREMENTS
Reg 8 LA27LA25 The adopters files must to contain information as directed in schedule 1 parts 6 & 7 This information needs to be monitored 1 st April
p.15
STATUTORY REQUIREMENTS
AAR 1983 Reg 14 LA27LA25 Policies and procedures must to be set up in line with Regulation 14 Adoption Agencies Regulation 1983 1 st April
p.15
STATUTORY REQUIREMENTS
AAR 1983 Reg 15 LA26 The service must to have in place written guidance on, access to records and disclosure of information.
p.15
GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION
Identified below are areas addressed in the main body of the report which relate to the National Minimum Standards and are seen as good practice issues which should be considered for implementation by the Authority or Registered Person(s). No. Refer to Standard * Recommendation Action
p.15
GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION
1 LA3 The agency should, without delay update information sent to prospective adopters.
p.15
GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION
2 LA5 All adopters should be given full information regarding young people and the matching process.
p.15
GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION
3 LA8 A system should be put in place to enable face–to-face contact between children and their birth relatives to continue
p.15
GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION
4 LA10 The adoption panels’ policy and procedure needs to reflect issues in standard 10 of the Adoption Minimum Standards.
p.15
GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION
5 LA12 The panel minutes should be accurate and informative, and reflect the discussion, reasons and conclusion reached.
p.15
GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION
6 LA13 The decision made by the decision maker should be given without delay.
p.15
GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION
7 LA17 The policies and procedures for adoption allowances should be reviewed.
p.15
GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION
8 LA18 A written protocol governing the legal and the medical advisor should be in place.
p.15
GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION
9 LA22 All adoption staff should be aware of the Whistle blowing policy of the agency and any counselling available. City of Plymouth Adoption Service Page 14 10 LA29 The agency should minimise loss of files by ensuring suitable lockable facilities and by having a disaster, recovery plan
p.15
GOOD PRACTICE RECOMMENDATIONS FROM THIS INSPECTION
• Note: You may refer to the relevant standard in the remainder of the report by omitting the 2-letter prefix e.g. LA10 refers to Standard 10. City of Plymouth Adoption Service Page 15
p.16
PART B INSPECTION METHODS & FINDINGS
The following inspection methods have been used in the production of this report
p.17
PART B INSPECTION METHODS & FINDINGS
Placing authority survey NO Placing social worker survey YES Prospective adopter survey YES Approved adopter survey YES Birth parent / birth family member survey YES Checks with other organisations and Individuals • Directors of Social services YES • Specialist advisor (s) YES Tracking Individual welfare arrangements YES • Interview with children NO • Interview with adopters and prospective adopters YES • Interview with birth parents NO • Interview with birth family members NO • Contact with supervising social workers YES • Examination of files YES Individual interview with manager YES Information from provider YES Individual interviews with key staff YES Group discussion with staff YES Interview with panel chair YES Observation of adoption panel YES Inspection of policy/practice documents YES Inspection of records (personnel, adopter, child, complaints, allegations) YES
p.17
PART B INSPECTION METHODS & FINDINGS
Date of Inspection 15/09/04 Time of Inspection 9.00 Duration Of Inspection (hrs) 70 Number of Inspector days 7 Additional Inspection Questions: Certificate of Registration was displayed at time of inspection NA The certificate of registration accurately reflected the situation in the service at the time of inspection NA
p.17
PART B INSPECTION METHODS & FINDINGS
Total Number of staff employed (excluding managers) 14 City of Plymouth Adoption Service Page 16 The following pages summarise the key findings and evidence from this inspection, together with the CSCI assessment of the extent to which the National Minimum Standards have been met. The following scale is used to indicate the extent to which standards have been met or not met by placing the assessed level alongside the phrase "Standard met?"
p.17
PART B INSPECTION METHODS & FINDINGS
The scale ranges from: 4 - Standard Exceeded (Commendable) 3 - Standard Met (No Shortfalls) 2 - Standard Almost Met (Minor Shortfalls) 1 - Standard Not Met (Major Shortfalls)
p.18
PART B INSPECTION METHODS & FINDINGS
"0" in the "Standard met?" box denotes standard not assessed on this occasion. "9" in the "Standard met?" box denotes standard not applicable on this occasion. “X” is used where a percentage value or numerical value is not applicable. City of Plymouth Adoption Service Page 17
p.18
The intended outcome for the following standard is:
• There is clear written statement of the aims and objectives of the adoption
p.19
There is a clear written statement of the aims and objectives of the adoption agency
which describes accurately what facilities and services they provide. Key Findings and Evidence Standard met? 1 At the time of the inspection, a ‘draft’ statement of purpose was seen. It was approved by Plymouth Social Services Committee but not by the executive side of the council. The statement of purpose gave a good overview of the future of the adoption service mainly identifying what needs to be done. Not all issues in Schedule 1 of the Local Authority Adoption Service (England) Regulation 2003 were addressed. The Agency does have a booklet for children and young people explaining the adoption process. It’s colourful and addresses the process well. This booklet does not reflect Plymouth Adoption Service’s statement of purpose, how to make a complaint or how to contact an independent advocate. The statement of purpose and the children’s booklet is only available in written form at present but the Manager said that every effort would be made to translate this in other
p.19
There is a clear written statement of the aims and objectives of the adoption agency
formats as required and felt confident this could be done quickly using local resources. Staff informed the inspector’s they were not familiar with the statement of purpose.
p.19
executive side of the council?
Is there a children’s guide to adoption? YES
p.19
information required by Standard 1.4?
NO City of Plymouth Adoption Service Page 18
p.19
The intended outcome for the following set of standards is:
• The needs and wishes, welfare and safety of the child are at the centre of the adoption process.
p.20
effective strategies to recruit sufficient adopters to meet the needs of the range of
children waiting for adoption locally. Key Findings and Evidence Standard met? 3 The inspectors found evidence that the adoption process is essentially child-centred. Observation of the adoption panel and discussion with the panel chair as well as discussion with, and questionnaires from, adoptive parents and placing social workers would support this view. The service had recently produced a development strategy for the new adoption team. Annual targets have been set. The aim is to increase approved adopters therefore expanding placement choice for children. The social workers within the adoption team were aware of the need to match children with families who best reflect the ethnic origin, cultural background, religion and language of the children. Inspectors were informed in cases where the agency does not have a suitable match, the local authority would refer cases to the National Adoption Register (NAR), South
p.20
effective strategies to recruit sufficient adopters to meet the needs of the range of
West Adoption Consortium (SWAC) or other consortiums or agencies. The inspector observed the panel where members requested the views of children regarding adoption and placements via their social workers.
p.20
In the last 12 months:
How many children were identified as needing adoptive families? 36 How many children were matched with adopters? 3 How many children were placed with the service’s own adopters? 31 How many children were placed with other services’ adopters? 13 How many children were referred to the Adoption Register? X
p.20
adopters does this represent?
97 % How many sibling groups were matched in the last 12 months? X
p.20
waiting for a match to be identified?
City of Plymouth Adoption Service Page 19
p.21
The intended outcome for the following set of standards is:
• The adoption agency recruits and supports sufficient adopters from
p.21
diverse backgrounds, who can offer children a stable and permanent home
to achieve a successful and lasting placement.
p.21
about the preparation, assessment and approval procedure and that they will be
treated fairly, openly and with respect throughout the adoption process. Key Findings and Evidence Standard met? 2 Adopters informed the inspectors that they felt Plymouth Adoption Service is not prejudice. Positive feedback was given about the first response from the agency and the informative information sent out. The inspectors viewed the information and found it in need of up dating to reflect the recent changes in the agency. Adopters raised, as a constant theme, the length of time before the initial assessments started and the lack of communication throughout this time. The manager stated that Plymouth do prioritise prospective adopters however, the system needs to be clear. Adopters informed the inspectors that they felt the preparation groups were informative and very good. They felt meeting people who have previously adopted was useful and enlightening. Adopters stated that they do view publications like ‘be my parent’ and ‘adoption Uk ‘ after
p.21
about the preparation, assessment and approval procedure and that they will be
approval to get a greater insight of children who are awaiting adoption placements.
p.21
See recommendation number 1
City of Plymouth Adoption Service Page 20
p.22
Prospective adopters are involved in a formal, thorough and comprehensive
assessment, preparation and approval process. Key Findings and Evidence Standard met? 1 The inspectors found the assessment and preparation process was not consistently rigorous for all prospective adopters. For example, on some files no evidence was viewed of checks taking place on older children’ in the household – over 18yrs, no previous name checks done, not a consistent approach to checking previous partners and health and safety checks were not done in a clear risk assessment approach. Overall the inspectors found that the forms F viewed had very little emphasis on competencies. The agency does have an appropriate policy for foster carers wanting to become adopters. On following up a complaint, inspectors found evidence that a reference had been presented to panel when the referee had withdrawn previously. A thorough investigation into why the referee had withdrawn was not evident. At the time of the inspection, preparation groups were being reviewed. There was no
p.22
Prospective adopters are involved in a formal, thorough and comprehensive
evidence to suggest that the effectiveness of the preparation groups is evaluated. It is recommended that such a system in introduced. Forms F varied in detail of information from the preparation groups. The agency has a corporate Equalities and Diversity policy, which provides the backdrop for the anti-discriminatory framework within which all services of the department are, expected to operate.
p.22
See requirement number 4
City of Plymouth Adoption Service Page 21
p.23
introduction and placement process, as well as any support to facilitate this they may
need. This will include the role of the Adoption Register for England and Wales. Key Findings and Evidence Standard met? 2 In the questionnaires adopters gave mixed views on whether they felt adequate information was given to then regarding the matching of children. Some felt social workers were very good at informing them of the procedures and helping them to understand forms E, others felt very much alone after being approved. The inspectors were informed that ‘snapshot sightings’ had taken place. The Commission for Social Care Inspection does not recommend this practice. Information given by the manager stated that three placements have disrupted in the last twelve months, one being a sibling group. One adopter stated,” the introductions were poor, we felt slightly in the dark and alone”. However others felt the introductions when very well and were child centred. Evidence was viewed of a matching report submitted to panel.
p.23
introduction and placement process, as well as any support to facilitate this they may
It is understood that the service had recently produced an addendum to the BAAF form F which covers the issues referred to under 5.3 of the National Minimum Standards. No evidence was viewed of information given to children about their prospective adopters, however the manager states this is encouraged.
p.23
Adoption Register?
YES City of Plymouth Adoption Service Page 22
p.23
Adoptive parents are helped and supported to provide stable and permanent homes
for the children placed with them. Key findings and evidence Standard met? 2 At the time of the inspection, the agency did not have a clear strategy for supporting adopters. Social worker have supported adopters however inspectors were informed that some adopters have received a very poor service. Many said that they feel they have to be pro-active in contacting the social worker prior to adoption orders being made. The manager informed the inspectors that the agency social workers have not approved any inter-country adoption since 2001. She stated the agency would purchase the service from an inter-country adoption specialist used by the consortium. Learning outcomes from a complaint has led to the service having strict confidentiality monitoring on letter-box contact. A recently introduced form developed requests adopters to sign to agree the safekeeping of information re, birth parents. The disruptions over the last twelve months have had meetings however, the minutes were
p.24
Adoptive parents are helped and supported to provide stable and permanent homes
not available for inspection and were in draft form at the time of the inspection.
p.24
See requirement number 5
Number of adopter applications started in the last 12 months 38
p.24
See requirement number 5
Number of adopters approved in the last 12 months 28
p.24
last 12 months
Number of adopters approved but not matched 23
p.24
last 12 months
Number of adopters referred to the Adoption Register 28
p.24
and adoption, in the last 12 months?
City of Plymouth Adoption Service Page 23
p.25
The intended outcomes for the following set of standards are:
• Birth parents are entitled to services that recognise the lifelong
p.25
implications of adoption. They will be treated fairly, openly and with
respect throughout the adoption process.
p.25
Standard 7 (7.1 – 7.5)
The service to birth parents recognises the lifelong implications of adoption. Key Findings and Evidence Standard met? 1 Four birth parents contributed to the evidence gathering during this inspection. All stated they were not kept informed throughout the process. Three of the replies stated that they were unhappy with the service they received, “I was not offered any counselling, if I was then things would have turned out better for me”. “ After my children were taken I was left to it. I felt betrayed by everyone who was involved. Counselling would have helped but none offered.” The inspector sampled ten form E’s that had gone to panel in the last four months. Two indicated that the birth parents had refused to sign the form; eight were left blank with no indication if the birth parents had seen it.
p.25
Birth parents and birth families are enabled to contribute to the maintenance of their
child’s heritage. Key Findings and Evidence Standard met? 1 The adoption service provides a post- adoption post-box system for birth families to maintain contact with children placed for adoption. Social workers spoken to were unclear regarding face-to-face contact. The system in place to facilitate this service requires social workers to inform the letterbox administrator, who will then in turn send a reminder to the team the month prior to contact taking place. Guidance around this system needs to be in place to enable social workers to follow the procedure. Social workers informed the inspector’s that birth families are encouraged to contribute to information provided in forms E, and in providing information for life- story work. Unfortunately this was not evidence. Some adopter’s informed the inspectors that children do not have up to date life story work. Proposed Adoption Support Plans viewed were of a varying standard regarding support to
p.25
See recommendation number 3
City of Plymouth Adoption Service Page 24
p.26
includes providing information about local and national support groups and services
and helping birth parents to fulfil agreed plans for contact. Key Findings and Evidence Standard met? 1 At the time of the inspection no written strategy had been developed regarding the adoption agency working with birth parents.
p.26
See Requirement Number 6
City of Plymouth Adoption Service Page 25
p.27
The intended outcomes for the following set of standards are:
• Each adoption agency has an adoption panel which is organised efficiently
p.27
children suitable for adoption, the suitability of prospective adopters and
the matching of children and approved adopters.
p.27
children suitable for adoption, the suitability of prospective adopters and
• The adoption agency’s decisions are made to promote and safeguard the welfare of children.
p.27
Adoption panels have clear written policies and procedures about the handling of
their functions and ensure that they are implemented. Key Findings and Evidence Standard met? 2 At the time of the inspection, a draft copy of adoption panel’s policies and procedures was in place. The manager was aware that more work was needed on this document to bring it in line with standard 10 of the Adoption Minimum Standards. Adopter’s spoken to confirm that they were able to attend panel if they wished.
p.27
See recommendation number 4
City of Plymouth Adoption Service Page 26
p.28
from overseas and seeks advice, when necessary, on the laws and eligibility criteria
for the overseas country. Key Findings and Evidence Standard met? 3 The inspector observed a quorate panel that brought diverse experience and qualities. Evidence was viewed of thoughtful consideration in the cases presented, issues identified in forms F & E were commented on tactfully and compliments given to good pieces of work. The panel could address time scales i.e., how long assessments took. This would evidence the monitoring role the panel. The agency has addressed suitable training for panel members; this includes joint training sessions with social workers and other local consortium members. At the time of the inspection the manager informed the inspector that a library for panel members would be set up. The chair informed the inspector that new panel members observe the panel before they take up a role as a member. A ‘buddy’ system is put in place to support new members for six months. Regular appraisals are done to address roles and any training needs.
p.28
from overseas and seeks advice, when necessary, on the laws and eligibility criteria
Is the panel a joint panel with other local authorities? NO
p.28
to avoid delays in the consideration of prospective adopters and matching children
and adopters. Key Findings and Evidence Standard met? 2 The adoption panel meet every two weeks to avoid unnecessary delays. Two administration clerks have time allotted to facilitate this. Panel members receive the papers 10 days prior to the panel date. This was borne out during the inspection. From the observation of the panel it was clear that each panel member carefully considered all papers. Discussion was seen to be extremely child-focused and very sensitive to all involved. Questions were insightful and carefully put. Social workers and adopters informed the inspectors that at ‘panel’ they have experienced delays. This is linked to the time keeping of each case. One social worker indicated that the time given for each case is not realistic. The minutes viewed need to record the whole meeting. For example, the inspector viewed one form F were areas clearly needed exploring. The panel minutes on file did not evidence
p.28
to avoid delays in the consideration of prospective adopters and matching children
that the issues had been raised however; the panel advisor stated the discussion took place before the social worker or adopter entered the meeting but was not recorded. The panel chair informed the inspector that individual members question sheets are sent to the panel decision maker along with the panel minutes.
p.28
See Recommendation Number 5
City of Plymouth Adoption Service Page 27
p.29
recommendation of the adoption panel and promotes and safeguards the welfare of
the child. Key Findings and Evidence Standard met? 3 The agency decision is taken by the Assistant Director Child Care Services. It is usually made within three to four days. The agency decision maker receives paperwork (reports and agenda) and draft minutes prior to meeting with the adoption advisor. During the inspection the agency decision maker stated that discussions regarding recommendations made at panel would be discussed with the panel chair and not the adoption advisor in future. At the time of the inspection the panel chair did not ratify the panel minutes however the adoption manager and the decision maker stated that in future that would take place prior to any decision being made. Social workers inform relevant parties of the recommendation made at the panel followed by the decision made by the Assistant Director. Not all adopter’s spoken to received written confirmation of the decision within seven days.
p.29
See recommendation number 6
City of Plymouth Adoption Service Page 28
p.30
The intended outcomes for the following set of standards are:
• The adoption agency is provided and managed by those with the appropriate
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The people involved in carrying on and managing the adoption agency:
• possess the necessary knowledge and experience of child care and
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adoption law and practice and
• have management skills and financial expertise to manage the work
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efficiently and effectively and
• ensure that it is run on a sound financial basis and in a professional manner. Key Findings and Evidence Standard met? 3 The inspectors spoke with the adoption manager and found her to have a sound knowledge of adoption law and practices. This adoption service has recently been reorganised. The department were in the process of setting up budget and monitoring systems. The adoption manager is aware of her responsibility regarding financial issues. The manager is committed by Plymouth Social Services to undertake management training. The inspectors viewed the manager’s job description and found it suitable. The manager informed the inspectors the recent introduction of the ‘performance management system’ is assisting in adjusting staffing levels to address the projected tasks of the adoption service. At the time of the inspection the manager had been in post for a very short period of time. Staff dynamic’s appeared to be unsettled.
p.30
of working in a childcare setting in last 5 years?
YES City of Plymouth Adoption Service Page 29
p.30
voluntary organisation or business concerned with safeguarding and promoting the
welfare of children. Key Findings and Evidence Standard met? 2 The manager had been recently appointed to the post of adoption manager however has worked for Plymouth authority for 27 years. The inspector viewed only one reference on file and no evidence of telephone references. No enhanced CRB check was evidenced however the inspectors were in formed that this check had been sent for.
p.31
See requirement number 7
City of Plymouth Adoption Service Page 30
p.32
The intended outcomes for the following set of standards are:
• The adoption agency is organised and managed efficiently, delivering a good quality service and avoiding confusion and conflicts of role.
p.32
Standard 16 (16.1 – 16.7)
The adoption agency is managed effectively and efficiently. Key Findings and Evidence Standard met? 3 The service is in its infancy. The manager and Assistant Director explained the vision they have for the future of the agency. Both were aware of the changes that need to take place and at the time of the inspection were laying down core tasks. The development progress is reported on a monthly basis to the Social Services Improvements Board. The Statement of Purpose needs to be reviewed to enable the agency to ensure it is run in accordance with it. At present the Statement of Purpose indicates what needs to be done and not what the agency does. Several adopters felt that communication between the adoption workers and the childcare workers was poor. One questionnaire stated-; “lack of communication between individuals in social services caused much unnecessary anxiety”. “Lack of communication and organisation by individuals let us and the process down and continue to do so”.
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Standard 16 (16.1 – 16.7)
Social workers informed the inspector that communication between the adoption service social workers and childcare workers is a stumbling block, however relationships do appear to be improving. Staff informed the inspectors that the manager of the adoption service is very approachable and supportive. Within the adoption team, staff appear to be uneasy with the changes that are being put in place, however they do appear supportive of one another.
p.32
Number of the above complaints which were substantiated
City of Plymouth Adoption Service Page 31
p.33
There are clear written procedures for monitoring and controlling the activities of the
adoption agency and ensuring quality performance. Key Findings and Evidence Standard met? 3 The adoption service monitors its performance in several different ways including supervision of staff, six monthly reports to the management team and the ‘Portfolio Holder’ is updated monthly on the number of adoptions. The Portfolio Holder is also updated six monthly on all other aspects of adoption. The agency has recently set up an adoption development group with a role to address quality assurance of the adoption service, i.e.-: the monitoring of children and the quality of adoption placements. At the panel meeting the inspector attended, evidence was viewed of a checklist for adoption papers for panel. It ensured team managers monitor all paperwork presented. Progress against the Improvement Plan, and development of a distinct agency, is reported on a monthly basis to the Social services improvement board (SSIB).
p.33
There are clear written procedures for monitoring and controlling the activities of the
The agency is aware the policy and procedures for adoption allowances needs to be reviewed. At present BAAF form H1 & 2 are used.
p.33
The adoption agency has access to specialist advisers and services appropriate to its
needs. Key Findings and Evidence Standard met? 2 The adoption panel has access to a legal and medical adviser; an educational representative is on the panel. Both the medical and the legal advisers require written protocols governing their engagement. Adoption social workers stated that they could approach the medical advisor if required. The manager stated that the legal advisor prior to the panel would notify her if there were any concerns. Plymouth has access to specialisms including inter country adoptions within the local consortium.
p.33
See recommendation number 8
City of Plymouth Adoption Service Page 32
p.34
The intended outcome for the following set of standards is:
• The people who work in the adoption agency are suitable to work with children
p.34
Anyone working in or for the adoption agency are suitable to work with children and
young people and to safeguard and promote their welfare. Key Findings and Evidence Standard met? 1 Plymouth Council’s Personnel Policies and Procedures Manual was viewed it indicated that only one reference would be required if an internal post is applied. Telephone references are not a requirement in this policy. The personnel files viewed did not clearly state that Criminal Record Bureau (CRB) checks at enhanced level had been carried out. The manager informed the inspectors that all social work staff hold a professional qualification in social work and are experienced social workers. During interviews with the social workers Inspectors found the group to have a good understanding of the legal implications of adoption for children. Children’s needs, behaviours rights and equality were discussed and the group once again gave a clear understanding of these issues. The group expressed a good in-depth knowledge of all aspects of adoption, however they did feel with new legislation being
p.34
Anyone working in or for the adoption agency are suitable to work with children and
implemented, further training is needed. No social workers have obtained a PQ award.
p.34
equivalent?
What % of the adoption service’s social workers have a PQ award? 0 % City of Plymouth Adoption Service Page 33
p.34
Staff are organised and managed in a way which delivers an efficient and effective
service. Key Findings and Evidence Standard met? 3 The recent re-structuring has impacted on the management and organisation of the staff group. Performance management has recently been introduced which staff feel creates more changes to adjust to. Adoption social workers informed the inspectors that they do receive regular supervision and appraisals from their line manager, however no evidence was viewed of case supervision within adopter’s files. The manager informed the inspectors that quality assurance checks are being introduced in files and paperwork to panel. The inspector observed a checklist on adoption papers presented to panel. One file viewed did indicate it had been audited. The manager informed the inspectors that the monitoring of administration tasks would be undertaken to ensure that as the adoption team becomes established, administration support will be adequate. Adoption social workers informed the inspectors that they were aware of HR policies and
p.35
Staff are organised and managed in a way which delivers an efficient and effective
procedures and the need to register with GSCC.
p.35
the needs of the adoption agency and they are appropriately supported and assisted
in providing a service. Key Findings and Evidence Standard met? 3 The adoption team has recently been formed. The existing needs for the service were incorporated into the design of the new team. The manager informed the inspectors that as the team becomes fully operational, staffing levels would be reviewed on a regular basis. The social work staff are experienced and were previously part of the placement team addressing fostering and adoption.
p.35
Number of social work posts vacant
In the adoption service. City of Plymouth Adoption Service Page 34
p.35
The adoption agency is a fair and competent employer, with sound employment
practices and good support for its staff. Key Findings and Evidence Standard met? 2 Staff informed inspectors that Plymouth Local Authority is a fair and competent employer. They gave examples of the support they were given like term time working, flexible working and close by parking with permits. Staff were not sure about any external counselling available but all felt support was positive within the team One staff member felt the department had a Whisleblowing policy, however the others were not sure.
p.36
There is a good quality training programme to enhance individual skills and to keep
staff up-to-date with professional and legal developments. Key Findings and Evidence Standard met? 1 The adoption team became operational on 1 st September 2004. Prior to his date the team held large fostering caseloads. This situation has impacted on adoption training in the past. Time restraints and workloads have made training a low priority. The social workers also felt the geographical area has made accessing relevant training difficult. The Agency has held annual joint adoption training with the adoption panel members and social workers since 1998. The manager is developing an annual training programme and states an audit of training needs of individual members of staff will be done. This was not in place at the time of the inspection. The agency subscribes to Adoption & Fostering Journal, Adoption UK Post Adoption Service and NORCAP to keep abreast of current changes. The manager states the legal advisor sends relevant case law pertaining to adoption on a
p.36
See requirement number 8
City of Plymouth Adoption Service Page 35
p.37
The intended outcome for the following set of standards is:
• All appropriate records are maintained securely, kept and are accessible when required.
p.37
maintained for each child, prospective and approved adopter with whom the agency
has worked. Key Findings and Evidence Standard met? 1 The children’s files viewed by the inspector’s were in some area’s quite chaotic. The manager acknowledges that the department as a whole has had concerns regarding the childcare files. Adopter’s files were of variable standards. No file monitoring was evident however the manager states a new file audit mechanism was being introduced. Decisions by supervisors were not evident on adopter’s records. The new adoption agency manager has designed a file format for both the children’s and adopter’s files. The adoption manager will sign off new files before storing. If files do not meet the standards they will be returned to the responsible team leader. The present policies and procedures do not address adequately the robust system of recording that is needed to safeguard adoption records. At the time of the inspection, IT project managers were working on updating present systems
p.37
maintained for each child, prospective and approved adopter with whom the agency
to suitably incorporate adoption recording.
p.37
way, to other adoption agencies and local authorities with whom it is working to effect
the placement of a child. Key Findings and Evidence Standard met? 2 Evidence was viewed of a general social services ‘access to records’ policy. The manager informed the inspectors’ that the Agency are looking to write a specific policy for the adoption service, taking into account Data Protection and the Human rights Act. The inspectors viewed matching meeting minutes, which indicated that other authorities received relevant information. Adoption Social Worker’s stated where possible they do give other authorities appropriate information. The manager stated this good practice is encouraged.
p.37
See requirement number 12
City of Plymouth Adoption Service Page 36
p.38
confidentiality and contents of files, including secure storage and access to case files
in line with regulations. Key Findings and Evidence Standard met? 1 A policy on case recording needs to be put in place. Evidence was viewed of staffs’ individual personnel files. At the time of the inspection no recording system was in place for complaints and allegations, however the manager does have some records kept electronically. The adopters files viewed were of a varying standard and would clearly benefit from a consistent approach to monitoring and recording. Very few entries were signed and dated, no evidence was viewed of monitoring or supervision, tip-ex had been used and not all entries were legible.
p.38
Up-to-date, comprehensive personnel files are maintained for each member of staff
and member of the adoption panel. Key Findings and Evidence Standard met? 1 Inspectors viewed a very good file system for all panel members. Sections regarding the appointment, induction including observation, training, attendance, checks and appraisals were evident. Unfortunately not all files contained the relevant checks. CRB checks consisted of a memo from the personnel section stating a CRB had been received. Evidence of enhanced CRB check including the number should be present. Confidentiality/disclosure of information was signed on all files viewed. Adoption staff files had a very good ‘recruitment process administrative checklist’. This indicated at a glance any missing documentation. The application form requested information on any gaps in employment history with reasons why. No information on staff qualifications was evident on personnel files however, were present on supervision files. The inspector did view one file that did not have an up to date CRB check, one with missing
p.38
Up-to-date, comprehensive personnel files are maintained for each member of staff
references and identification needs to be in place on all files.
p.38
See requirement number 7
City of Plymouth Adoption Service Page 37
p.39
The intended outcome for the following standard is:
• The premises used by the adoption agency are suitable for the purpose.
p.39
Standard 29 (29.1 – 29.5)
Premises used by the adoption agency are appropriate for the purpose. Key Findings and Evidence Standard met? 2 At the time of the inspection the adoption agency was in the process of moving premises. The new premises were light, airy and suitably situated. The manager informed the inspectors that new IT equipment would be installed within the week, and all adoption staff would have laptops or work stations. The Assistant Director confirmed this. Staff informed the inspectors that there are heavy-duty lockable facilities at their old premises that will be moving to the new premises. The agency uses the ‘care first’ TI package and is currently addressing the security aspects to ensure it meets adoption requirements. The system is password protected. The agency is very pro-active when considering the requirements of archived files, risk assessments are in place and shortfalls have been identified. A Disaster Recovery Plan
p.39
Standard 29 (29.1 – 29.5)
needs to be put in place and shortfalls eliminated All archived files are kept at a separate building.
p.39
See recommendation number 10
City of Plymouth Adoption Service Page 38
p.40
Date
City of Plymouth Adoption Service Page 39
p.41
D.1 Local authority manager’s comments/confirmation relating to the content and
accuracy of the report for the above inspection. We would welcome comments on the content of this report relating to the Inspection conducted on 15 th September 2004 of inspection of City of Plymouth Council adoption services and any factual inaccuracies:
p.41
D.1 Local authority manager’s comments/confirmation relating to the content and
Please limit your comments to one side of A4 if possible City of Plymouth Adoption Service Page 40
p.41
Action taken by the CSCI in response to the provider’s comments:
Amendments to the report were necessary YES
p.42
Action taken by the CSCI in response to the provider’s comments:
Comments were received from the provider YES
p.42
Action taken by the CSCI in response to the provider’s comments:
Provider comments/factual amendments were incorporated into the final inspection report YES
p.42
Action taken by the CSCI in response to the provider’s comments:
Provider comments are available on file at the Area Office but have not been incorporated into the final inspection report. The inspector believes the report to be factually accurate
p.42
Note:
In instances where there is a major difference of view between the Inspector and the local authority adoption manager, both views will be made available on request to the Area Office.
p.42
to be addressed and stating a clear timescale for completion. This will be
kept on file and made available on request.
p.42
report:
Action plan was received at the point of publication YES
p.42
report:
Action plan covers all the statutory requirements in a timely fashion YES
p.42
report:
Action plan did not cover all the statutory requirements and required further discussion NO
p.42
report:
Provider has declined to provide an action plan NO
p.42
Public reports
It should be noted that all CSCI inspection reports are public documents. City of Plymouth Adoption Service Page 41
p.42
relating to the inspection conducted on the above date(s) and that I agree with
the statutory requirements made and will seek to comply with these.
p.43
Date
Note: In instance where there is a profound difference of view between the Inspector and the Registered Provider both views will be reported. Please attach any extra pages, as applicable.
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City of Plymouth Adoption Service / 15th September 2004
Commission for Social Care Inspection 33 Greycoat Street London SW1P 2QF
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City of Plymouth Adoption Service / 15th September 2004
Telephone: 020 7979 2000 Fax: 020 7979 2111
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City of Plymouth Adoption Service / 15th September 2004
National Enquiry Line: 0845 015 0120 www.csci.org.uk
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City of Plymouth Adoption Service / 15th September 2004
S0000056793.V179812.R01 © This report may only be used in its entirety. Extracts may not be used or reproduced without the express permission of the Commission for Social Care Inspection
p.44
City of Plymouth Adoption Service / 15th September 2004
The paper used in this document is supplied from a sustainable source
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