Barnardos North West Fostering Service (NW Region)

Barnardos North West Fostering Service (NW Region) Inspection report for independent fostering agency

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SC040580 Unique reference number 12 July 2007 Inspection date Jeffrey Banham Inspector Key Type of Inspection

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5 Lineside Close Address LIVERPOOL L25 2UD 0151 4880822 Telephone number

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Email

Family Connections Registered person John Hardy**103303** Registered manager Susan Withington**175222** Responsible individual 10 July 2006 Date of last inspection .

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Email

This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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Email

You can obtain copies of The Children Act 2004, Every Child Matters and The National Minimum Standards for Children's Services from: The Stationery Office (TSO) PO Box 29, St Cripins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000. This report details the main strengths and any areas for improvement identified during the inspection. The judgements included in the report are made in relation to the outcome for children set out in the Children Act 2004 and relevant National Minimum Standards for the establishment.

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The inspection judgements and what they mean

this aspect of the provision is of exceptionally high quality Outstanding: this aspect of the provision is strong Good: this aspect of the provision is sound Satisfactory: this aspect of the provision is not good enough Inadequate: 3 of 10 Inspection Report: Barnardos North West Fostering Service (NW Region), 12 July 2007

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Brief description of the service

Barnardo's North West Fostering Service is a independent registered fostering provider based in Liverpool. It is part of the Barnardo's organisation that has a range of services for children and families in the north west of England. The service operates from its main offices in Lineside Close, Liverpool. The fostering service provides a range of foster placements for children with disabilities. It specialises in the placement of children with severe learning disabilities. Foster carers offer long term placements that often see children through to adulthood. The service also has short term and contract care placements that provide respite placements for children placed both with long term carers and to children living with their families. Barnardo's North West has 32 long term carers with 31 children in placement. It also has three contract carers and 21 short break carers.

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Summary

The inspection took place over four days on site and one observing the fostering panel. The service manager and deputy service manager were interviewed. Two of the social work staff were interviewed and three foster carers, each with a long term placement of one young person, were seen in their own homes. Carers' and children's files were examined. Survey questionnaires were received from four placing social workers and fourteen foster carers. A meeting of the fostering panel was observed and written information was received from the service manager of the fostering service. The overall quality rating is good. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

The provider has responded to the good practice recommendations previously made. Specifically it has improved its systems to obtain all the information on children referred by local authorities to enable them to be matched with carers and have their needs identified and met. Information relating to children is stored securely in carers' homes. Social workers have had guidance on undertaking health and safety assessments of carers' homes. The role and responsibilities of the supervising social worker have been reviewed to ensure they offer both support to and monitoring of the practice of foster carers. The British Association for Adoption and Fostering Health (BAAF) Assessment form is used for all young people for whom the service has a responsibility for undertaking their annual medical. Recording of the educational achievements of young people is now clearer. These improvements enable children's development to be more

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Improvements since the last inspection

effectively monitored. National Vocational Qualification (NVQ) training for foster carers has been developed to ensure carers have the skills to care appropriately for children. Expert advice about the responsibilities of local authorities in supporting children into adult has been obtained and disseminated to foster carers through training and information programmes. The service continues to develop its expertise in promoting the interests of children during the transition process.

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Helping children to be healthy

The provision is good. The fostering service has a range of polices and practices to ensure the health of children in placement is given a high priority. The high levels of vulnerability and the complex needs of 4 of 10 Inspection Report: Barnardos North West Fostering Service (NW Region), 12 July 2007 all the children in placement require carers and social workers to work closely together to ensure health care needs are identified and met. Health care plans are drawn up with the foster carer, parents where they are involved, and the placing authority. Specialist provision is available from a range of health care professionals and foster carers are provided with training and support so that they can give the invasive treatments that are often required. The length of time that some children are with carers, sometimes many years, means that knowledge about them and their needs is comprehensive. Carers are aware of their responsibilities and act on

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Helping children to be healthy

their own initiative if they feel the need arises. Health issues are monitored through both the regular "Looking After Children" (LAC) processes that are the responsibility of the placing authority and the supervision provided for carers by the social workers in the fostering service. The service ensures that foster carers have the necessary consents for medical treatment, for both routine and emergency care. Some consents are not as clear or as accessible as they could be by virtue of the length of time they have been on file. Some situations are potentially complicated by the legal status of the child in placement and the issue of who holds parental responsibility. Children have often complex range of medication that has to be administered by carers every day. The service has introduced a chart for recording the administration of medication, but other issues such as storage of medicines, labelling and monitoring the accuracy

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Helping children to be healthy

of recording are not always clear and fully understood. It is not always clear if social workers are correctly monitoring the range of medication practices required of carers for children who are in their care.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. Barnardo's North West has a range of systems in place to ensure that children and carers are safe. Staff are recruited in accordance with Barnardo's nationally-applied recruiting procedures. The manager. deputy manager and staff are all qualified and experienced in family placement work. Rigorous health and safety assessments are carried out on carers' homes at the time of initial assessment and subsequently through regular review. The assessments and subsequent "safe caring" policies are specific to each child with his or her own carer. The foster placement agreements describe the responsibilities of each carer and the needs of the child placed. This process also ensures that matches of children with their carer take into account the needs of the children and the capacities of the carer to meet those needs. Carers provide devoted and dedicated care over long periods of time to children with a range of complex needs. This care

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Protecting children from harm or neglect and helping them stay safe

enables children to develop their potential and feel secure in the placement. Barnardo's North West takes action to ensure carers have the resources to enable them to care for children safely, and acts as a strong advocate for children in placement, even though such actions are not the primary responsibility of the fostering service. Barnardo's has recently reorganised the fostering panel so that it now provides a service to all three of the organisation's fostering services in the north west. There is a new independent chair and new membership. There are a number of issues that the panel has to review as it develops its practices. It does not yet provide a systematic quality assurance function to any of the fostering services. There is, for example no facility to provide formal appraisal of the "Form F" foster carer assessments presented to panel. Although there is a "panel advisor" there is no person to whom the role of "panel gatekeeper"

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Protecting children from harm or neglect and helping them stay safe

(the monitoring of the quality of all items presented to panel) has been ascribed. The "agency decision maker" can sit in on panel meetings, thereby potentially compromising the independence of the panel. There is no full time panel administrator. Representatives from each of the three services take the minutes for the items relevant to them. Panel minutes can be confusing, with "abbreviated notes", "notes of discussions" and "notes of discussion of 5 of 10 Inspection Report: Barnardos North West Fostering Service (NW Region), 12 July 2007 notes". Panel minutes relevant to each case do not record who is present for that discussion, and items presented to the panel remain anonymous. This potentially restricts the quality of information available to panel members. The panel has not yet had the opportunity to discuss issues of how it conducts it business, nor to have any joint training with the social workers in

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Helping children achieve well and enjoy what they do

The provision is outstanding. Children are happy and develop well. Foster carers demonstrate that despite the complex needs of the children in their care, they are given every opportunity to develop their potential. The service actively recruits carers who can meet the diverse range of needs of the children it serves and many children have been in placement for most of their lives. Each child has a clear plan for his or her education, a statement of special educational need, and regular reviews through the LAC process and the statement review process to ensure the needs are met. Carers are aware of their responsibilities and work directly and on their own initiative with schools to ensure education is given a high priority. Children's records and reviews show that many achieve substantial progress in their development whilst in their foster placement. Additional support for both carers and children is available. Transport to and from school is facilitated wherever

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Helping children achieve well and enjoy what they do

it is required. Carers have specialised and modified vehicles. Specialist equipment such as hoists, wheelchairs, beds and baths is available to carers so that children are supported as much as possible to be involved in all aspects of family life and life in the community. The fostering service actively intervenes on carers' behalf to arrange for placing authorities to provide equipment such as ramps and tracking for vehicles so children can be taken out. The activities of carers in supporting the education and achievement of children is monitored through the regular supervision and the foster carer review process.

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Helping children make a positive contribution

The provision is outstanding. Contact issues are established at the time of placement and are subject to regular review. Foster carers are aware that contact between children and birth families is important for the well being of children. Foster carers are given initial training in managing and promoting contact and are paid relevant travel expenses to enable contact to take place. Some children have members of their birth families who visit them in placement, even where they have been in placement with foster carers for a number of years. All of the children in placement have complex communication needs. Foster carers have developed extensive knowledge of the children for whom they care and are able to articulate their understanding of the ways in which the child is communicating. Foster carers work well with other professionals to ensure a child's wishes and feelings are represented. Children are provided with a range of specialist resources and communication aids

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Helping children make a positive contribution

both at home and in school to ensure they are understood as well as possible.

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Achieving economic wellbeing

The provision is outstanding. The most significant issue affecting long term placements is the subject of transition, whereby a child moves into the ambit of adult services as they become adults. Foster carers characterise this time by describing it as "This nightmare process" and "It causes heartache and grief all round." Barnardo's North West operates with a number of local authorities in the region. These local authorities can have different policies as to the age at which children transfer and the 6 of 10 Inspection Report: Barnardos North West Fostering Service (NW Region), 12 July 2007 age at which adult teams become involved. Other particular difficulties arise as local authorities negotiate between themselves as to who has, and will have, continuing responsibility for the child as he or she becomes an adult. Foster carers can wait months for the provision of vital equipment or for assessments. The fostering service has developed extensive knowledge about

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Achieving economic wellbeing

the law and practice issues regarding transition. Foster carers are given training in the topic to ensure they understand what is likely to happen and what their responsibilities will be for the child in placement. Expert legal advice has been obtained so that foster carers and the fostering service are clear about the law and the responsibilities of local authorities. The policies of local authorities can have significant impact on families who often regard the children in placement as "their own" as they may have been with them for fifteen years or more. Throughout this time the fostering service provides carers with support, guidance and advice. The service also acts as a strong advocate for the children in placement, and as a result of the knowledge it holds, and a clear sense of what constitutes child centred practice, engages assertively and professionally with local authorities to ensure they are aware of their responsibilities and how

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Achieving economic wellbeing

their actions impact upon carers and children. The rates, fees and allowances paid to carers are clear and constitute part of the foster placement agreement. Foster carers say they are paid in full and on time, and are financially well supported to enable children to have access to a range of resources, both physical and financial, to promote their welfare and development.

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Organisation

The organisation is good. Foster carers say that the support they receive from Barnardo's is very good. "Provides excellent support together with advice and training" and "Barnardo's provides me with 24/7 support to enable me to care for my child in a more relaxed manner" are typical of the comments received from the fourteen carers who returned questionnaires as part of the inspection. Foster carers receive regular recorded supervision and are subject to annual reviews. Care plans are reviewed through the "Looking After Children" system and Safe Caring plans and risk assessments are regularly updated. A training programme is provided to meet the general needs of foster carers and the more specialised needs of caring for children with complex conditions. The support, advice and guidance that the service provides for children and carers involved in the process of transition to adult services is particularly appreciated by the majority of carers. Foster carers

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Organisation

are provided with training at the time of approval and when approved. A range of courses is offered both as standard topics for all, such as health and safety and safeguarding, and specialist training so that carers can meet the often complex needs of children. Foster carer attendance on training is monitored through the supervision process. The single foster carer training record held on the file is not always kept up to date. The service provides out of hours support that meets the needs of carers. The system is based on foster carers having the telephone numbers of their supervising social worker and the managers, so that someone is always available. Although this system does not constitute an out of hours rota as such, the support carers need is always available. Foster carer files are regularly monitored by the deputy team manager, and supervising social workers receive regular supervision. Social workers say they are well supported

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Organisation

by the service. The foster carer's annual review is carried out by the supervising social worker and the deputy service manager. A small number of foster carers expressed the view that this in-house process had caused some initial difficulty, and supervising social workers recognised the potential for conflict of interests as there was no "independence" to the reviewing process. Each child has a case record. Some children are in placement with their carers for ten or more years, and their records clearly show that carers have a comprehensive knowledge of the child's needs and work hard at all times to promote their welfare and development. Cases that have 7 of 10 Inspection Report: Barnardos North West Fostering Service (NW Region), 12 July 2007 been more recently referred have all the "Looking After Children" documents on file. The files show that the fostering service makes every effort, both formal and informal, to obtain all the

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Organisation

necessary documentation so that carers have all the up to date information on children. Foster carers are asked to keep records on children. Those carers who have been with the service for a long time, and are more likely to regard the children placed with them as "their own", operate the recording process in different ways. There is a lack of clarity and consistency about a number of areas about recording and the managing and supervision of foster carers' recording.

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Statutory requirements

This section sets out the actions, which must be taken so that the registered person meets the Care Standards Act 2000, The Fostering Services Regulations 2005 and the National Minimum Standards. The Registered Provider must comply with the given timescales.

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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • review the procedures for the establishing of medical consent to ensure each foster carer has clear and current medical consent for all the treatments and interventions required for children in placement • review the practice and systems for the administration of medication to children in placement to ensure effective monitoring of practice • review the operation of the fostering panel to ensure its policies, practices and procedures enable it effectively to fulfil its role for the fostering service • review the system for foster carer review to ensure independent scrutiny of practice • review the system for foster carer recording so that the process is applied consistently by all carers and meets the requirements of records for children in care. 8 of 10 Inspection Report: Barnardos North West Fostering Service (NW Region), 12 July 2007

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The intended outcomes for these standards are:

• the fostering service promotes the health and development of children (NMS 12) Ofsted considers 12 the key standard to be inspected.

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The intended outcomes for these standards are:

• any persons carrying on or managing the service are suitable (NMS 3) • the fostering service provides suitable foster carers (NMS 6) • the service matches children to carers appropriately (NMS 8) • the fostering service protects each child or young person from abuse and neglect (NMS 9) • the people who work in or for the fostering service are suitable to work with children and young people (NMS 15) • fostering panels are organised efficiently and effectively (NMS 30) Ofsted considers 3, 6, 8, 9, 15 and 30 the key standards to be inspected.

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The intended outcomes for these standards are:

• the fostering service values diversity (NMS 7) • the fostering service promotes educational achievement (NMS 13) • when foster care is provided as a short-term break for a child, the arrangements recognise that the parents remain the main carers for the child (NMS 31) Ofsted considers 7, 13 and 31 the key standards to be inspected.

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The intended outcomes for these standards are:

• the fostering service promotes contact arrangements for the child or young person (NMS 10) • the fostering service promotes consultation (NMS 11) Ofsted considers 10 and 11 the key standards to be inspected.

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The intended outcomes for these standards are:

• the fostering service prepares young people for adulthood (NMS 14) • the fostering service pays carers an allowance and agreed expenses as specified (NMS 29) Ofsted considers none of the above to be key standards to be inspected.

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The intended outcomes for these standards are:

• there is a clear statement of the aims and objectives of the fostering service and the fostering service ensures that they meet those aims and objectives (NMS 1) • the fostering service is managed by those with the appropriate skills and experience (NMS 2) • the fostering service is monitored and controlled as specified (NMS 4) 9 of 10 Inspection Report: Barnardos North West Fostering Service (NW Region), 12 July 2007

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Annex A

• the fostering service is managed effectively and efficiently (NMS 5) • staff are organised and managed effectively (NMS 16) • the fostering service has an adequate number of sufficiently experienced and qualified staff (NMS 17) • the fostering service is a fair and competent employer (NMS 18) • there is a good quality training programme (NMS 19) • all staff are properly accountable and supported (NMS 20) • the fostering service has a clear strategy for working with and supporting carers (NMS 21) • foster carers are provided with supervision and support (NMS 22) • foster carers are appropriately trained (NMS 23) • case records for children are comprehensive (NMS 24) • the administrative records are maintained as required (NMS 25) • The premises used as offices by the fostering service are suitable for the purpose (NMS 26) • the fostering service is financially viable (NMS 27) • the fostering service has robust financial processes (NMS 28)

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Annex A

• local authority fostering services recognise the contribution made by family and friends as carers (NMS 32) Ofsted considers 1, 16, 17, 21, 24, 25 and 32 the key standards to be inspected. 10 of 10 Inspection Report: Barnardos North West Fostering Service (NW Region), 12 July 2007

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