Children's Home run by Appletree Treatment Centre Limited in Westmorland and Furness

SC386003 Unique reference number 7 May 2009 Inspection date Anne Bannister Inspector Key Type of Inspection

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5 December 2008 Date of last inspection .

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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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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: SC386003

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Brief description of the service

This four bedded children's home, one of three run by the company. It is a detached house with its own front and rear garden areas. The home has access to local facilities and provides accommodation and care for four young people of either gender, aged 12 to 16 years. Single bedroom accommodation is provided for all young people. The service provided is primarily aimed at young people who have lived in one of the other homes registered by the company and who have been unable to return to families or foster families before their 13th birthday. The home has been established to ensure consistency of care to young people and to ensure they develop life skills for independence.

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Summary

This was the homes first inspection since registration. It was a key inspection. During the course of the inspection all key standards were inspected. The home admitted its first young person in January 2009 and is establishing a quality service for young people. There is an experienced and supportive management team, who support their care staff team and enable them to address young people's assessed needs. The judgement is that the care of the young people is satisfactory overall. However, many of the outcomes for young people are judged to be good, and the overall judgement is judged satisfactory due to actions raised concerning safeguarding. The care of young people meets most of the key National Minimum standards (NMS), but requires further development in some areas. The overall quality rating is satisfactory. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

Not applicable. This is the homes first inspection.

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Helping children to be healthy

The provision is good. Young people have opportunities to work with care staff, to plan and shop for meals. Records show that the meals provided are varied and they promote a healthy and nutritious diet. Menu planning has also linked to the home's promotion of equality and diversity, with themed nights being a regular feature on the menu. Staff have an understanding of what constitutes a balanced diet, which they share with young people, in order to help them develop an awareness of nutritional issues. All staff involved in food preparation hold basic food handling certificates.

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Helping children to be healthy

The health and well-being of the young people living at this home is closely monitored and their health needs are well met. Detailed health plans are in place for all young people living in the home. However, consent forms have recently been revised and the new version fails to ensure that permission for first aid to be administered is sought. An action has been raised in relation to this. Records show that each young person is registered with a local doctor, dentist and optician. Staff encourage young people to attend appointments. They also seek to promote healthy lifestyles by linking in with local services, to promote young people's awareness about keeping safe and drug and alcohol awareness. 4 of 10 Inspection Report: SC386003 All staff have received training in the safe handling and administration of medication. Systems for the administration and storage of medicines are appropriately maintained. Designated staff

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Helping children to be healthy

members hold responsibility for monitoring the system.

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Helping children to be healthy

These actions show young people's health needs are well met.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. Overall arrangements in place to safeguard and promote the safety and welfare of young people are satisfactory with many of the outcomes being assessed as good. The staff team are highly committed to ensuring that young people in their care are protected from harm. On occasions, the staff team have had concerns that young people are not responding to the measures they have put in place to keep them safe. There is evidence that in these situations, the manager organises review meetings to address the risks young people are placing themselves in.

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Protecting children from harm or neglect and helping them stay safe

The home has suitable policies on privacy and confidentiality. Staff show respect for young people's privacy and the importance of maintaining confidentiality is key to the good practice displayed by staff. Relationships between staff and young people are good and create a supportive and nurturing atmosphere, in which young people feel comfortable.

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Protecting children from harm or neglect and helping them stay safe

There have been a number of occasions when it has been necessary to search young people's rooms. Documentation recorded is not always signed by all staff involved in the room search and an action has been raised to address this deficit.

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Protecting children from harm or neglect and helping them stay safe

Staff take concerns and complaints raised by young people seriously. Young people spoken to confirm that they are aware of the various ways they can raise a concern or complaint. They feel that staff do respond to issues they raise with them, which are usually sorted out informally. However, a recommendation has been made that records should clearly indicate, that young people are signing to confirm they are happy with the outcome of staff intervention.

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Protecting children from harm or neglect and helping them stay safe

Young people are protected well when bullying occurs and there is a clear understanding that it will not be tolerated in any form. Staff respond quickly and effectively when issues arise. Such incidents are well documented and carefully monitored by the staff team. Young people spoken to indicate that staff work hard to ensure their safety and they are clear that bullying in any form is not acceptable to staff.

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Protecting children from harm or neglect and helping them stay safe

All staff spoken to have a good understanding of child protection procedures and a rolling programme of child protection training for all staff is in place, to ensure that they have and maintain the skills, to protect young people from abuse. These actions show that the home has appropriate practices, policies and procedures in place, to protect young people from abuse.

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Protecting children from harm or neglect and helping them stay safe

All staff have received training in managing behaviour. The organisation currently uses Crisis Aggression Limitation Management (CALM).The staff team have identified that the techniques employed in the two other homes, which accommodate younger children, do not adequately safeguard teenagers. The senior management team is in the process of reviewing behaviour management policy and practice in view of the issues raised. An action has been raised to ensure that any changes in policy and practice are notified to Ofsted. Staff are consistent in their application of early interventions to prevent situations from escalating. The inspector observed good working relationships between young people and staff. Staff work positively with young 5 of 10 Inspection Report: SC386003 people and they encourage, praise, reinforce and reward acceptable behaviour, actively supporting young people to develop socially acceptable behaviour. Unacceptable behaviour is

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Protecting children from harm or neglect and helping them stay safe

addressed and discussed with young people. Young people may be asked to replace items they have damaged. Staff are fully aware of the types of sanctions they can use and those they must not use. Young people are aware of the types of rewards and sanctions used. All sanctions imposed on young people are fully recorded and the staff team are routinely reviewing and monitoring the effectiveness of sanctions given.

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Protecting children from harm or neglect and helping them stay safe

The home has risk assessments in place for all aspects of the safety of the premises and grounds. There are also risk assessments relating to young people's behaviours and planned activities they undertake. These risk assessments are regularly reviewed and updated, to ensure young people's continued safety. Visitors are welcomed into the home, once they have satisfied staff of their identity, the purpose of their visit and they have signed the visitors book. All fire alarm tests and fire safety equipment checks are up-to-date. All gas and electrical appliances receive an annual check. These actions show that the home is committed to ensuring young people live in a safe and secure environment.

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Protecting children from harm or neglect and helping them stay safe

The company has in place procedures, relating to the selection and vetting of all staff working at the home prior to employment,that meets the requirements of Standard 27 of the Children's Home national minimum standards. All required pre-employment checks are generally carried out and staff recruitment records are well maintained. However, one recruitment file seen showed no evidence that a conviction had been discussed prior to confirmation of appointment. The registered manager advised me that the member of staff openly discussed the issue during interview but notes had not been made of the circumstances leading to the offence. This deficit results in an action being raised and the overall grading being judged as satisfactory.

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Helping children achieve well and enjoy what they do

The provision is satisfactory. All young people are given individualised support in line with their needs and wishes. Individual support is always available to young people when they require it. Young people spoken to indicated there is always someone on duty they can approach to discuss issues with. Files viewed also showed the home ensures young people receive identified specialist advice and support when required. Monthly liaison with specialist agencies ensures that care staff are kept aware of any issues being raised in counselling sessions which might effect young people’s behaviour.

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Helping children achieve well and enjoy what they do

There have been difficulties in engaging young people in individual learning programs during the transition period. Plans to integrate them into mainstream schooling have failed to be put in place. The organisation is in the process of addressing this with the local authority. During the course of the inspection education plans suited to address young people's individual needs were presented to care staff by the teacher responsible for key stage 3. These revised programmes will enable the care staff team to support and encourage young people's educational attainment. Care staff are keen to support young people's learning through close liaison with teaching staff.

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Helping children make a positive contribution

The provision is good. One of the strengths of the home is the placement planning and individual support provided to young people. These meet the requirements of the National Minimum Standards. Staff have 6 of 10 Inspection Report: SC386003 a good understanding of young people's individual needs, and young people are positive in their views about staff who work with them and the care provided.

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Helping children make a positive contribution

Young people are assisted to maintain constructive contact with parents, family and other people significant in their lives. Contact arrangements are discussed at the time of the young people's admission and are recorded in their placement plan. Staff in the home work closely with the young people's families and carers. When part of their care plan, young people have regular home contact visits and staff provide transport and escort facilities for them to travel home. Young people's views, and those of their parents/carers and placing authorities, are regularly sought and taken in to account.

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Helping children make a positive contribution

Young people benefit from weekly team meetings to discuss issues relating to community living as well as one to one sessions with their key workers.

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Achieving economic wellbeing

The provision is good. Young people are encouraged and helped to develop independent living skills to help them look after themselves. These include assisting in the planning of menus, shopping and preparation of food. Growing their own vegetables and taking responsibility for decisions about their life The home liaise closely with placing authorities, parents/carers and other agencies to ensure suitable placements are arranged for young people when they leave the home. The staff team are developing individualised programmes to support the development of young people's independence skills. They will link into Pathway plans when young people reach this stage of their development.

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Achieving economic wellbeing

Documentation shows that when young people show particular skills and interests the care staff team will find and support them in work placements to develop their skills and self confidence. The development of young people's self awareness, self confidence and life skills in preparation for leaving care is key to the service provided by the home.

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Achieving economic wellbeing

The home is a detached house set in a quiet residential area. It is within easy travelling distance of local amenities and facilities and has front and rear gardens that are suitably maintained. There are good relations with neighbours and young people resident make use of local facilities. The home is well decorated and furnished and kept clean. Young people have a say in the general décor and furnishings, and any repairs or maintenance required are suitably addressed. There is central heating throughout and young people have their own single bedroom which they can personalise with posters and photographs if they wish. Young people's bedrooms have at least one window providing natural light, suitable lighting, furniture for clothes storage and areas for personal study. Young people may have personal electrical equipment in their bedrooms if they wish. A written record is kept of all visitors to the home. There is suitable space for

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Achieving economic wellbeing

young people to engage in leisure activities and meet with visitors in private.

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Organisation

The organisation is satisfactory. Overall outcomes for the management of the home are satisfactory with many of the outcomes being assessed as good. Actions arising under safeguarding influence the overall judgement given. The home is efficiently managed, providing a stable, safe environment for the young 7 of 10 Inspection Report: SC386003 people who live there. The Statement of Purpose is clear in setting out what care the home will provide and how it will be provided.

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Organisation

The school's promotion of equality and diversity is good. The home has assessed and determined the individual needs of young people in areas such as culture, religion, risk assessments and equality. The care plan developed by the home, identifies the young person's assessed individual needs in these areas and outcomes are recorded and constantly reviewed. Matters that promote fairness, such as access to the complaints system and reviewing of sanctions used with the young people are good.

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Organisation

All staff receive formal supervision on a fortnightly basis. They receive daily informal support and supervision at the end of each shift. This indicates that young people are cared for by a staff team that are supported in their roles to meet young people’s needs.

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Organisation

Viewing of staff duty rota's, and observation of working practices, show the home is adequately staffed outside education hours. However, there have been issues with non school attendance that have resulted in senior staff having to supervise young people during the school day. The extent this occurs is being monitored by senior management and rotas will be reviewed and adjusted if necessary. The home employ waking night staff. One member of care staff sleeps in each night to provide additional support if young people require it.

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Organisation

Staff training programmes include a thorough induction programme. The staff team appear competent in their roles, having been together prior to the admission of the first young person. During this period a significant amount of training and team building occurred.

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Organisation

The home has an NVQ training programme in place and are working towards the 80% qualified staff team. These actions show the home has systems in place for staff to obtain relevant training and qualifications.

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Organisation

The organisation has a performance appraisal scheme which will be implemented with the staff team and ensure all staff have personal development plans in place.

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Organisation

Monthly monitoring visits by the Responsible Individual and the Registered Manager are carried out and form part of the quality assurance system of the home. The home is developing its quality monitoring systems and seeks feedback from placing authorities, parents or carers and young people as part of this.

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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 Childrens Homes Regulations 2001 and the National Minimum Standards. The Registered Provider must comply with the given timescales.

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Due date Action Standard

8 June 2009 ensure there is written permission from the person with parental responsibility for the administration of first aid (Regulation 20) 8 of 10 Inspection Report: SC386003 8 June 2009 ensure records of room searches are signed by all those present (Regulation 11) 8 June 2009 ensure that when convictions are shown on criminal records documentation their is recorded evidence that these have been discuseed as part of the interview process ( Regulation 26) 8 June 2009 advise Ofsted of the outcome of the review of the behaviour managerment policy/ practice for Willow Bank and notify us of any revision of the policy to be implemented within the home within 28 days of the review being completed. (Regulation 17.3)

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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 manner in which the outcome of informal complaints investigations are recorded so that it is clear whether or not young people are satisfied with the outcome (NMS 16) • review with staff the detail in which they record any discussion with young people following a physical intervention to ensure there is evidence that both staff and young people have considered how they can work together to prevent such situations re-occurring. (NMS 22) 9 of 10 Inspection Report: SC386003

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