Children's Home run by Essandore Limited in St Helens

SC066218 Unique reference number 10 August 2009 Inspection date Sonya Robinson Inspector Key Type of Inspection

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28 October 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: SC066218

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Brief description of the service

The home offers accommodation for up to five young people, of either sex from 10 years old up to 17 years old in the registration category of children with learning disabilities and physical disabilities.

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Brief description of the service

The home has good access to local facilities, such as shops, schools and transport links.

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Brief description of the service

Accommodation is provided over two floors. Bedrooms are sited on each level and young people are provided with a choice upon admission. All bedrooms are single occupancy and provide en-suite bathroom facilities. The house has a range of facilities to meet the physical and learning needs of young people, including a light and sensory room, soft play room, two lounges and a spacious kitchen. All areas of the home are accessible to young people.

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Summary

At this unannounced full inspection, all key standards were inspected. This is a satisfactory service overall.

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Summary

Young people benefit from positive relationships with staff, they are afforded a range of facilities and opportunities to encourage and support a healthy lifestyle, to develop their life skills and to reach positive outcomes from education. However, there are issues around the documentation, which have impacted on a number of standards. The home has taken on several new staff since the last inspection and this enables consistency and commitment of approach.

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Summary

Staff benefit from training and support, they work well with other professionals to meet the complex and holistic needs of young people in areas such as emotional and physical well-being. 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

There were seven actions and five recommendations raised at the previous visit.

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Improvements since the last inspection

The manager was asked to ensure that there is an up to date health plan for young people accommodated at the home, setting out in detail the level of care and support provided to promote and protect health needs. To ensure that there is an up to date placement plan for each young person accommodated at the home and to ensure each young person has appropriate information regarding the management of medicines.

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Improvements since the last inspection

The documentation is much improved and each young person does have a health care plan in place, the home has taken this a step further and developed an action plan around this. However, this document is new and is not fully completed in parts. Each young person does have a placement plan and this is a good document for staff to implement with others as identified within these. The medication systems are much improved, staff have received training in this area and they inform that the systems are 'working better'.

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Improvements since the last inspection

The manager was required to ensure records relating to complaints are appropriately maintained. To ensure records of visits to the home for the purpose of monitoring, reflect the opinions of 4 of 10 Inspection Report: SC066218 parents, relatives and young people, in order to form an opinion of the standard of care provided in the home. To maintain an accurate and up to date record of measures of control used and that measures of control must be reasonable and must not restrict the movements of any child living at the home. The manager was also asked to ensure all known risks to the health or safety of children are identified and appropriately addressed in line with their needs.

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Improvements since the last inspection

Records relating to complaints have been maintained. Monitoring systems have been set up to record the views of young people, parents and relatives, although the frequency of these has lapsed. Young people are not restricted in their movement throughout the home, the front door has a key pad lock for security purposes, the code is accessible to those within the home. Each young person has an individual risk assessment, which is up to date.

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Improvements since the last inspection

The manager was asked to take into account the following: to ensure all staff are aware of and do not exceed the measures they can take, to prevent a child leaving without permission under current legislation government guidance; to draw up for each child, an up to date behaviour management plan which reflects the strategies employed to encourage and support positive behaviours; to ensure appropriate systems are in place to protect young people from the effects of bullying; to ensure that the home's statement of purpose is reviewed to reflect the current service and facilities provided; to ensure that a minimum of 80 per cent of all care staff have completed a National Vocational Qualification at level 3 in the Caring for Children and Young People or an equivalent qualification.

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Improvements since the last inspection

Staff have undertaken training in the areas of safeguarding and behaviour management since the last inspection. Each young person has a behaviour management plan, which identifies how young people should be supported. There are policies and procedures in place with regards to bullying. At present this is not an issue at the home. The statement of purpose has been reviewed, however it still does not accurately reflect the service being offered by the home. Lastly the recommendation around ensuring 80 per cent of staff have completed their National Vocational Qualification at level 3 or equivalent qualification is repeated.

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Improvements since the last inspection

The seven actions raised have been addressed and two recommendations have been highlighted again on this inspection.

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Helping children to be healthy

The provision is satisfactory. Young people enjoy healthy and varied meals, which meets their dietary needs. Staff understand what makes a healthy and balanced diet and encourage young people to develop healthy eating habits. Young people are encouraged to plan and choose what they have to eat, to go shopping for food and to cook where appropriate.

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Helping children to be healthy

Young people have plans showing their health needs and the arrangements for meeting them. However, these are not always up to date. Further important information, such as immunisations are not noted within all of the expected documentation.

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Helping children to be healthy

Staff monitor young people to make sure they are healthy, by encouraging them to attend routine health checks and by ensuring they get medical treatment when they are unwell. However, permission from an appropriate authority has not been sought in all instances. The home has good links with specialist health and advisory services, to make sure that young 5 of 10 Inspection Report: SC066218 people get suitable support. Staff deal with health issues sensitively and make sure young people get appropriate support and advice to promote healthy lifestyles.

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Helping children to be healthy

The home manages young people's medication safely. Staff make sure that young people only have medication specifically prescribed for them and take it in line with the prescription instructions. Staff keep detailed records of any medicines stored in the home and the administration of medicines to young people. Medication is securely stored in a suitable cabinet. However, the policy and implementation of the storage for medication is being monitored in line with best practice guidelines, to ensure it does not exceed specific temperatures.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. Staff demonstrate a positive approach to ensuring that young people feel valued and their privacy and dignity is maintained. This is achieved by implementing appropriate records, such as placement plans and risk assessments, which reflects the level of care provided to each young person.

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Protecting children from harm or neglect and helping them stay safe

The home has an accessible complaints procedure. Young people can access this and all complaints are given high regard and they are acted upon. Staff speak and interact with young people to ensure that they are happy and they have opportunities to make their feelings known.

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Protecting children from harm or neglect and helping them stay safe

Young people, their parents and other relevant authorities are involved in the development of care records, such as health plans, placement plans and risk assessments. Staff have a clear understanding of young people's communication methods. This is used to ascertain individual opinions with regards to how they wish to be supported, in ways that promotes their welfare and keeps them safe. Records explain how the home keeps young people safe, in line with their assessed needs, in areas such as safe moving and handling, running off and medication.

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Protecting children from harm or neglect and helping them stay safe

Bullying is not an issue for young people. Staff are aware of the potential for bullying and provide supervision and encourage young people to deal with any difficulties constructively when necessary. Staff are aware of young people's rights, legislation and guidance relating to freedom of movement and follow this in practice. The home has detailed individual risk assessments.

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Protecting children from harm or neglect and helping them stay safe

Staff build positive relationships with young people by explaining and showing young people what is socially acceptable behaviour. Staff see young people in a positive light and are committed to helping them when they anxious or upset. Also, they are knowledgeable and understanding about young people's individual behaviours.

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Protecting children from harm or neglect and helping them stay safe

Staff use effective communication skills to encourage young people to develop socially acceptable behaviour. Records relating to sanctions show that they are used minimally. Records relating to physical intervention show that it is also used minimally, although these records do not meet the Regulations in terms of how they are recorded.

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Protecting children from harm or neglect and helping them stay safe

Staff praise young people when they do well and reward them. They also reassure young people when they are upset and help them deal with their anxieties and frustrations in a positive way. Staff do not condone unacceptable behaviour and assist young people to communicate their frustrations. 6 of 10 Inspection Report: SC066218 Young people live in a safe and secure environment. Staff carry out regular health and safety checks, including fire safety systems to make sure that the home is a safe place to live. Staff have attended an appropriate training programme, which encompasses all aspects of safeguarding young people with physical and learning disabilities, including delivering and maintaining safe practices around social, clinical and medical support needs.

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Protecting children from harm or neglect and helping them stay safe

All staff working at the home are appropriately vetted, however systems are not robust enough to fully safeguard young people to a good standard, such as photographic identification being consistently held on file.

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Helping children achieve well and enjoy what they do

The provision is satisfactory. Young people's individual needs are identified and met by their placement plan. Staff put the plan into practice at all times to a satisfactory standard. Staff spend time individually with young people. They meet a range of young people's potential needs, including personal care, healthy lifestyles, dealing with frustrations, communication and disability. The home has a range of resources and facilities, including a multi-sensory room, to support young people and to promote their individual needs.

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Helping children achieve well and enjoy what they do

Young people's education is promoted and supported by staff. However, young people did not have a personal education plan. Staff encourage young people to learn and develop their skills and knowledge through activities, which builds confidence. The structure of the home supports young people's attendance at school.

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Helping children achieve well and enjoy what they do

Young people are encouraged to take part in suitable leisure activities both inside the home and in the wider community. Their individual interests are encouraged and supported with young people who are able to continue with activities they enjoy with their families.

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Helping children make a positive contribution

The provision is good. Each young person has in place a clear placement plan and other supporting documents, such as risk assessments. Placement plans provide information to demonstrate how care is provided to each young person. The home's systems for monitoring and reviewing the placement and care records involves young people, their parents and social workers.

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Helping children make a positive contribution

Young people have clear arrangements for contact with their families to help them maintain relationships. Staff actively ensure young people have suitable regular contact and that the arrangements promote and safeguard young people’s welfare. They work closely with young people’s families to let them know about their progress and to involve them in decisions about the care provided.

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Helping children make a positive contribution

Staff work well with young people, to ascertain their opinions and feelings around the care and support they are afforded. The home utilises a range of resources, to promote consultation with young people. Staff have sought experience through working closely with schools, in the use of various methods of communication, such as makaton and picture exchange communication systems. The staff are therefore, able to recognise individual methods of communication, which enables them to seek young people's views. 7 of 10 Inspection Report: SC066218

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Achieving economic wellbeing

The provision is good. Staff encourage young people to develop their skills and to become more independent suitable to their age and understanding. They routinely learn skills through taking part in the running of the home, such as shopping, using money and simple household tasks. There is evidence to show that young people are making progress in carrying out their daily routines.

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Achieving economic wellbeing

Young people receive regular pocket money and clothing allowance money and records of their use are maintained to act as a safeguard for young people. However, these records are not sufficiently monitored and basic administration errors have occurred.

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Achieving economic wellbeing

The home is of a good standard of accommodation to meet the needs of young people with a range of physical, emotional and learning needs. All parts of the building to which young people have access are adapted and facilities within the home ensure that all young people enjoy the benefits of an inclusive service. For example, the home has a lift for the use of young people who use wheel chairs, this allows them to access the upper floor of the building.

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Achieving economic wellbeing

The accommodation provided is warm, welcoming and maintained to a high standard. Young people benefit from a spacious environment that includes two lounges, light and sensory room and soft play room. The outdoor area also provides young people with space to relax and play in a safe and secure setting.

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Organisation

The organisation is satisfactory. The promotion of equality and diversity is satisfactory. Young people's rights are respected. There is evidence to demonstrate that the individual care needs of young people are identified, direct work with young people is undertaken and that they are kept safe.

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Organisation

The home has a statement of purpose, it sets out what care the home provides and how this will be accomplished. However, it does not fully reflect the service and is due for review. Young people have access to a children's guide to the service, which has been written using symbols allowing young people access to important information, such as complaints and day to day arrangements within the home.

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Organisation

The home is staffed to meet the individual needs of those living there. This is achieved by undertaking risk assessments around support needs and implementing placement planning, which effectively assesses the support needs of each individual in relation to staffing levels.

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Organisation

Staff employed at the home are provided with support to ensure that the needs of young people are met. Staff have access to a range of training courses that are aimed at meeting the diverse needs of young people and this includes specific training around disabilities, safeguarding and moving and handling. However, not all of the staff employed currently hold a National Vocational Qualification at level 3 in the Caring for Children and Young People or an equivalent qualification.

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Organisation

Monthly monitoring visits are undertaken and reports contribute to the manager's evaluation of the service however, several have been omitted or mislaid. 8 of 10 Inspection Report: SC066218 Young people have accessible care records, that are clear and reflect the standard of care and support delivered to each young person. Systems within the home ensure that records are maintained to a satisfactory standard.

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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

18 September 2009 obtain written permission from a person with parental responsibility for each child, for medical treatment and first aid (Regulation 20 (1)) 18 September 2009 ensure that within 24 hours of the use of any measure of control, restraint or discipline in a children's home, a written record is made in a volume kept for the purpose (Regulation (17) (4) ) 18 September 2009 ensure all staff records contain all of the information required under the Regulations (Reg 26, Schedule 2)

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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): • ensure that young people's immunisation histories are recorded within their health care plan (NMS 12) • ensure each child or young person has an up to date health plan that fully identifies the physical, emotional and health needs (NMS 12) • ensure that the policy and implementation of the storage for medication is in line with best practice, for example guidelines laid down by the Royal Pharmaceutical Society of Great Britain (NMS 13) • ensure that each young person has a personal education plan which explicitly addresses their educational needs (NMS 14) • ensure that children's clothing and personal requisite needs are fully met and that these different allowances are monitored (NMS 11) • ensure that the home's statement of purpose is reviewed to reflect the current service

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Recommendations

provided (NMS 1) • ensure new staff receive at least one and a half hours of one to one supervision from a senior member of staff, fortnightly, during the first six months of their employment (NMS 28) 9 of 10 Inspection Report: SC066218 • ensure that a minimum of 80 per cent of all care staff have completed National Vocational Qualifications at level 3 in Caring for Children and Young People or an equivalent qualification (NMS 29) • ensure that monthly audits undertaken by the representative of the home are maintained by the home and that any recommendations made are acted upon (NMS 32) • ensure that the Registered Person of the home monitors and signs the home’s records at least once a month, to identify any patterns or issues requiring attention and takes action where necessary (NMS 33). 10 of 10 Inspection Report: SC066218

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