Children's Home run by Milestones Care Homes Ltd in Wirral

SC065780 Unique reference number 4 November 2009 Inspection date Nick Veysey Inspector Random Type of 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 8 Inspection Report: SC065780

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Brief description of the service

This children's home cares for up to three children from six years to 17 years old with emotional and behavioural difficulties. It is a semi detached house with four bedrooms near the centre of the town. The location of the house enables young people to access a range of community facilities easily. It is close to local shops, public transport and other community facilities.

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Brief description of the service

Three young people live in the home and one of them took part in the inspection.

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Summary

This visit was an interim inspection and was unannounced.

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Summary

All the outcome areas for young people were looked at during this inspection with the exception of enjoying and achieving, making a positive contribution, and achieving economic well-being.

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Summary

The inspection looked at the progress the home has made with the requirements and recommendations made at the last inspection. These related to: information for young people, their parents and social workers about the support and services provided by the home; and staff induction.

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Summary

This continues to be a good service that meets the regulations and standards consistently well. Young people enjoy living in the home and feel safe and very well supported. The home is very well managed and staffed by very competent and skilled people who are committed to supporting vulnerable young people. The home provides young people with stability and security. This is enabling them to make good progress in all aspects of their lives. For example, young people’s behaviour is improving, they get on well, they are developing healthy lifestyles, and feeling more confident as individuals, as a result deal with new challenges very well.

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Summary

The main area for improvements relate to ensuring that young people’s health records are always up-to-date, young people have access to their personal education plans, and that records show how effective each sanction has been in improving young people’s behaviour. Also, although the management of medication is safe, it does not take into account the special arrangements for any controlled drugs. 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

At the last inspection the home was asked to up date its statement of purpose and provide Ofsted with a copy of its children’s guide. Also, the manager was asked to ensure that staff induction followed the Children's Workforce Development Council's standards. The home has taken appropriate action to resolve all these requirements. The home has a clear written statement for parents and social workers of how the home operates and plans to meet young people’s needs. The children's guide provides important information about the home in a way that is easily understood by young people. This means young people know what support they can expect from the home and how they will be looked after. Also, all staff now follow a suitable and comprehensive induction programme to ensure they understand their responsibilities and are able to develop the knowledge and skills they require to do their job effectively. 4 of 8 Inspection Report: SC065780

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Helping children to be healthy

The provision is good. Young people enjoy healthy and nutritious meals that meet their dietary needs. They confirm that they like the food, routinely plan meals, go with staff to buy food and are encouraged to help to cook and bake. Staff fully understand the importance of good nutrition and what makes up a balanced diet. They have a good awareness that some young people have difficulties with eating and actively encourage young people to develop healthy and nutritious eating habits.

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Helping children to be healthy

Young people's physical health and emotional well-being is actively promoted. Young people have easy access to community health services and are registered with a local doctor, dentist and optician. They have comprehensive health plans, which clearly show how their general and specific health needs are met. However, not every health plan is up-to-date taking into account recent changes in young people's health needs and treatment.

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Helping children to be healthy

Staff have an excellent understanding of the full range of young people’s health needs. They closely monitor young people to make sure they are healthy, by encouraging them to attend routine health checks, such as going to the dentist, and by ensuring they get suitable medical advice and treatment when they are unwell. The home has good links with a range of specialist health and advisory services to make sure that young people get suitable support with individual health issues.

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Helping children to be healthy

Also, staff have excellent insight into the impact on young people’s emotional health of domestic abuse and being separated from their families. They provide young people with stability and security to enable them to deal with the challenges they face. Young people said they felt really nervous when they first moved in, but staff helped them feel at home. Also, they said that staff have helped them feel confident enough to get a part-time job.

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Helping children to be healthy

Staff always encourage young people to take an active interest in looking after their own health and leading healthy lives. They encourage young people to take responsibility for their own health needs appropriate to their age and understanding. The home places emphasis on promoting healthy lifestyles, for example encouraging physical activity, such as swimming and playing football. Also, young people have easy access to information about a wide range of health and social issues, including sexual health, smoking, alcohol and drugs. Young people get clear information and advice to help them know about the range of different options they have. This enables them to make informed choices about their health.

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Helping children to be healthy

The home’s procedures for managing medication are put into practice effectively to ensure young people’s welfare is promoted and protected. Medication is securely stored, and records of any medication taken by young people are up-to-date and accurately kept. Staff make sure that young people only have medication specifically prescribed for them and take it in line with the prescription instructions.

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Helping children to be healthy

Although the home’s practice is safe and there is no evidence of any mistakes in managing medication, there is not a clear system for managing controlled drugs in line with the recommended practice, which is designed to minimise potential medication errors. The administration of controlled drugs is not witnessed by a second person and the home does not keep a separate record showing the balance of the medicine stored in the home. 5 of 8 Inspection Report: SC065780

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Staff respect young people's privacy consistent with good parenting and the need to protect young people. Young people’s privacy and confidentiality is respected. Young people have single bedrooms and the bathroom arrangements promote privacy and dignity. The accommodation provides space where young people can relax easily and spend time alone when they wish. Information about young people is managed confidentially and held securely in the office.

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Protecting children from harm or neglect and helping them stay safe

Young people know how to complain and confirm that their concerns are taken seriously and promptly and fairly addressed. They have access to information about the complaints procedure and staff encourage young people to let them know when they have concerns or if they are unhappy.

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Protecting children from harm or neglect and helping them stay safe

Young people feel safe. Staff give protecting young people from harm a high priority. This involves providing young people with excellent advice about personal safety. Staff understand fully their responsibilities to promote and safeguard young people’s welfare. Staff are knowledgeable about the home’s procedures for responding to concerns about young people's safety. They work well with safeguarding agencies to protect young people by reporting any concerns promptly.

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Protecting children from harm or neglect and helping them stay safe

Young people do not have difficulties with bullying and generally get on well. At times they have been fed up with other young people’s behaviour and confirm that staff helped to sort this out and things are much better. Staff work effectively with young people to enable them to get on with other young people and deal with problems constructively. This includes talking about how to engage with other people by making positive comments and listening to what they have to say. Also, staff help young people to develop their social and communication skills, enabling them to be confident and assertive to say when they are not happy with other people’s behaviour.

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Protecting children from harm or neglect and helping them stay safe

The home has been effective at ensuring that young people do not go missing and come in on time. Young people have detailed individual risk assessments and plans for what staff should do if they are missing. The plans clearly set out what action is taken to protect young people, including: staff trying to contact young people by telephone; going out to look for them; and collecting them when they are found.

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Protecting children from harm or neglect and helping them stay safe

Staff are very good at encouraging young people to develop socially acceptable behaviour and challenge difficult behaviour constructively. Young people know what standards of behaviour are expected and the possible consequences of any poor behaviour. Staff view young people in a positive light and encourage acceptable behaviour by praising and rewarding them, talking to them, trying to understand their behaviour and building positive relationships with them. Staff have excellent insight to the issues that influence young people’s behaviour, such as low self-esteem or missing their family, and take steps to help young people feel positive about themselves. This approach is extremely effective and has led to significant improvements in young people’s behaviour, for example reducing swearing. Also, the support and understanding young people receive has enabled them to deal successfully with new situations, such as starting

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Protecting children from harm or neglect and helping them stay safe

college. 6 of 8 Inspection Report: SC065780 Young people live in a safe environment. They are protected by a comprehensive range of detailed health and safety procedures and risk assessments. Staff carry out regular health and safety checks, including fire drills to ensure the premises are safe and secure.

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Organisation

The organisation is good. The home is very well run and the quality of care is consistently good. Young people are looked after by a competent staff team who have a wide range of skills and experience. The skills within the team match the needs of young people living in the home well. The staff team reflects cultural backgrounds of the young people living in the home. The numbers of staff on duty meets the needs of young people in the best possible way. This includes the support they need for activities, visits and appointments.

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Organisation

Staff are well-supported by the manager and have a clear understanding of their roles and responsibilities. They know who they contact for support should the manager not be available. They confirm that when they need support and guidance, the manager is always available and helpful and receive one-to-one supervision regularly. In addition, team meetings take place every month, to allow the whole staff team to discuss and review individual young people, the running of the home, staff development and training and to look at ways to improve the service they offer.

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Organisation

Staff have good access to suitable training. The training programme comprehensively covers the needs of young people and provides staff with the skills and knowledge to effectively do their jobs. It is regularly reviewed, to check if there are any additional training needs. Staff confirm that the training helps them understand young people better and how to support them.

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Organisation

The home has good systems in place to review the quality of care provided. The provider and manager consistently monitor the running of the home every month. They identify areas for improvement and steps are taken to address the issues.

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Organisation

Young people are encouraged to read and make comments about what is written about them. The home’s written records provide a very clear picture of individual young people’s needs, development and progress. Young people’s records are well-organised and contain up-to-date information about them. However, young people’s personal education plans showing their needs and arrangements for their education are not available on their files. 7 of 8 Inspection Report: SC065780

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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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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 health plans are kept up-to-date to take into account any changes to their needs and the support they receive (NMS 12.2) • ensure that a suitable system is put into practice for managing controlled drugs; to include the witnessing of the administration of the medication; and maintaining separate controlled drug record that is regularly checked (NMS 13.2) • ensure that the sanctions record includes a written evaluation of the effectiveness and consequences of each sanction used with young people (NMS 22.10) • ensure that each young people's file contains a copy of their personal education plan setting out a record of their educational needs and the support they require. (NMS 14.2) 8 of 8 Inspection Report: SC065780

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