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

SC033268 Unique reference number 1 July 2009 Inspection date Anne Bannister Inspector Key Type of Inspection

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23 February 2009 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 9 Inspection Report: SC033268

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Brief description of the service

This 12 bedded children's home is one of three run by the company. The home is in a small village with a purpose-built school also on site. It is a detached house with its own extensive grounds. The home has access to a range of local facilities in a nearby town. It is registered for 12 young people, aged from six years old up to 12 years old, of either gender, with emotional and behavioural problems. There are currently 11 young people on roll. Most young people have a statement of special educational needs, which provides for their additional needs. Young people living in the home have had disrupted schooling and are typically attaining below the expected levels for their age on admission.

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Summary

This was an unannounced key inspection, during the course of which all key standards were inspected.

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Summary

Young people's assessed needs are met by staff who have developed strong, positive relationships with the young people and their carers. The staff team works closely with a range of outside agencies, in order to meet the range of needs presented by young people. Young people are generally positive about the care they receive in the home. They indicate that staff are helping them to look at the way they react to situations, so that they respond in a more appropriate manner.

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Summary

Young people are encouraged to develop healthy lifestyles. The practices implemented within the home ensure that young people's health and dietary needs are appropriately met. The life skills used within leisure activities assist young people to develop skills which will enhance their self esteem and link into planned education programmes.

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Summary

Where recommendations have been raised, they relate to inadequacies in documentation that fails to fully evidence the good practices implemented by staff when working with young people. 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

There was one action made at the last inspection. This related to the risk assessments of the site, all of which had not been updated annually. Since the last inspection, all risk assessments of the site have been reviewed in a manner that now ensures they meet the Children's Home national minimum standards.

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Helping children to be healthy

The provision is good. Staff encourage and promote healthy eating and menus ensure that young people receive a balanced and nutritious diet. Records of menus indicate that a varied diet is provided, which meets young people's nutritional needs. Meal times are relaxed, social occasions where appropriate social skills are encouraged. The cook consults with young people and ensures varied alternatives to the planned meals are available. These actions ensure that staff are equipping young people with the knowledge to make choices about their eating habits. 4 of 9 Inspection Report: SC033268 Young people have detailed health plans, which are generally updated following every appointment. However, the post of school nurse is currently vacant and care staff are taking young people for appointments. They are not always feeding back the outcome of such appointments to the locum nurse, therefore, health records are not up to date. An action has

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Helping children to be healthy

been raised relating to this deficit. Young people's health records indicate that specialist support and advice is sought to meet assessed needs.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. The staff team are committed to ensuring that young people in their care are protected from harm.

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Protecting children from harm or neglect and helping them stay safe

Staff receive training in relation to the privacy and confidentiality wishes of the young people. Secure cabinets in the home ensure that confidential records are kept safely. Young people's bedrooms and bathrooms have doors with locks, so that privacy can be maintained. These actions ensure that young people's rights are protected, in relation to maintaining their rights of privacy and confidentiality.

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Protecting children from harm or neglect and helping them stay safe

Young people spoken to know what to do if they are unhappy about something. They know how to make a formal complaint but indicate issues are generally solved by 'by telling Val or Kath'. There is also a suggestions and worries box that young people can post concerns into. This box is regularly checked by senior management and a written response to the issues raised by the young people is displayed above the box. Some young people value this method of communicating issues, as they do not always find it easy to discuss their feelings. All young people spoken to felt staff would listen and take action if they raised issues with them.

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Protecting children from harm or neglect and helping them stay safe

All care staff spoken to have a good understanding of safeguarding procedures. A rolling programme of child protection training for all staff has been put into place, to ensure that they have and they continue to maintain the skills to protect young people from abuse. The home maintains detailed records of any incidents made under safeguarding guidelines and ensures notifications are made to the appropriate authorities. 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

There is a clear and comprehensive behaviour management policy, which is consistently used by all staff.

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Protecting children from harm or neglect and helping them stay safe

All physical interventions and sanctions imposed in response to unacceptable behaviours, are appropriately recorded and are monitored by the senior managers, to identify trends in behaviours and to ensure staff consistency. However, the manner of recording the effectiveness of sanctions used does not reflect the level of discussion which takes place within the staff team. The manner of recording in the sanction log does not give clear indication as to whether the sanction has been imposed in care or education hours. A recommendation has been made in relation to these issues.

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Protecting children from harm or neglect and helping them stay safe

The home has a written procedure for how staff must respond when young people are absent without authority. There is careful monitoring of the number of instances where this occurs and actions are taken by staff, to try to ensure that young people are not continuing to place themselves at risk by this practice. Records indicate that relatively few absences occur during care hours. 5 of 9 Inspection Report: SC033268 Evidence and observation shows that the home has a responsible attitude towards health and safety matters. The home has risk assessments in place for all aspects of the safety of the premises and grounds. However, a significant incident relating to a young person gaining inappropriate access to part of the building had not resulted in risk assessments of this area being reviewed. An action has been raised in relation to this. There are also risk assessments relating to young people's behaviours and the planned activities they undertake. These risk

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Protecting children from harm or neglect and helping them stay safe

assessments are reviewed as necessary to ensure young people's continued safety. Visitors are welcomed into the school, once they have satisfied staff of their identity and the purpose of their visit and when they have signed the visitors book. All fire drills, fire alarm tests and fire safety equipment checks are up to date. All gas and electrical appliances receive an annual check. The home's actions show that there is a commitment 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

Recruitment files examined, indicate that the organisation operates appropriate recruitment procedures that meets with the requirements of the Children’s Homes Regulations. This shows that all reasonable steps are taken, to ensure that staff employed are suitable to work with young people.

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Helping children achieve well and enjoy what they do

The provision is good. The staff team have considerable skills in addressing the individual needs of the young people living at the home. Placement plans detail how individual needs will be addressed. Practice observed indicates that staff routinely take into account the culture and understanding with the young people they are supporting. Staff are constantly reviewing the manner in which they relate to young people, in order to ensure they are enabling them to communicate their needs, wishes and concerns.

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Helping children achieve well and enjoy what they do

Education is provided on site. Staff have good links with the teaching staff and ensure that they act quickly to support young people if any difficulties arise. However, a practice has developed where young people appear to be bringing sanctions home from the school day to be implemented by care staff. This practice needs to be reviewed, as punishments from the school day should not be routinely sent for care staff to supervise and they are impacting on the activities care staff have planned. The care team support young people's education by ensuring that planned activities support their learning. However, care plans do not always fully reflect the extent to which this is taking place. A recommendation has been raised in relation to this.

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Helping children make a positive contribution

The provision is good. The home has a number of care planning documents which, when read collectively, provide good information on young people's individual needs and how they will be met. Plans cover all areas required and they are regularly reviewed. Young people's views and those of significant others are sought when forming and reviewing care plans. However, although meeting the requirements of the national minimum standards, discussion with both staff and young people indicates that the plans are not always reflecting the extent of the input by staff to address young people's assessed needs. A recommendation has been made to reflect the need for the home to further review the content of care plans. 6 of 9 Inspection Report: SC033268 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

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Helping children make a positive contribution

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 have a variety of ways to ensure that they influence the decisions about their lives. These include house tutor sessions, which helps them prepare for and express their opinions in reviews, house meetings which occur on a weekly basis and a reflection time at the end of the school day, that enables the young people to assess how they have coped with the day.

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Helping children make a positive contribution

There are suitable procedures in place for young people moving in to the home. Young people visit the home before admission, they meet with staff and young people resident and they are given relevant information on how the home operates. They may bring personal possessions with them on admission and a record of these is kept. The home does not accept emergency admissions. Young people already resident are informed and consulted about new admissions and the manager takes into account any possible impact new admissions may have on those already resident.

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Achieving economic wellbeing

The provision is good. Discussions with staff and observation of care records clearly indicates that young people receive care and support to prepare them for placement when they move on from the home. The staff team are skilled at developing transition plans to support young people in this process. However, there are occasions when failure by placing authorities to find alternate placements results in young people becoming stressed. There is evidence that staff maintain frequent contact with placing authorities to try to address these issues.

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Achieving economic wellbeing

The home is large a detached house set in a quiet residential area. It is within easy travelling distance of local amenities and facilities and it has extensive gardens that are suitably maintained. Young people resident make use of local facilities. The home is reasonably well decorated and furnished and kept clean. Some areas of the home promote a more homely feel than others and there is a development plan in place, which indicates how this is being addressed. Any repairs or maintenance required are suitably addressed by a full time maintenance team. There is central heating throughout and young people have their own single or double 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 and furniture for clothes storage. Young people may have personal electrical equipment in their bedrooms if they wish.

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Achieving economic wellbeing

There is suitable space for young people to engage in leisure activities and to meet with visitors in private.

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Organisation

The organisation is good. 7 of 9 Inspection Report: SC033268 The home is efficiently managed, providing a stable and safe environment for the young 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 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, are good.

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Organisation

Since the previous inspection, two staff have resigned and there has been periods of sickness for key staff. Viewing of staff duty rotas and observation of working practices, shows that senior managers ensures that the home remains adequately staffed for the young people currently living there. Until the vacancies are filled, this is being achieved through the good will of care staff volunteering to undertake extra shifts and the employment of regular relief staff, to ensure consistency of care for young people.

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Organisation

The staff training programmes include a thorough induction programme. The staff team appear competent in their roles. The home has a National Vocational Qualification training programme in place and exceeds the 80 per cent qualified care staff team. These actions show the home has systems in place for staff to obtain relevant training and qualifications. The organisation has a performance appraisal scheme for all staff and ensures all staff have personal development plans in place.

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Organisation

The operation of the home is well monitored by senior management. Where deficits in practice are noted in Regulation 33, or Schedule 6 monitoring inspections by the Registered Manager, a date by which they need to be addressed is indicated on their reports. The home also sends out an annual questionnaire to placing authorities seeking their views on the service provided. Parents and carers views are also sought on the care the young people receive at the home during the course review meetings.

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Organisation

These actions show that the home has a development strategy and is continually reviewing the facilities and services it provides, in order to provide high quality childcare to the young people in their care.

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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

31 July 2009 ensure that care staff communicate the outcomes of appointments with health professionals to the school nurse so that health plans accurately reflect how young people's health needs are being addressed.(Regulation 20) 8 of 9 Inspection Report: SC033268 31 July 2009 ensure that risk assessments of the building are reviewed following any significant incident (Regulation 23)

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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 when young people misbehave during the school day sanctions given are not inappropriately carried over care hours(NMS 14) • review the content of the home's care plans to ensure they effectively reflect all the work care staff are undertaking with young people and the progress being achieved (NMS 2) • provide further guidance/training for staff regarding how they record their assessment of the effectiveness of sanction (NMS 22) • ensure that care plans clearly evidence how the care team are supporting young people's education in the role of 'good parent' (NMS 14) • review the manner of recording sanctions to make it clear whether they have been given by care or education staff ( NMS 14) 9 of 9 Inspection Report: SC033268

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