Children's Home run by North Lakes Children’s Service Limited in Cumbria

SC356907 Unique reference number 4 November 2009 Inspection date Anne Bannister Inspector Key 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 9 Inspection Report: SC356907

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Brief description of the service

This seven bedded children's home is one of two run by the company. There is also a purpose-built school 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. Young people living in the home also have access to the facilities available in the city, which is approximately 20 minutes away. The site provides education and care for boys aged 10 to 17 years who have emotional, social and behavioural difficulties, including learning difficulties within or outside the autistic spectrum of disorder. The home provides en-suite accommodation for seven young people and separate school facilities for up to 14 learners aged 10 to 17 years. The property has been converted to a high standard and maintains a homely feel. Communal areas include two lounges, a games room, a dining room and kitchen.

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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 positive relationships with the young people and their carers. 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 actions and recommendations have been raised, they relate to breaches in regulation and inadequacies in documentation that fail 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

Three actions were raised following the previous inspection. They related to recording of injuries in the accident book; the need to review risk assessments of the site; and the need to address deficits in recruitment practice relating to the recording of references given verbally. All have been adequately addressed

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Helping children to be healthy

The provision is good. The home promotes healthy eating and this is reflected in the planned menus. There is evidence that young people are involved in the preparation of some meals which link to their educational programme. Individual preferences, along with any specific dietary needs are accounted for. Staff organise cultural days to develop young people's knowledge of lifestyles in other countries. Meals are relaxed, social occasions enjoyed by both staff and young people. 4 of 9 Inspection Report: SC356907 Young people's health needs are thoroughly assessed. Health information is obtained from placing social workers, so that staff have a clear understanding of the young people's health needs and how these are to be met. Health plans are detailed documents, addressing specific personalised needs. Practice in the home is for young people to be registered with local health professionals, such as the doctor, dentist and optician. The home operates procedures that

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Helping children to be healthy

comply with the administration and safekeeping of medicines. These are effectively monitored by the school nurse. All staff administering medicines have received appropriate training. Recently the home has revised the form seeking medical consents for treatment and for the administration of medicines. The new form fails to gain permission for young people to be given non prescribed medication and an action has been raised in relation to this deficit.

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Helping children to be healthy

Young people are positive about the manner in which their health needs are addressed. Statutory medical examinations are organised. Specialist advice and help is organised, when needed, to support specific identified health needs. Positive health promotion by staff ensures young people receive advice and information, which will help them to make positive choices relating to relationships, drugs and alcohol.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Overall, the arrangements to safeguard and promote the safety and welfare of young people are good, with many outcomes for young people being assessed as outstanding. Staff show respect for young people's privacy and maintain appropriate levels of confidentiality. Young people have their own individual single bedrooms, that have appropriate locks on the doors. Secure cabinets in the home ensure that confidential records are kept safely.

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Protecting children from harm or neglect and helping them stay safe

One young person's room has been searched since the last inspection. When such searches do occur, they are appropriately recorded but recording of this incident failed to meet the requirements of standard 9.8 of the national minimum standards. All staff involved had failed to sign the documentation completed. An action has been raised in relation to this deficit.

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Protecting children from harm or neglect and helping them stay safe

Incidents of being absent without authority relate to specific young people and some residents have no history of such behaviour. Staff work with the relevant young people to help them address these issues. There are appropriate policies and procedures in place, that detail action for staff to take should young people go absent without permission. Documentation used for recording any such incidents does not meet with regulatory requirements. There is no recorded evidence that, on return, young people are offered the opportunity to speak with someone outside the home about the reasons for their absence.

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Protecting children from harm or neglect and helping them stay safe

Bullying is currently not a concern for young people who stated they were not bullied at the home. There are good systems in place for recording any such incidents that may take place. There are suitable policies and procedures in place that provide good guidance for staff on bullying issues and how to address them.

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Protecting children from harm or neglect and helping them stay safe

All care staff have a good understanding of safeguarding procedures. A rolling programme of safeguarding training for all staff is in 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. However, although the home is adhering to the local authority safeguarding guidelines, by not referring minor injuries to young people during a physical 5 of 9 Inspection Report: SC356907 intervention, a recommendation has been made that all injuries should be referred under safeguarding guidelines. The Registered Manager accepts that this is best practice despite the local authority's guidance. 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

Staff take seriously concerns and complaints raised by young people. Young people spoken to know what to do if they are unhappy about something. They indicate issues are generally solved by speaking to staff informally and they 'sort it'. However, they also know how to make a formal complaint if they are unhappy about issues. There have been no complaints since the last inspection.

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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. All staff have been trained in behaviour management techniques and they are skilled at diverting young people's negative behaviours into a more positive activity. 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. Young people are aware of the sort of behaviour that may result in sanctions being imposed on them, showing their awareness of the home's behaviour management policy. Sanctions are appropriately recorded and there is documented evidence that the home is reviewing their effectiveness. Following any incident of physical intervention, behaviour management plans are reviewed. This is to consider whether the intervention has been effective

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Protecting children from harm or neglect and helping them stay safe

and to look at alternative strategies to be used in the future. The aim is to defuse and divert future incidents, in a manner which makes physical intervention unnecessary and keeps young people safe.

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Protecting children from harm or neglect and helping them stay safe

The home operates recruitment procedures that meet with the requirements of Schedule 2 of the Children's Home Regulations 2001. However, on one file examined there was no evidence that a two year break in employment history had been explained. During the course of the inspection the Registered Manager amended the interview form to ensure that applicants are in future routinely asked to give explanation for such occurrences. This amendment ensures that every reasonable step is taken to ensure staff employed to work with young people are suitable to do so.

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Protecting children from harm or neglect and helping them stay safe

A designated member of staff, who has received appropriate training, oversees health and safety issues and risk assessments. The environmental hazards in the building are assessed appropriately and suitable measures are put in place, to promote young people's physical safety. Professional technicians regularly service the electrical equipment, gas appliances and equipment for preventing, detecting and extinguishing fires. This helps to promote the safety of young people in the home. Fire prevention arrangements are robust. These actions show all reasonable measures are taken to ensure young people live in a safe environment.

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Helping children achieve well and enjoy what they do

The provision is good. Observation of staff practice and documentation seen, indicates that young people receive personalised support. The home has well established links with a range of outside agencies that supports young people in developing a positive view of themselves and others. Young people indicate that staff are approachable and that there is always someone on duty who they would approach if they needed help or advice. Staff spoken to are knowledgeable about young people's individual needs. 6 of 9 Inspection Report: SC356907 Developing educational potential forms a clear part of the home's philosophy of care. Staff are positive in their approach to education and its value for the young people in their care. All young people are participating in individual learning programmes. Education plans are arranged to suit young people's individual assessed needs. Care staff are observed to support young

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Helping children achieve well and enjoy what they do

people's learning through close liaison with teaching staff. This enables them to provide practical and emotional support to young people experiencing difficulty. The staff team are also skilled at recognising and celebrating young people's achievements and personal successes. These actions show young people's educational needs are appropriately addressed.

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Helping children make a positive contribution

The provision is good. Systems are in place to ensure that young people are able to move into and leave the home in a planned and sensitive manner. Pre-admission documentation is comprehensive and ensures that the home feels that they are able to adequately address the needs of the young person. However, it does not reflect fully the discussion that takes place about the likely impact of the proposed admission on the existing group of young people. A recommendation has been raised in relation to the home's failure to evidence the good practice implemented in matching the needs of the group of young people they care for.

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Helping children make a positive contribution

The care team works hard to ensure that young people are fully involved in all decisions affecting their lives. All young people have care plans in place, which concentrate on how their needs are to be addressed and the roles and responsibilities of other key individuals in the young person's life. The plan is based on an assessment of their needs and detailed risk assessments. They are developing documents, which now evidence the targets set to attain positive outcomes for all young people in the home's care. Young people, social workers and other key professionals and family members are involved in monitoring and reviewing the plans.

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Helping children make a positive contribution

Young people's views and those of their families or carers and social workers are sought regularly and taken into account. Residents' house meetings are regularly offered to young people. Minutes of these meetings do not always indicate that young people receive feedback on issues they have raised at previous meetings. A recommendation has been raised to address this.

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Helping children make a positive contribution

The home maintain good contact with young people's families and their social workers and parents or carers. Young people are encouraged to maintain contact in line with their placement plans and staff give practical support in making this possible.

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Achieving economic wellbeing

The provision is good. Young people are assisted to develop skills, which will prepare them for independent living. Young people work with staff to develop a programme of independent living, which assists them to develop these skills. These plans will link into pathway plans when young people reach this stage of their development.

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Achieving economic wellbeing

The home is located on the edge of a small market town. It is set in a converted country house set in two acres of land. It provides en-suite accommodation for seven young people. The property has been converted to a high standard and maintains a homely feel. Communal areas include two lounges, a games room, a dining room and kitchen. The location of the home is convenient for leisure facilities, transport and other community facilities which are important 7 of 9 Inspection Report: SC356907 for young people's development. Young people benefit from homely accommodation which is decorated and furnished to a high standard. They have their own individual, lockable en-suite bedrooms, which are well personalised. These actions ensure the home provides a high standard of accommodation for young people, and that young people can be involved in choosing furnishings and decorations for the home.

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Organisation

The organisation is good. The statement of purpose and young people's guide provides a detailed picture about the service. This includes what the home's function and purpose is and important matters that young people need to know about, while living at the home. On admission, all young people receive a user friendly guide, that tells them what they should expect from the home, including their right to express issues about living in the home, which they may not be happy with. Recently young people have participated in developing a 'Welcome to our home' DVD which prospective new residents can view prior to coming to look around the home.

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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 plans developed by the home, identify the young people's assessed individual needs in these areas and outcomes are recorded and reviewed each month. Matters that promote fairness, such as access to the complaints system are good.

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Organisation

The staff team is a mix of male and female staff. All staff either hold relevant qualifications, are studying towards obtaining them, or are completing the organisation's induction training programme. All staff are scheduled to begin studying towards the National Vocational Qualification at level 3 within six months of starting work, with the aim of obtaining the award within one year. The staff induction training programme covers all relevant areas and it is based on the Children's Workforce Development Council programme 'Your Induction to Work in Children's Social Care'. These actions show that the organisation has systems in place for staff to obtain relevant training and qualifications. The Registered Manager ensures there are sufficient members of staff on duty, to adequately meet the needs of young people and there is evidence to show that, when young people's behaviours require it, staffing provision is

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Organisation

increased. An 'on call' system is in operation enabling staff on duty to contact senior staff at any time for support. Staff were positive about the support they receive from the home's management team. These actions show staff are suitably trained and supported.

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Organisation

The Registered Manager and senior managers within the organisation acknowledge that since the last key inspection supervision of staff has not occurred within the frequency indicated in standard 28.2 of the national minimum standards. An action plan had been implemented by the home to address this and systems are now in place to ensure supervision schedules are met. Not all staff with supervision responsibilities have received training to support them in this role. A recommendation has been made to address this.

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Organisation

Regulation 33 visits take place within the frequency required and are generally unannounced. The format followed ensures all required areas are covered. The Registered Manager completes both weekly and monthly reports that exceed regulatory requirements and takes action to address any issues raised as a result of all these checks. These actions show the operation of the home is well monitored. 8 of 9 Inspection Report: SC356907 Young people's case files are kept securely in a suitable place. They contain relevant information and young people are aware they can view their own files if they wish.

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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

7 December 2009 ensure that consent is gained for the administration of non-prescribed medicines to young people (Regulation 21) 7 December 2009 ensure that all records relating to searches carried out of young people's rooms meet the requirement of standard 9.8 (Regulation 15) 7 December 2009 ensure that young people are offered the opportunity to speak with someone outside the home about the reasons for their absence. (Regulation 16)

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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, contrary to the local authority's safeguarding guidelines, all injuries received as a result of a physical intervention are notified under safeguarding procedures (NMS 17) • ensure that there is evidence that young people receive feedback on issues they have raised in residents' meetings (NMS 8) • ensure that admission documentations reflects the level of discussion that takes place on the impact of the proposed admission on the existing group of young people (NMS 5) • ensure all staff with supervision responsibilities receive training from an external resource to equip them with the skills to undertake their role (NMS 27) • ensure that recruitment files evidence explanations given for any gaps in employment. (NMS 27) 9 of 9 Inspection Report: SC356907

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