Children's Home run by Keys Child Care Limited in Warrington

SC026991 Unique reference number 27 January 2010 Inspection date Karen Forster Inspector Key Type of Inspection

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26 August 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: SC026991

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Brief description of the service

This service is maintained by a nationwide independent company. The children's home accommodates four children of either sex, aged between nine years and 17 years. The service provides medium- to long-term care for children with attachment disorders.

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Brief description of the service

The premises provides shared space for the group, which includes lounge and diner, a second lounge, kitchen, garden and bathing facilities.

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Brief description of the service

There were four young people resident at the time of the visit, all of whom contributed towards the inspection.

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Summary

This visit is an unannounced key inspection including all of the Every Child Matters outcome areas, plus an additional outcome area of organisation. This is an outstanding service. Outcomes for individual children and young people are excellent, and demonstrate individualised care and support that reflect young people's needs exceptionally well. Recommended areas for further development include; improved access to laundry facilities and a review of the paint work to the exterior of the property. A review of the medication administration records is also recommended. The overall quality rating is outstanding. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

The recommendation from the previous inspection report has been addressed, ensuring that records of the looked after child medical are now included within young people's files.

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Helping children to be healthy

The provision is outstanding. Healthy lifestyles are extremely well promoted through the consistent use of healthy eating plans, and the provision of a wide range of physical activities. The young people's records include a comprehensive list of known food preferences, and staff encourage young people's involvement in both menu planning and meal preparation. Healthy snacks such as fruit and fresh drinking water are always available, and treats are well monitored by staff. This means that young people enjoy a balanced and varied diet. Young people make good use of regular opportunities for exercise and outdoor activities.

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Helping children to be healthy

Health care records are very comprehensive and include details of the last looked after child medical. This means that historical and current health care needs are clearly recorded, and used well to inform the young people's health care programmes. There is evidence that primary health care professionals are consulted whenever required, and young people benefit from the consistent manner in which prescribed courses of treatment are implemented by their support staff.

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Helping children to be healthy

Items of medication are administered with a high regard to medical detail, by care staff who are trained in medication administration. Medication is kept securely in a locked medication 4 of 9 Inspection Report: SC026991 cupboard in the office, and there is a sound system for stock checks on stored medication items. Clear policies and procedures are in place and are well known and implemented by staff. This means that young people are offered medication in line with their medical prescription, and staff on subsequent shifts know when medication has been offered and administered. Although medication administration records are completed appropriately, there is a risk of a minimal margin of error due to the lack of space for the day and date entries. This means that staff's date entries are not always clear, as the print is very small. The majority of staff have attended a one-day emergency first aid course and recently appointed staff are scheduled to

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Protecting children from harm or neglect and helping them stay safe

The provision is outstanding. The home's personal care procedures promote the privacy and safety of young people extremely well. Young people and staff maintain a high regard to the privacy of others, which means that individuals can have uninterrupted use of their bedrooms and bathrooms. Personal data relating to young people is stored securely in line with internal policy and the standards.

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Protecting children from harm or neglect and helping them stay safe

There is a comprehensive complaints procedure in place, which is well known by staff and young people. The home's young people's guide provides child-friendly guidance on how to make a complaint. The home's complaints record indicates that comments are well received and followed up by senior staff within the service. This means that complaints from external parties and young people's comments are taken seriously, and the complainant is updated with the progress of their case.

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Protecting children from harm or neglect and helping them stay safe

Children’s safeguarding procedures are excellent, with young people’s welfare a top priority. Staff confirmed that they are aware of their responsibilities within the home’s child protection procedures and have received safeguarding training. The local authority's safeguarding manual is available within the home to complement the home's clearly written safeguarding policies. The internal protocols have been verified by the Local Safeguarding Children Board, as required by the standards.

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Protecting children from harm or neglect and helping them stay safe

Young people report that incidents of bullying are rare, and staff swiftly intervene to discourage any unacceptable behaviours from escalating. There is an obvious culture of open and positive communication between the young people and adults within the group, where staff explain to individuals why certain behaviours are unacceptable. This means that young people learn to manage their own behaviour and explore the impact of their behaviour on others within the group.

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Protecting children from harm or neglect and helping them stay safe

The home's protocol regarding young people going missing from care suitably reflects the dependency levels of the service users. Staff members are clear regarding permissible measures to use in an attempt to stop young people leaving the home without authority. The home's policy is clear, meets the standards and staff are familiar with the content. This means that any episodes of missing young people would be followed up with suitable responses, reflective of the gravity of the situation.

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Protecting children from harm or neglect and helping them stay safe

Young people using the service are helped to appreciate when they present acceptable behaviour, through the use of meaningful positive rewards. This means that young people receive consequences that they value and which encourage the presentation of acceptable behaviour. 5 of 9 Inspection Report: SC026991 The consequences of any unacceptable behaviour, including, for example, a brief loss of privilege are in line with the standards and suitable for the group.

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Protecting children from harm or neglect and helping them stay safe

The home's policy regarding physical intervention meets the standards, and all established staff have received instruction in the safe control of challenging behaviours. The preferred model of physical intervention includes de-escalation and only uses restraint as a last resort, which meets the standards and helps to keep young people safe. The recording of restraints within the home meets the standards. A clear, factual, written account containing all of the elements required by the standards, is completed for every episode of intervention within the home.

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Protecting children from harm or neglect and helping them stay safe

There are detailed risk assessments in place for each of the young people. These are frequently reviewed alongside the care placement plans. Comprehensive risk assessments are also in place in relation to the living environment and the home's fire safety. The detailed fire safety risk assessment is well implemented to reduce the risk of fire within the home. The home's checks on utilities within the home, including oil and electrical supplies, are in order and meet the standards. This means that the home takes consistent action to maintain the safety of occupants and visitors.

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Protecting children from harm or neglect and helping them stay safe

The home maintains suitable evidence for all of the clearance checks for new staff, as required by schedule two of the regulations. This means that young people are cared for by suitably cleared staff from within the home.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Young people receive a personalised care service that is highly suitable to their needs, and promotes their abilities. Staff work hard to address the care objectives outlined within the care placement plan, by maintaining a continuity of care and consistent relationships with the young people and their placing authorities. There is a clear link established between the care action plan and the content of key worker sessions. This means that areas identified for development are given good priority, and receive the attention of the young people and key worker. The level of both verbal and written communication between staff in the home is sound, and means that staff are consistent in their approach towards individual young people. Therefore, young people enjoy consistent, safe care programmes that optimise their abilities and help to further develop their social and emotional development.

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Helping children achieve well and enjoy what they do

Staff encourage hobbies and interests, but also provide new opportunities for individuals. Every effort is made to give the young people broad life experiences, and to access a range of facilities and services in the community. Positive problem solving is used to break down any obstacles to community access, which enables young people to grow and realise their potential. Staff are committed to promoting a good range of opportunities that are enjoyable and enable individuals to experience positive achievements. This means that young people are extremely well supported and encouraged to enjoy activities and achieve.

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Helping children achieve well and enjoy what they do

The young people attend full-time education, and daily contact is maintained with the respective school networks. Home staff liaise closely with staff in class to provide a positive level of support to individuals, and promote a consistent approach to academic progress. This means that young people are encouraged and well supported to attend class, and complete their academic programmes. 6 of 9 Inspection Report: SC026991

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Helping children make a positive contribution

The provision is outstanding. Young people's strengths and needs are clearly identified through statutory assessments and care planning mechanisms, provided by the respective placing authority. This data is then extremely well managed by the service, to inform the internal therapeutic programme and care placement plan. This means that staff within the service are very familiar with the young people's histories, and highly knowledgeable in relation to their presenting therapy and care needs. Therefore, young people receive an integrated programme of care and therapy, that very closely matches their personal profile.

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Helping children make a positive contribution

Regular care reviews take place, and records indicate that young people's views are taken into account within this review process. This means that young people's care is consistently monitored by independent personnel, to check that the care provided continues to meet identified needs. The staff prepare highly detailed review reports, which enhance the quality of discussion within the review programme.

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Helping children make a positive contribution

Contact arrangements for each of the young people are extremely well planned and implemented from within the home. Practical and emotional support is provided by key staff, to enable young people's contact with significant individuals. Any restrictions on contact are clearly recorded and respected by key staff in the home. This means that young people keep in touch with people that are important to them.

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Helping children make a positive contribution

The young people's records include comprehensive pre-admission information, including risk assessments and placement information records. The relevant looked after child documentation is maintained within the home during and after admission for reference. This very positive level of data provides the home's staff with a wealth of relevant information, to inform their safe care of individual young people. A positive level of contact between the service and young people is developed pre-admission. Designated key workers meet young people prior to the start of the placement, which means that individuals are prepared and informed during the move to their new home.

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Helping children make a positive contribution

All of the young people within the group are actively encouraged to make a positive contribution to the service. Staff take regular planned and incidental opportunities to listen to young people's views, and to involve all individuals in plans for the home. This makes young people feel involved and an important part of the group.

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Achieving economic wellbeing

The provision is good. Young people are provided with plenty of opportunities to practise their existing life skills, and to develop new self-help skills. This provides individuals with a firm foundation for their future life. Those young people eligible for statutory pathway planning, are working with the responsible placing authority to develop suitable transitional programmes of care. This means that older residents within the home are receiving positive support from their social workers and care staff, to develop a plan of care for after their 16th birthday.

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Achieving economic wellbeing

The home is well designed and meets the accommodation needs of the group of young people very well. There is a wealth of space, both inside and outside the home, which benefits the young people as it provides them with opportunities for leisure opportunities. The paintwork 7 of 9 Inspection Report: SC026991 on the home's external wooded fascias, is peeling and missing in places. This detracts from the otherwise positive external view of the building.

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Achieving economic wellbeing

The living environment is furnished and decorated to a high standard and provides a very homely and domestic environment. The home's washing machine was out of operation at the time of the inspection, which restricted the group's access to laundry facilities. There is no impact on young people's outcomes however, as arrangements were in hand to use the local launderette facilities until the new unit is fitted. Sleeping accommodation is provided within single bedrooms, which are very personalised and child-friendly. Bedroom doors are alarmed to alert the sleeping-in night staff to any night time activity.

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Organisation

The organisation is outstanding. The home provides a clearly written Statement of Purpose that meets the requirements of schedule one to the regulations. This means that clear and current information relating to the service, is available for stakeholders and interested parties. The young people's guide to the home is readily accessible and the content is well known to the resident group.

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Organisation

The promotion of equality and diversity is outstanding. Young people benefit from the staff group's well- developed understanding and sensitive approach to their individual needs. Young people's heritage is respectfully recognised and well celebrated within the group. Care planning information is extremely well implemented by staff, to provide care that promotes each individual's identity. This means that the content of the care plans and staff practice build on young people's strengths, and focus on the abilities of individuals using the service. Young people share and enjoy leisure opportunities and community activities with their peers, from both within and from outside the home.

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Organisation

A large proportion of staff are trained at level three in the National Vocational Qualification (NVQ), for the residential care of children and young people. This means that the abilities of most of the staff have been independently assessed against a national standard. An optimum level of reflective practice is used within the staff group, which allows training and instruction to inform and improve the outcomes for young people.

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Organisation

Generous staffing levels allow for the well-planned programmes of care to be consistently implemented to a high standard. Staff are seen supporting young people through their daily care routines, meal times, therapy sessions, leisure activities and during non-structured times. This means that young people have consistent access to familiar staff throughout their day. The care within the home is extremely well organised by the manager, who makes very good use of the skills within the staff team. Thus motivated and enthusiastic staff provide positive outcomes for young people.

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Organisation

The home's comprehensive induction programme reflects the induction standards for care staff provided by the Children's Workforce Development Council. This means that new staff receive a childcare specific foundation training programme, which includes a nationally recognised competence assessment. A very broad level of foundation and specialist training is provided as part of a rolling programme by the provider company. This training clearly matches the home's statement of purpose and the needs of the resident group. 8 of 9 Inspection Report: SC026991 The quality of care is monitored very regularly by senior staff within the home, and the resulting reports meet the requirements of schedule six to the regulations. The accounts of the quality of care practice include feedback from young people, their families or social workers. This feedback mechanism is a very positive feature of the quality assurance programme, and is

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Organisation

indicative of the consultative and proactive culture of the home.

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Organisation

The service maintains two well-indexed files, that contain all of the young people's records as required by schedule three of the Children’s Home’s Regulations 2001. This means that both current and historical personal record information is available within the home. The home's care placement action plan is written in the first person, which maintains the young person as the focus of the plan and helps the subject's understanding of the information.

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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): • review the format of the medication administration records, to ensure that sufficient space is allowed for date and day entries (NMS 13) • ensure that the home has consistent access to laundry facilities within the service (NMS 24) • review the state of repair of the external paintwork on wooden fascias on the building and repair where necessary. (NMS 24) 9 of 9 Inspection Report: SC026991

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