Children's Home run by Nugent Care 2019 in St Helens

SC022447 Unique reference number 18 June 2009 Inspection date Norma Welsby Inspector Key Type of Inspection

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27 January 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: SC022447

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Brief description of the service

This children's home provides modern and domestic accommodation, for a maximum of three young women. The house is located on the site of a secure estate but is an open house and is independently equipped and has its own extensive gardens.

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Brief description of the service

Placements are arranged on a short term transitional basis, for young women who have previously been placed within one of the secure units, located on site. The purpose of the home is to provide a more focused opportunity, a stepping stone, for young women to prepare for their next placement, in an open setting. The use of this house can also allow additional opportunities for increased levels of semi-independent living within a domestic setting.

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Brief description of the service

The home's staffing structure includes team manager, senior and support care workers. The staff team is managed and supported by the on site Registered Manager. Staffing arrangements provide a dedicated staff team, with two members of staff on duty, throughout the day and night.

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Brief description of the service

The area is well served with local shops and community resources and the local town centre is approximately one and a half miles away and easily accessed by public transport.

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Summary

During this unannounced inspection all key national minimum standards were examined. The service is judged satisfactory and includes many good features. This unit has been open for 12 months and has made good progress. Staff have developed many key skills and work very well as a team in supporting young women to prepare for their next placement. Work is also in progress to strengthen the management of the service, including staff support, and this will consolidate improvements already made.

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Summary

A particularly strong feature of the service is the staff team's commitment to working closely with each young person to stay safe. A social worker involved with the service has expressed these comments, 'Staff are extremely dedicated and thorough in their efforts to keep the young person safe. I cannot praise staff highly enough'. Young people living at the service are also very complimentary about the service, commenting that it is a very positive placement for them and that 'staff really care' and work hard in their interests. 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

At the last inspection in January 2009 five actions and two recommendations were made. The Registered Manager was asked to review the reporting of safeguarding issues to ensure that procedures are robust. This action has been positively addressed in consultation with the local authority. The second action related to fire safety procedures and in particular ensuring that detailed records are maintained on site and are available for inspection. Records are now kept on site, but these records do not fully evidence that all staff receive refresher training in fire prevention. The provider was also asked to review the management arrangements of the open house to ensure effective leadership in a manner that delivers the best possible care and support for young people. This action is in the process of being complied with and interim arrangements 4 of 9 Inspection Report: SC022447 have been put in place. An action was also made in respect of the formal supervision of staff

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Improvements since the last inspection

and positive progress has been achieved, but some gaps still remain. The final action required the service to improve the quality of children's records generally and staff have made improvements in many areas.

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Improvements since the last inspection

The two recommendations related to ensuring that the Statement of Purpose includes all relevant details and that staffing arrangements were reviewed to ensure that the needs of young people are appropriately and consistently met. Both of these recommendations have been addressed, but the Statement of Purpose was again identified as having some information that is not entirely up-to-date.

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Helping children to be healthy

The provision is good. The service promotes healthy lifestyles to a good standard. Young people are provided with an excellent range of health care support to meet their needs and they are encouraged to lead a healthy lifestyle.

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Helping children to be healthy

The staff maintain a record of meals provided and a record of daily food consumption by young people. There is a good awareness of the importance of healthy eating and young people are given lots of information to raise their own awareness and personal responsibility. Cultural diversity is also embraced positively. Staff work hard to motivate young people, to be involved in menu planning, shopping and food preparation.

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Helping children to be healthy

The service benefits from the input of a qualified nurse, who is based on site on a part-time basis. As well as meeting ongoing health needs, the nurse has established a close relationship with the young women and provides advice and education, on many personal health related issues. The service is very well supported by a local doctor and the local hospital, with which special arrangements are in place. Health care notes are maintained to a good standard. Staff have attended a range of health related training courses, but have not had the benefit of specialist training in mental health, which would enable them to better meet the diverse and complex needs of young people in their care. While staff are provided with first aid training, current records do not confirm that the service provides a member of staff with a valid first aid certificate on duty at all times.

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Helping children to be healthy

Designated staff take responsibility for administering prescribed medication and ongoing refresher training is provided. Suitable storage is provided and a system of stock control is in place. Not all prescribed medication has a pharmacist's dispensing label and only very brief details had been hand written on the medication packaging. Medication administration records are satisfactory.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. The service has comprehensive policies and procedures in place to promote the safety of young people. Staff are very committed to providing young people with support and knowledge to develop their own sense of personal safety and acceptable risk taking.

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Protecting children from harm or neglect and helping them stay safe

Young people's privacy is respected and personal information is handled confidentially. 5 of 9 Inspection Report: SC022447 There is an established complaints procedure in place and a senior manager has delegated responsibility to oversee complaints. Staff take a positive approach to managing complaints and endeavour to resolve them as soon as possible.

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Protecting children from harm or neglect and helping them stay safe

Staff are knowledgeable about safeguarding and child protection procedures. A recent improvement has been in ensuring communication with the local authority, when reporting incidents, is robust and issues are followed up in a timely fashion. A comprehensive staff training programme, provides staff with regular opportunities, to undertake refresher training. A policy to counter bullying is also in place and staff manage situations well and are particularly proactive in ensuring young people are aware of bullying issues and what to do if they are bullied.

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Protecting children from harm or neglect and helping them stay safe

The service has written policies and procedures in place, in respect of unauthorised absence. Staff have good links with the police liaison officer and have established individual protocols with agreed timescales for notification.

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Protecting children from harm or neglect and helping them stay safe

Staff encourage acceptable behaviour, by providing clear boundaries and structure. A reward system is in place, along with a system of reparation. Staff have an open and positive rapport with young people and they work hard to enable young people to develop a better sense of personal responsibility and respect for others.

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Protecting children from harm or neglect and helping them stay safe

The house provides a safe and comfortable domestic environment, which is maintained to a high standard. Young people have their own personal space and access to a garden to undertake a variety of horticultural activities. Fire records to not evidence that staff receive ongoing training in fire prevention.

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Protecting children from harm or neglect and helping them stay safe

An established recruitment procedure is in place, that appropriately vets new members of staff. On site records, however, do not fully evidence that robust checks have been carried out. All visitors to the service are also vetted.

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Helping children achieve well and enjoy what they do

The provision is good. Young people are encouraged and supported to enjoy a wide range of activities and to achieve. Staff work hard to build motivation and confidence and to help young people achieve good outcomes from their placement.

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Helping children achieve well and enjoy what they do

A key worker system is in operation and regular key working sessions are taking place. Staff work confidently with the young people and they have established a positive and open rapport. Young people benefit from one to one support, but also have unsupervised time with friends and peers. Good risk assessments are in place and staff maintain open and positive communication with young people at all times.

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Helping children achieve well and enjoy what they do

Young people have an educational plan. Education is provided on-site in the school rooms and some less formal sessions also take place in-house and within the community, if this approach meets the needs of the individual better.

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Helping children achieve well and enjoy what they do

Staff support young people in their interests, acknowledge their achievements and are providing a range of new opportunities. Staff provide a good range of structured activities, balanced with a recognition, that young people also need to have some personal control, over their own leisure time. It is also acknowledged, that young people need to spend quality time with peers. 6 of 9 Inspection Report: SC022447

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Helping children make a positive contribution

The provision is good. Staff are committed to enabling young people to make a positive contribution and to achieve good outcomes from their placement. Staff feel that young people benefit from their placement, feeling more confident and better prepared to move on.

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Helping children make a positive contribution

Each young person has a placement plan in place, that is regularly reviewed. There is good evidence of very close liaison with placing authorities, with staff playing a key role in influencing the next planned placement.

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Helping children make a positive contribution

The service is effective in promoting contact with family and friends. Contact agreements are in place. Staff promote good levels of contact with family members and promote positive relations with peers.

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Helping children make a positive contribution

Staff are becoming very skilled at introducing new young people to the house and in supporting them to move on. Staff are aware of the importance of individual assessment and transitional plans, along with issues such as compatibility.

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Helping children make a positive contribution

Consultation is explored on different levels, including direct day to day consultation, a young person's forum and through key working sessions. Staff are encouraging young people to participate in the day to day operation of the home and to make a positive contribution to their placement plan and review meetings. Staff work hard to engage young people in decision making and help them to see the consequences of poor decisions and how to make better choices in future.

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Helping children make a positive contribution

An independent visitor visits the young people regularly and has done so for several years. Senior managers also visit the house regularly, but the service does not maintain a record of how often the Registered Manager visits the house.

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Achieving economic wellbeing

The provision is good. Young people benefit from a well maintained, domestic and homely environment. Good attention is given to enabling young people to manage money effectively and to respect their own and other people's belongings. Staff also work hard to encourage young people to work positively towards their future and to develop their personal responsibility. For example, young people are involved in a range of activities that improves their confidence and insight into various social situations.

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Organisation

The organisation is satisfactory. The management of the open house is the responsibility of the Registered Manager, who also manages the on site secure service. The house has a dedicated staff team, including a team leader. While many of the day to day responsibilities are delegated to a team of staff, who have varying positions within the organisation, the Registered Manager maintains overall responsibility as a registered individual. Currently, however, a record of the time the Registered Manager spends in the open house is not maintained. 7 of 9 Inspection Report: SC022447 The house has a stable staff team. Recent internal changes have achieved good outcomes and staff are developing an excellent range of skills to support young people in this open setting and prepare them for moving on. Good staffing ratios are deployed and staff work flexibly to meet individual needs. Young people feel very well supported and were very complimentary in

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Organisation

All day staff, with the exception of just one relief member of staff, have achieved national vocational qualification (NVQ) to level 3. In the near future night staff are also to be given the opportunity to study for NVQ's. Staff have regular team meetings and also receive formal supervision. While the supervision of staff has improved considerably during the past six months there are still gaps in the frequency of supervision taking place which means that National Minimum Standards are not met in respect of all staff.

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Organisation

There are other shortfalls in specific areas of management responsibility. For example, the Statement of Purpose is not always up-to-date and all relevant information and significant records, such as measures of control, are not adequately or thoroughly monitored.

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Organisation

The promotion of equality and diversity is good. Young people receive very individualised support to meet their assessed needs and staff are highly committed to helping young people stay safe. Operational policies promote anti discriminatory practice and evidence supports the service's commitment to further improving equality and diversity in practice to enhance outcome for young people.

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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 July 2009 ensure that at all times at least one person on duty has a suitable first aid qualification (Regulation 20, NMS 13) 18 July 2009 ensure that on site staff records evidence full details of recruitment checks including level of CRB check and confirmation of POCA check and a photograph (Regulation 26 Schedule 2, NMS 27) 18 July 2009 ensure that the statement of purpose contains all relevant and up-to-date information, for example current staffing details (Regulation 4, Schedule 1, NMS 1) 18 July 2009 ensure that significant records, such as measures of control, are regularly monitored by the registered manager and includes a signature against each entry and details of any subsequent action. (Regulation 17, NMS 22) 8 of 9 Inspection Report: SC022447

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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): • provide staff with appropriate training and support to meet mental health needs of young people (NMS 12) • ensure that all prescribed medication held on site is properly labelled with the pharmacists dispensing label (NMS 13) • provide all staff with refresher training in fire prevention and ensure accurate records are maintained (NMS 26) • maintain a record of the Registered Manager's time spent visiting/managing the unit (NMS 33) • ensure that staff supervision is more rigorously pursued particularly when a planned session does not take place. (NMS 28) 9 of 9 Inspection Report: SC022447

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