Children's Home run by 4d Care Ltd in Cambridgeshire

SC064557 Unique reference number 10 August 2009 Inspection date Joanne Vyas Inspector Key Type of Inspection

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26 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 10 Inspection Report: SC064557

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Brief description of the service

This home is a large detached property located in a small village. It is registered to accommodate up to six young people aged between 12 and 18 years with emotional and behavioural difficulties. The home is fully equipped for all aspects of daily living and provides sufficient space for group and separate activities. All young people have their own bedroom. There are two small classrooms in a building on the home’s grounds for the exclusive use of young people living in the home. This facility is registered with the Department for Education and Skills.

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Brief description of the service

Five young people currently live in this home, of which, four were present and participated in the inspection.

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Summary

At this full unannounced inspection all key standards were inspected.

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Summary

This home has been judged as inadequate due to poor health and safety procedures and the potential risk of serious harm to both staff and young people, in particular with regard to the high risk from fire. Nevertheless, young people say that they are happy, feel well cared for and appreciate the family atmosphere provided. A young person said, 'This is the best care home I've ever been to'. Their welfare is enhanced by the positive relationships that exist between staff and young people, and between young people and their peers. There is a strong focus on meeting the needs of each individual young person including supporting and encouraging them to value their cultural and religious backgrounds. The promotion of equality and diversity is good throughout the standards inspected. Staff work closely with a wide range of outside agencies in order to meet the full range of young people’s needs. However, improvements can

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Summary

be made to health and safety procedures, in particular, with regards to fire. Monitoring of these procedures has failed to identify major shortfalls. Placement plans do not provide enough detail. First aid given to young people and the effectiveness of any sanctions given are not recorded. The overall quality rating is inadequate. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

At the previous inspection, the Registered Manager was asked to comply with two actions and one recommendation. He was asked to ensure placement plans, including the health care plan, are kept under review and revised as necessary. Placement plans are now revised every three months and provide a basic insight into the assessed needs of young people. A new placement plan is going to be introduced which will provide a more comprehensive account. The Registered Manager was also asked to ensure records for young people are always signed and dated. This has been fully complied with.

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Helping children to be healthy

The provision is satisfactory. Staff are focussed and committed to ensuring a good quality provision for health care for young people living at this home. They are proactive and responsive to the emotional and health care needs of the young people. All young people are registered with doctors, dentists and opticians. 4 of 10 Inspection Report: SC064557 A qualified play therapist is part of the management team and provides play therapy as appropriate for young people. They also have access to other healthcare professionals including mental health services. Each young person has a satisfactory health plan which is up-to-date.

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Helping children to be healthy

Young people are given choice regarding the food they eat. They take an active role in planning, shopping and helping to prepare meals. This is something they take pride in. Some young people have special dietary needs or preferences which staff are aware of and encourage the young people to plan menus that reflect this. Most staff have undertaken their basic food hygiene training.

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Helping children to be healthy

The safe handling of medication is well managed in this home. Staff receive training in the safe handling of medication. None of the young people currently take any prescribed medication and there is only a small stock of homely remedies. Medication is accurately recorded, received and disposed of appropriately.

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Helping children to be healthy

All accidents are recorded but any first aid given to a young person is not recorded. All staff are trained in first aid and renew their training as appropriate.

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Protecting children from harm or neglect and helping them stay safe

The provision is inadequate. The privacy of young people is respected by staff. The living arrangements provide space where they can relax and easily find privacy away from others if they wish. All bathrooms have appropriate locks on the doors. Staff knock on bedroom doors and wait to be asked to come in before entering. All records are kept confidentially. Young people's issues are not discussed openly.

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Protecting children from harm or neglect and helping them stay safe

The safety and rights of both staff and young people are protected. Staff are concerned about keeping young people safe and are competent in their knowledge of protecting them. Young people said they feel safe living at this home. A young person said, 'Yes I feel safe. I know all the staff so I can speak to them. I've got the home's number so I can call them. If its an emergency, they'll pick me up straight away'. Staff receive training on safeguarding young people as part of their induction and then at regular intervals. All bullying is taken seriously and dealt with effectively. Young people said there is very little bullying and everyone is aware of the consequences for bullying and these take effect immediately. A young person said, 'There's a little bit of teasing, like within a family. Staff talk to you if there are any problems'. There are comprehensive risk assessments in place. The high staffing levels, vigilance and

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Protecting children from harm or neglect and helping them stay safe

working practices adopted by the home go some way to reducing opportunities for bullying to occur. For example, staff work with young people to develop their understanding of the diversity of their community and the importance of tolerance of others. Discussion with young people supported this work takes place. The home has a written procedure for action when young people are absent without authority. There are few incidents of absconding from the home. Young people are enabled by the procedures to return to the safety of the home in a supported manner.

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Protecting children from harm or neglect and helping them stay safe

Concerns raised by parents and young people are appropriately and swiftly resolved. Opportunities exist for young people to make complaints within the weekly house and key worker meetings as well as informally through daily contact with staff. Young people are fully aware of the complaints procedure and are given feedback about the outcome of their 5 of 10 Inspection Report: SC064557 complaints. A member of staff said, 'We listen and encourage them to look at solutions and options'.

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Protecting children from harm or neglect and helping them stay safe

Staff view young people positively and there is a family atmosphere in the home. Young people said that the rules are fair and are there for their safety. They also said that restraints are carried out properly and for the right reasons. They are not injured during restraints. Sanctions are also given out fairly. Staff are given training during their induction, which includes de-escalation as well as physical intervention. There is a minimal amount of physical intervention carried out in this home. The behaviour management plans are satisfactory. Sanctions are applied fairly and appropriately. Staff effectively manage challenging behaviour in a calm and professional manner.

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Protecting children from harm or neglect and helping them stay safe

Young people are protected by satisfactory recruitment procedures. Safety checks are completed and staff only commence employment when they have a satisfactory Criminal Records Bureau (CRB) disclosure and two satisfactory references. All visitors sign into the building and must show identification.

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Protecting children from harm or neglect and helping them stay safe

The home does not have risk assessments for aspects of safety of the premises and grounds. There is a fire risk assessment but it is unclear when this was last reviewed as there is no date on the assessment. Young people’s behaviour and activities are risk assessed. Young people know the fire evacuation procedures. All staff are given fire safety training during their induction and fire drills are carried out regularly. Records of fire drills do not state the time the drill was carried out to show that drills are carried out at different times of the day and night. Fire safety equipment is checked by external contractors every six months but is not checked regularly, by the home's staff, as per the home's fire risk assessment. A number of fire doors do not shut properly and a handle is missing from the inside of the dining room door, therefore, making it difficult for someone to escape that room. Some fire doors, including the kitchen door, are

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Protecting children from harm or neglect and helping them stay safe

propped open. A pan over half full of oil was found on the cooker hob. This is used for frying chips. This is an extremely hazardous practice and the pan was removed at the time of the inspection. Cleaning chemicals are stored in an unlocked cupboard under the kitchen sink to which young people have access. Food stored in the fridge is not labelled with the date of opening and the date it should be discarded. Window restrictors in young people's bedrooms have been removed or broken. Young people and staff are not protected by the home's health and safety procedures and therefore are potentially at risk of serious harm.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Young people have excellent relationships with staff and are kept active. Activities include fishing, camping, cycling and day trips. There are lots of resources within the home such as game consoles, DVDs, books and games. Also the home has four vehicles to transport young people. The young people’s own individual interests are supported. Young people have just returned from a holiday to Croatia which they said they thoroughly enjoyed. Young people are involved in planning activities, outings and holidays.

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Helping children achieve well and enjoy what they do

Staff are positive in their approach to education and its value for young people. All young people are in full time education, most of which takes place in the home's own education rooms. Staff support young people in school where this is required to ensure they can access the full curriculum. They ensure each young person's education is promoted and supported. 6 of 10 Inspection Report: SC064557 Individual support is detailed in each young person's placement plan. Observations and discussions with staff demonstrate that staff ensure each young person's individual needs are fully met. Young people are encouraged to value their own culture and religion. The practical individual support is reflected in the records of key worker sessions along with memory books which depict activities that young people have taken part in. These include work on cultural identity, activities and holidays. The staff know the young people well and are very

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Helping children achieve well and enjoy what they do

knowledgeable of their individual needs and the implications this has for their care.

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Helping children make a positive contribution

The provision is satisfactory. Staff are able to provide a high standard of care to young people and meet their individual needs with the knowledge and understanding they have of them. An assessment of need, placement plan and risk assessments are in place for each young person. Plans are reviewed on a three-monthly basis. Plans currently provide basic information and are not comprehensive. Young people, their parents and their social worker are consulted about the plans and subsequent reviews. A record is made at the end of each day for each young person, documenting their mood, activities, behaviour and other relevant information. Reports compiled at the end of each week are copied to parents and social workers. Key workers ensure they spend time with the young people they key work for and document these sessions.

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Helping children make a positive contribution

Statutory reviews are taking place within the required timescale. Records of the meetings are held alongside reports prepared by staff prior to reviews taking place. Collectively they provide evidence that details areas of progress. Young people confirm they are encouraged and supported to attend their reviews. They work with their key worker prior to the review to prepare the report.

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Helping children make a positive contribution

The Statement of Purpose clearly sets out the home’s admission policy. Young people are supported during the admission process and when leaving the home. Staff carefully consider group dynamics when admitting a new young person.

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Helping children make a positive contribution

Staff encourage and support young people in maintaining contact with parents and everyone else who is significant to them. A young person said, 'Staff nag me to keep in contact with my family!' Staff facilitate contact with parents, support young people to ensure it is positive for the young person, parents and siblings and ensure parents and social workers are kept up-to-date with the progress young people make. Plans detail the role of contact in promoting cultural identity and experiences.

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Helping children make a positive contribution

Young people are given the opportunity to make appropriate choices and decisions. They recognise that staff are supportive in helping and guiding them towards making positive decisions for themselves. They gave the role of their key worker and house meetings as examples. Minutes evidence diversity and tolerance are regular agenda items. The relationships between young people and staff are excellent. Young people are relaxed in the company of staff and are quick to approach them with any issues they may have.

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Achieving economic wellbeing

The provision is satisfactory. Young people live in a homely environment with high quality furnishings. There is a large amount of communal space. The young people have good facilities. Their bedrooms are highly 7 of 10 Inspection Report: SC064557 personalised and they can personalise communal areas if they wish and photographs of young people and staff are evident. The home is clean and tidy and relatively well maintained. The management team are aware of the maintenance issues and plans are in place to ensure they are dealt with. Young people value their home and their surroundings.

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Achieving economic wellbeing

Young people have leaving care plans in place. Leaving care is well planned and sensitively carried out. Staff encourage young people to carry out a variety of tasks independently or with support. These include cooking, shopping and cleaning. Each young person's placement plan clearly identifies independence work young people are encouraged to carry out. Staff provide a consistent and committed approach to enabling young people to successfully transition into adulthood.

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Organisation

The organisation is inadequate. There is a clear Statement of Purpose that reflects the practice and functions of the home. Staff provide each young person with a guide to the home when they first arrive. This ensures that young people understand the ethos of the home, the rules and the type of activities they can expect to be involved in. The commitment to promoting equality and diversity is explicit in this information.

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Organisation

Staff training is supported by the organisation. An annual programme covers mandatory training which all staff are expected to undertake. However, less than half of the staff have a National Vocational Qualification (NVQ) level three or above and this is in Health and Social Care. Although it is recognised that this qualification has been taken at a children's home, and therefore has some relevance, it is not the qualification asked for by the National Minimum Standards i.e. the Care of Children and Young People. However, staff have completed other specialised training this year with regard to children and said they found this very useful.

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Organisation

There are sufficient staffing levels to meet the needs of young people. A record of staff shifts is recorded on the home's rota and this shows there is a balance of gender and cultural backgrounds of staff wherever this is possible. Staff hand over meetings ensure that each shift is appropriately planned and issues arising from earlier are competently communicated.

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Organisation

The promotion of equality and diversity is good. Evidence supports a consistent commitment to improving equality and diversity in practice. Young people receive an individual service in the home which is designed to meet their personal needs. All staff have a good knowledge of the young people they are working with ensuring their needs are consistently met.

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Organisation

The monitoring of the home by the manager is not evidenced by regular signing of records. However, a three-monthly report is completed on the functions and practice of the home. Additionally, the organisation employs an independent person to visit at least once a month to check how the home is run and also produces a report. However, these reports have failed to identify the poor health and safety procedures, in particular with regard to fire, in operation at this home. The lack of such monitoring and its inaccuracy may adversely affect the safety and wellbeing of young people who live in this home.

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Organisation

Young people's records are kept in good order and reflect the information necessary for staff to care and support them throughout the placement. 8 of 10 Inspection Report: SC064557

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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 August 2009 ensure, after consultation with the fire authority, to take adequate precautions against the risk of fire; provide adequate means of escape and the review of fire precautions and testing of fire equipment at suitable intervals (Reg. 32) 23 August 2009 ensure all parts of the home to which children have access are so far as reasonably practicable free from hazards to their safety. This specifically relates to cleaning chemicals stored in an unlocked cupboard in the kitchen; food labelling and the use of a pan of oil for frying chips (Reg. 23) 31 August 2009 ensure unnecessary risks to the health and safety of children accommodated in the home are identified and as far as possible eliminated (Reg. 23) 31 August 2009 ensure the person carrying out the visit under Regulation 33 inspects the premises of the children's home, reporting on its physical condition. This specifically relates to fire hazards within

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Due date Action Standard

the home (Reg. 33) 31 August 2009 ensure a system is established and maintained, which monitors the matters set out in schedule 6, at appropriate intervals. This specifically relates to the incorrect reporting of fire hazards and fire equipment checks (Reg. 34).

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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 a written record is kept by the home of all first aid treatment given to children (NMS 13.2) • ensure a record of the use of sanctions include the effectiveness of the sanction (NMS 22.10) • ensure at least four fire drills are held, including drills held at night, within a twelve month period (NMS 26.8) • ensure each child's placement plan clearly sets out all their assessed needs specifically with regards to their cultural, religious and dietary needs (NMS 2.1) • ensure there are systems in place to sign the home's records, as set out in schedule 6, at least once a month, to identify any patterns or issues requiring action (NMS 33.1) 9 of 10 Inspection Report: SC064557 • ensure that staff complete a National Vocational Qualification Level 3 in the Care of Children

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Recommendations

and Young People (NMS 29.5). 10 of 10 Inspection Report: SC064557

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