Children's Home run by Children and Family Services Limited in Luton

SC028599 Unique reference number 11 February 2010 Inspection date Mary Timms Inspector Random Type of Inspection

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10 September 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: SC028599

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Brief description of the service

This is a privately owned children’s home which provides residential care for up to four children with learning difficulties who may also have a physical disability. The home is an extended detached domestic dwelling in a residential area of a large town. Children have individual bedrooms of which some have ensuite facilities. Required adaptations and equipment are provided. There is a garden to the rear of the home.

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Summary

This was an unannounced interim inspection. The visit was planned to review care arrangements against key national minimum standards under the staying safe outcome area. The progress the registered person has made with previously set required actions and recommendations was also reviewed.

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Summary

A number of areas set for improvement on the full inspection in September 2009 have not been actioned. Inadequate arrangements are in place to ensure that children stay safe. Findings include areas of poor record keeping and unsafe recording systems. There is a lack of evidence that appropriate action is always taken to ensure that children are fully safeguarded. Management monitoring is not robust and fails to ensure that areas of shortfall are identified and acted upon promptly.

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Summary

This report includes limited reporting under organisation, positive contribution, economic wellbeing and being healthy. 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

Areas of improvement are noted, however, action has not been taken in all areas of required action set on the previous inspection. There is also a lack of progress with some of the recommendations set to raise standards in line with national minimum standards.

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Improvements since the last inspection

The recording of the administration of medication is improved. The registered person has ensured that staff understand their role in recording and witnessing medication given to children. A thermometer has now been placed within the medication storage cabinet, however, there is still no structured system to check the temperature of the medication cabinet to ensure that it is appropriate for the medication in use. The service has taken action to collate a plan of action should an emergency medical situation arise which will require the support of an individual with parental responsibility.

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Improvements since the last inspection

Records kept when a measure of control is used are again found to lack adequate detail and to not fully meet the requirements of regulation and national minimum standards, necessary to evidence that children are fully safeguarded.

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Improvements since the last inspection

Action has been taken to provide a copy of the Local Safeguarding Children Board procedures for staff. The home's safeguarding procedures have not been updated to clarify the actions which should be taken should an allegation be made against a member of care staff. 4 of 9 Inspection Report: SC028599 Areas are again found where care arrangements are not supported by a thorough and detailed risk assessment to support the protection of children.

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Improvements since the last inspection

Placement plans continue to lack detail in some areas. The registered person has taken action to initiated the review of children's placement plans, however, there is a lack structure to the review process. Plans are currently 'under review'. There is a lack of clarity to show how children's progress is monitored, a lack of evidence of when plans were written and agreed, and the date of the last review. The acting manager demonstrates that there is a plan to in future record the dates and changes made to plans on each review.

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Improvements since the last inspection

The registered person has taken action to plan fire evacuation drills for the coming year. One drill has recently been facilitated, however, the event has not been recorded in the dedicated fire log. Action has not been taken to consult with the local fire authority in order to clarify the need to produce individual fire evacuation plans.

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Improvements since the last inspection

The service has not implemented structured systems to gather feedback from placing social work teams or parents, however, does plan to initiate group meetings during which feedback about the quality of the service will be gathered.

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Improvements since the last inspection

Staff training records are again found to be poorly maintained and on the day of inspection there was a lack of clarity as to which staff had undertaken which areas of training. Some further information was provided following the inspection which demonstrates that key areas of training are arranged. There is a lack of evidence that each member of staff has been appropriately trained and are authorised by a responsible health professional to carry out health care tasks in relation to the care of individual children.

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Improvements since the last inspection

It was not possible to fully assess how the home implements an induction programme for staff as there have been no new starters since the last inspection. However, the service does not yet have in place an induction programme for future new staff which reflects the standards set by the Children's Workforce Development Council. The arrangements for the provision of one-to-one supervision for staff are improved.

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Improvements since the last inspection

The carpeting within the home has been improved. Some carpets have been cleaned and others have been replaced, thus improving the quality of the environment for children.

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Helping children to be healthy

The provision is satisfactory. The service has recently reviewed the medication policies and procedures, staff training has been provided and there are good links with a local pharmacy. There is a lack of process in place to monitor the temperature of the medication cabinet, necessary to ensure the safe storage of some medication.

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Helping children to be healthy

The service supports children who have some areas of skilled health care tasks necessary to support their individual needs. Staff undertook recent refresher training in relation to supporting children with a gastrostomy tube. However, the service has not obtained the endorsement of the responsible health professional to support practice, and to confirm that only trained and skilled staff carry out health care tasks for children. 5 of 9 Inspection Report: SC028599

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Protecting children from harm or neglect and helping them stay safe

The provision is inadequate. Children are not always protected by care arrangements.

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Protecting children from harm or neglect and helping them stay safe

Fire safety procedures have recently been reviewed and updated. However, a current fire safety risk assessment has not been produced to support safeguarding arrangements within the home. This means that decisions, such as not using fire safety symbols within the home, are not supported by a current risk assessment to clarify that this is not a risk to children. A fire evacuation drill was recently undertaken with both staff and children, however, this has not been recorded within the home's own fire safety records.

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Protecting children from harm or neglect and helping them stay safe

Individual care arrangements are not always informed by a detailed risk assessment for areas of known and potential hazard, necessary to inform staff practice and to clarify how children will be fully safeguarded.

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Protecting children from harm or neglect and helping them stay safe

Local Safeguarding Children Board procedures are readily available to staff working in the home. The home's safeguarding children policies and procedures have been reviewed since the previous inspection. However, these do not clarify that any allegation against care staff must be referred to the local authority designated officer. This raises the potential that should such a referral be necessary it may be processed inappropriately.

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Protecting children from harm or neglect and helping them stay safe

There is poor record keeping in relation to occasions when children are found to have marks or bruises on their body. Whilst a record is kept showing the mark has been noted, detailed records are not maintained of the circumstances, and the concern is not automatically referred to the local authority or placing social worker. There is also a lack of adequate record keeping on occasions when children are 'hit' by another resident. Records fail to adequately clarify the children involved, whether there was an injury and how this has been followed up. There is no confirmation of appropriate notifications. There is also a lack of evidence of robust management oversight of these concerns, necessary to ensure that appropriate action is taken on such occasions and to evidence that children are fully safeguarded.

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Protecting children from harm or neglect and helping them stay safe

The home has a complaints record book. However, this is found to be an unsafe recording system due to having had pages torn from the log. There is also no index system to support robust record keeping and management oversight of complaints.

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Protecting children from harm or neglect and helping them stay safe

Records required by regulation and national minimum standards are not maintained in relation to the use of a measure of control. A loose leaf record is kept of observations of events leading to the use of a measure of control, however, the level of recording fails to meet requirements and the recording system is unsafe. The documents are not always filed appropriately, which raises the potential for documents to go missing or to be missed within management monitoring.

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Helping children make a positive contribution

The provision is satisfactory. Children's care is informed by an individual placement plan. However, sometimes plans are not adequately detailed to ensure that needs will be fully met, and are not always supported by an 6 of 9 Inspection Report: SC028599 assessment of need. There is also a lack of clarity as to the home's procedure for monitoring children's progress and for reviewing placement plans.

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Achieving economic wellbeing

The provision is satisfactory. Children are encouraged to develop new skills and abilities. However, written plans do not reflect an assessment of need and lack clarification about how children's progress will supported and monitored. This means that children's care is not informed by a comprehensive and agreed plan, necessary to support and guide their transition towards an adult placement or semi-independence.

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Organisation

The organisation is inadequate. There is a vacancy for the position of Registered Manager within this service, an acting manager currently has management responsibility for this home. There is also a deputy manager and experienced senior staff.

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Organisation

Staff training records are not maintained in good order. There is a lack of accessible individual staff training records to evidence that staff are appropriately knowledgeable and competent. Some further information was forwarded to Ofsted shortly after the inspection which shows that staff team have attended recent training in relation to safeguarding children, and confirms that some staff have attended fire safety and behaviour management training. The service does not have in place an induction programme developed for new staff which reflects the standards set by the Children's Workforce Development Council, this means that the service may not develop and support new staff in line with national guidelines for the children's workforce. Staff receive regular one-to-one supervision which supports their development and care arrangements for children.

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Organisation

There is a lack of robust management monitoring of care arrangements necessary to ensure that children are fully safeguarded by care arrangements. Areas of concern reflected within this report have not been identified by managers working in and visiting the home.

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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

22 March 2010 ensure that unnecessary risks to the health or safety of children are identified and so far as possible are eliminated. In particular, this relates to the need to produce a current fire safety risk assessment and also to ensure that detailed risk assessments are undertaken in relation to known hazards for individual children (Regulation 23 b) 7 of 9 Inspection Report: SC028599 22 March 2010 maintain in respect of each child a record in permanent form which includes the information, documents and records specified in Schedule 3. In particular this relates to the need for children's files to hold full details of any accident involving the child while accommodated in the home (Regulation 28.1) 22 March 2010 prepare and implement a written policy which is intended to safeguard children accommodated in the home from abuse or neglect. In particular this relates to the need to clarify in policy and written guidance for staff what action must be taken when

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Due date Action Standard

a child is found to have either an explained or unexplained mark or bruise on their body (Regulation 16.1) 22 March 2010 prepare and implement a written policy which is intended to safeguard children accommodated in the home from abuse or neglect. In particular this relates to the need to clarify in policy and written guidance for staff what action must be taken when a child is 'hit' by another child (Regulation 16.1) 22 March 2010 ensure that within 24 hours of the use of any measure of control, restraint or discipline, a written record is made in a volume kept for the purpose which shall include the areas set out in regulation (Regulation 17.4) 23 March 2010 establish and maintain a system for monitoring the matters set out in schedule 6 at appropriate intervals and improving the quality of care provided in the home. (Regulation 34.1)

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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 there is a comprehensive plan for young people which specifies the support and assistance they will need to receive to enable a successful transition into adulthood, and which is implemented in practice. Plans should include agreed current targets and clarify how progress will be reviewed (NMS 6.1) • ensure that at least four fire evacuation drills take place in a twelve month period, and that these are recorded (NMS 26.8) • ensure that the home's safeguarding policies and procedures are consistent with those produced by the Local Safeguarding Children Board. In particular, this relates to the need to clarify within these procedures the requirement to report allegations against carers to the Local Authority Designated Officer (NMS 17.4) • ensure that the home's recently updated safeguarding procedures are submitted for

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Recommendations

consideration and comment to the Local Safeguarding Children Board and any comments are taken into account (NMS 17.4) • take appropriate action after regularly reviewing the record of complaints. In particular this relates to the need to operate a safe recording system where pages cannot be removed without explanation (NMS 16.7) 8 of 9 Inspection Report: SC028599 • ensure that a written record of all training for all staff is maintained in the home. (NMS 31.4) 9 of 9 Inspection Report: SC028599

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