Children's Home run by Keys Direct Care Limited in North Northamptonshire

SC033817 Unique reference number 10 June 2009 Inspection date Caroline Brailsford Inspector Key Type of Inspection

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2 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 8 Inspection Report: SC033817

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Brief description of the service

This home is one of four registered children's homes owned by the company and provides residential placements for three young people with emotional and behavioural difficulties.

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Brief description of the service

The home is situated in a rural setting close to a town where a range of leisure and community resources can be accessed. The home has large gardens, single bedrooms and provides pleasant and spacious communal areas. The staff team have use of a dedicated vehicle to support the care of young people.

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Summary

This inspection was an unannounced key inspection and all the key National Minimum Standards were inspected. The home is judged as satisfactory and there have been improvements since the last inspection. In particular behaviour management and the way that complaints are managed has improved and the Manager now completes inspections in line with the Regulations. The five actions from the last inspection have all been completed and the one recommendation is also now complete. The outcome areas Enjoying and Achieving, Positive Contribution, and Being Healthy are judged as Good. The outcome areas Staying Safe and Organisation are judged as Satisfactory There are three actions made as a result of this inspection and one recommendation. 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

The five actions from the last inspection have been addressed. The recording of physical interventions is improved and meets the Standards and Regulations, the record also now includes a section to record that the young people have been asked if they require medical attention. In addition new guidelines have been prepared for staff to use regarding the measures of restraint which can be used in the home. Complaints are properly recorded including the outcome which is clear and the Manager ensures that she inspects the home in line with schedule 6. She ensures that the home is meeting the needs of the young people and its Statement of Purpose.

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Helping children to be healthy

The provision is good. The young people enjoy a healthy lifestyle and staff support and encourage them to eat healthy meals. They choose their food and help to shop and cook in line with their own needs. The care plans comprehensively cover health issues. The staff are knowledgeable about young people's health and emotional needs and know what support to give. As a result, their health needs are met well. Other professionals are used to ensure all elements of health are met as far as possible. For example, therapists, dentists and opticians which are all well documented in individual files. Health needs are also covered in risk assessments where there are actions for staff to follow to reduce risks. One risk assessment did not adequately cover a health risk and although the staff were very clear about the information this has the potential to put the young person at risk. 4 of 8 Inspection Report: SC033817

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Helping children to be healthy

Staff members are trained in first aid and on the administration of medicines. Administration, storage and recording of the medicines works well, and the staff are clear about the procedures ensuring safety in this area. There are elements of good practice in this area. For example, running totals are kept of all medicines including household medicines, and all household medicines are only given from a prescription from a medical practitioner.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. The young people have their own privacy. The staff use good practice and this ensures that they protect the young people's dignity wherever possible, knocking on doors prior to entering bedrooms and ensuring that young people have their own keys where appropriate.

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Protecting children from harm or neglect and helping them stay safe

There is a formal complaints procedure available and the one complaint about the home since the last inspection has been managed well with the outcome clearly recorded. Young people have the opportunity to comment on the outcome ensuring that their views can be expressed. There are good relationships between the staff and the young people and a high staff ratio allows quality time to develop the relationships. The outcome being that there are open lines of communication between the staff and the young people should there be an issue, which can then be resolved easily on a day to day basis.

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Protecting children from harm or neglect and helping them stay safe

The more long standing staff understand what they should do if there is a safeguarding issue in the home. However the procedure for inducting new staff on this is not clear, the result being that not all are totally familiar with what they should do should there be an allegation. All staff said that they would immediately telephone their superior but the finer detail is kept in a guidance document. Not all staff are aware of this document and this has the potential for parts of the procedure to be missed potentially putting children at risk. The positive relationships between staff and young people mean that there is more of a chance of the young people raising an issue directly with them, and all young people confirm that it is easy to do this with staff. Also there is always a staff member that they can talk to both during the day and during the night. Young people feel safe living at this home. Bullying issues are dealt with promptly

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Protecting children from harm or neglect and helping them stay safe

by the staff who see this as a safeguarding issue.

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Protecting children from harm or neglect and helping them stay safe

There have been instances of the young people going missing. Procedures and risk assessments document the risks to young people should this occur. The detail is not always sufficient in these documents, and as a consequence does not provide the staff with specific information about what they should do. However, the staff are very clear about how to keep individuals as safe as possible should this occur.

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Protecting children from harm or neglect and helping them stay safe

The staff have built up positive relationships with the young people and see them in a very positive light. They base their management of behaviour on active encouragement of acceptable behaviour and build on the skills and qualities that young people possess. The young people's behavioural needs are well understood by the staff and they know what the triggers are for more challenging behaviour from individuals. Young people feel that staff know them very well. Most staff have completed training and are competent in diffusing situations to try to avoid the use of physical intervention. There has been one instance where there have been 2 newer staff on duty at night together, one of whom had not completed the behaviour management training. However, this shift was risk assessed by the Manager as safe. Behaviour management is something that generally the staff team are good at, and helps the young people

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Protecting children from harm or neglect and helping them stay safe

to progress in their overall behaviour. The use of physical intervention is used as a last resort 5 of 8 Inspection Report: SC033817 and should this become necessary, there is a procedure for documenting this in a bound book in line with the National Minimum Standards. The risk assessments detailing the individual protocols for behaviour management do not always reflect actually how it has been agreed for the behaviour to be managed.

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Protecting children from harm or neglect and helping them stay safe

There is a fire log where checks on equipment are recorded and fire drills and tests are up to date. The gas and electric has been tested in line with the National Minimum Standards. The home has risk assessments for aspects of safety of the premises and grounds including fire, young people’s behaviour and activities. These generally provide adequate information about steps to be taken to minimise the risks.

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Protecting children from harm or neglect and helping them stay safe

There is a recruitment system in the home which maintains appropriate levels of safety for the young people. This includes Criminal Records Bureau checks at enhanced level, proof of identity and references prior to employment.

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Helping children achieve well and enjoy what they do

The provision is good. The staff know how they should deliver individual support to the young people based on assessment, care plans and other information in their file. As a result the young people receive a good level of support from staff who understand their needs. Good relationships between the staff and young people ensure that they are able to approach the staff with their problems during the day and at night. There is always enough staff so that there is someone there at all times to offer support to young people when it's needed. The staff also seek advice from other agencies as required.

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Helping children achieve well and enjoy what they do

Appropriate education is organised for young people although the manager has reported some difficulties from other agencies which has caused some delays. Each young person has their education and further training planned properly by staff who encourage the young people in their skills and interests. Where young people do not attend school, alternatives are actively sought and staff put great importance on education. Staff are well aware of the leisure needs of individuals and there is an emphasis on personal choice. The young people enjoy their activities in and out of the home which they choose themselves.

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Helping children make a positive contribution

The provision is good. Each young person has a comprehensive care plan which works very well in practice. The plan ensures that individual needs are met. The staff clearly know the young people very well and understand what their needs are. The plans are shared with the placing authority and are regularly reviewed by the Manager. The young people feel involved in their care plans.

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Helping children make a positive contribution

There are regular statutory reviews for the young people and all information regarding the review meeting is kept together. The staff are well aware of the key information from these meetings and this is incorporated into the delivery of the care to the young people. The young people are supported to attend the meetings so that they are involved in decisions which are made.

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Achieving economic wellbeing

The provision is satisfactory. 6 of 8 Inspection Report: SC033817 The environment has a domestic, homely appearance which meets the National Minimum Standards. Each of the young people have their own bedroom which is personalised according to their wishes. There is ample furniture and a lockable facility in each room.

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Organisation

The organisation is satisfactory. There is a young people's guide and Statement Of Purpose in the home. The document contains most of the information required by the National Minimum Standards. However the arrangements for the surveillance equipment in the home (pressure pads outside bedroom doors), are not covered by the statement of purpose or placement plans. Although there is a heading for bullying and safeguarding, the information is around bullying and safeguarding arrangements are not properly addressed.

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Organisation

There is a very competent staff team who are motivated by their enjoyment of their job and their work with the young people. The young people like the staff and feel that they care about them. The staff team possess the skills that they need to look after this client group well. Training is well organised on the whole, although there are some gaps in the induction process, in physical intervention and safeguarding and one new staff member has been included on the usual rota without this essential training.

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Organisation

The staff team work well together and there are good systems in place so that there are opportunities for discussion about individual young people and the running of the home generally. This helps to provide a consistent approach to the young people. Staff are sufficient in number to provide good quality care to young people and as a consequence the young people can progress in their overall development.

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Organisation

The Manager has applied to become registered. She is well thought of by the staff and the young people and knows the needs of the young people well. She has a broad knowledge of operational issues in the home. There are regular inspections which she completes to ensure that the overall performance in the home reflects the statement of purpose. There is also a Deputy Manager who takes the place for the Registered Manager in her absence and senior staff who also support the managent of the home. The management of equality and diversity in the home is good and the Manager ensures that each young person is seen as an individual and is treated as such.

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Organisation

Each child has a permanent and private record of their progress which is detailed and also contains daily logs and information about goals and any progress made. There are some areas of recording that seem repetitive although very comprehensive.

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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 of 8 Inspection Report: SC033817 19 June 2009 ensure that unnecessary risks to the health and safety of children accomodated in the home are as far as possible eliminated. This is in particular relation to health risks and behaviour management issues (Regulation 23) 19 June 2009 ensure that there is written policy regarding safeguarding which is prepared and implemented and sets out the procedure to be followed in the event of an allegation of abuse or neglect (Regulation 16, 1, a and b) 1 July 2009 include in the Statement of Purpose all matters listed in Schedule 1 (Schedule 1, point 17 and 19)

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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 all staff receive training in accordance with the National Minimum Standards. This is in particular relation to behaviour management (Schedule 2) 8 of 8 Inspection Report: SC033817

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