Children's Home run by Building Bridges Care Homes Ltd in St Helens

SC063284 Unique reference number 1 February 2010 Inspection date Elizabeth Taylor Inspector Random Type of 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: SC063284

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Brief description of the service

The home provides care for up to five young people of mixed gender with emotional and behavioural difficulties, between the ages of 11 to 17 years. The property is a large, detached house situated in a residential area close to a town centre. Each young person has their own bedroom. There is a large garden to the rear and parking space to the front of the house. The house is close to local shops, transport links and community resources.

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Summary

At this unannounced interim inspection, progress with previous recommendations and key standards for 'staying safe' only were inspected. Three young people contributed to the inspection process and were complimentary about the way they were cared for. Whilst there is evidence of good practice and positive work being undertaken with the young people, the overall judgement for the home remains satisfactory as not all key standards were assessed.

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Summary

Staff have positive relationships with the young people and are supportive in their approach. Staff work well with one another, and other professionals, to meet the needs of young people. Improvements have been made to record keeping and increasingly demonstrate how staff contribute to help young people achieve positive outcomes and keep themselves safe. 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

Seven recommendations were made following the last inspection. The manager was asked to ensure records in the home reflected that young people received medication safely and that their diets were monitored to ensure they ate a balanced diet. A review of the system for the administration of medication shows accurate records are now maintained. Details of individual young people's diets are recorded but remain variable in their nutritious content, according to their personal preference. Nevertheless, young people are supported to understand about healthy eating and to receive appropriate treatment to maintain their good health. The home was asked to ensure records reflected whether young people were involved in regular fire drills. The reporting of fire drills has been revised and shows young people regularly engage in them. This means young people know how to respond in the event of an emergency. Initial placement

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Improvements since the last inspection

plans are now implemented to show how the home will care for young people newly admitted, prior to a formal review of their placement. This means staff have a basis to work with the young person during an interim period. Regular reviews of young people's plans take place though the system is not robust in being implemented in a timely manner to reflect young people's changing needs. The manager was asked to ensure minor repairs were made to the accommodation to ensure it remained in good condition. Repairs have been completed and work continues to ensure young people live in a comfortable environment which is safe. The provider was asked to ensure the external monitoring system reporting on the operation of the home was robust and covered all required record keeping and included young people's views. The format has been revised and sufficient detail is reported to show the home's strengths as well as any shortfalls. This contributes to the development of the service for young people.

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Helping children to be healthy

The provision is good. Young people are actively involved in the planning of weekly menus and are helped to understand about healthy eating. In addition, older young people are supported to plan, shop for and prepare a main meal for themselves several days each week. This enables them to gain appropriate skills to prepare them for adulthood. Weekly menus offer a balanced and varied diet, though, not all young people actually choose to eat nutritious foods. Young people's actual dietary intake is recorded and monitored and staff continue to promote wholesome foods with varying degrees of success.

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Helping children to be healthy

Young people's individual health care needs are identified and plans are developed to address them. However, not all plans are updated in a timely manner to reflect significant changes in health needs. Clear targets are identified in the plans and records show young people's routine health care needs are addressed. Support is also provided for health issues, such as smoking cessation, drug and alcohol misuse and sexual health. Education in health and social issues is identified as a key working task and records show staff discuss relevant issues with the young people on a regular basis. Specialist services are also gained to support young people's varied needs.

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Helping children to be healthy

The home's system for the storage of medication is secure and promotes young people's safety. Prescribed and non-prescribed medication is administered to the young people in accordance with safe practice and records are properly maintained. There is evidence to show unused or out of date medication is disposed of safely. A risk assessment process is used to inform whether young people are able to self-administer medication. This promotes their independence skills.

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Protecting children from harm or neglect and helping them stay safe

The provision is satisfactory. Young people's privacy and confidentiality is respected and upheld by staff at all times. All young people have their own bedrooms. Sufficient shower and bathing facilities are provided to promote young people's privacy.

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Protecting children from harm or neglect and helping them stay safe

A child-friendly complaints format is readily available to young people for them to use to raise concerns or issues. Young people have confidence in the process and say their concerns are taken seriously and are looked into. Records show what action senior staff take to rectify concerns and complaints and the outcome of their investigations. Young people are encouraged to record whether they are satisfied with the outcome, though, not all choose to do so. However, young people who do record their views express their satisfaction with the outcome. The home's complaints process supports young people to voice their feelings if they are unhappy with any aspect of living in the home.

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Protecting children from harm or neglect and helping them stay safe

The manager has a clear and robust procedure for referring child protection concerns and works effectively with other agencies and professionals to safeguard young people. Staff take appropriate action to report young people who are absent without permission, in accordance with individual risk assessments and a protocol developed between the home and police. Staff report young people's absences in a timely manner and liaise closely with relevant people to try to keep young people safe. Staff also take steps to keep in touch with young people whilst they are absent. The system is effective in promoting young people's safety as far as practicable. 5 of 8 Inspection Report: SC063284 Young people are aware of the home's stance on anti-bullying and records show they are supported to openly discuss any concerns they may have about bullying. Staff discuss young people's behaviour and help them understand how this may impact negatively on others.

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Protecting children from harm or neglect and helping them stay safe

Although young people did not raise this as an area of concern, staff reported that there are occasions when young people's behaviour is viewed by others as bullying. However, they continue to address this in both group discussions and with individual young people.

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Protecting children from harm or neglect and helping them stay safe

Young people are encouraged to behave in an acceptable manner and their achievements are rewarded by an incentive scheme which is related to individual goals. A balance is maintained between the imposition of sanctions and offering young people the opportunity to make reparation in another form. These measures are effective in practice for some, but not all, young people. Each young person has an individual behaviour management plan and risk assessment which identifies concerns about their known and suspected behaviours. The documents are comprehensive and contain strategies for managing their challenging or unacceptable behaviours. Clear written guidance is also provided to staff in young people's daily routine about measures which encourage young people to behave acceptably and those which can trigger or inflame a situation. These practical measures ensure staff respond consistently to young people and have

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Protecting children from harm or neglect and helping them stay safe

the tools to deflect or divert conflict as much as possible. Young people are helped to express and manage their anxieties and anger in an acceptable way which supports their socialisation skills.

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Protecting children from harm or neglect and helping them stay safe

Regular checks are recorded on the home's fire alarm system and other safety equipment. The home's fire risk assessment is up to date and records show regular fire drills and evacuations take place which involve both staff and the young people. This ensures young people know what to do in the event of an emergency and that they live in accommodation which is maintained to promote their safety.

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Protecting children from harm or neglect and helping them stay safe

All visitors to the site are vetted and are required to sign a central log book. This ensures visitors are monitored and do not pose a danger to the young people.

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Helping children make a positive contribution

The provision is good. Individual placement plans for young people cover all areas of their need but are variable in detail. For example, some plans identify practical, measurable targets to show how young people's needs are promoted and met. However, this is not consistent practice in all plans. A key working system operates in the home, although, all staff are expected to support young people. Records of key working sessions and other individual work carried out with young people are well recorded. These demonstrate discussions and staff's actions are linked to helping young people achieve targets in their placement plans.

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Helping children make a positive contribution

There is an internal reviewing process for young people's placement plans. However, the three monthly timeframe is rather rigidly adhered to. This means significant incidents and changes in young people's needs do not automatically trigger a review of their plan. Consequently, not all young people's plans accurately reflect their current needs. 6 of 8 Inspection Report: SC063284

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Achieving economic wellbeing

The provision is satisfactory. Young people are supported to develop practical, daily life knowledge and skills. They gain these skills by taking part in tasks, such as planning meals, cooking, food and clothes shopping and doing their own laundry. Each young person has regular pocket money and a clothing allowance, dependent on their age. They are supported to learn about budgeting and other essential skills to equip them for semi-independent or independent living. Relevant services, such as the Aftercare Team and Connexions are actively involved in supporting young people.

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Achieving economic wellbeing

The home is adequately furnished and equipped to meet the needs of the young people who live there. Some items of furniture and floor coverings are beginning to show signs of wear and tear, though, a programme of redecoration and refurbishment is currently taking place. As a result, some rooms look bare as pictures have not yet been replaced on walls and homely touches, such as ornaments are absent. Systems are in place to ensure minor and major repairs are addressed. Overall, young people live in a comfortable environment where their safety is promoted.

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Organisation

The organisation is good. The culture of the home is open, friendly and child-centred. Staff are deployed in numbers sufficient to meet the needs of the young people. Young people benefit from a staff team which has worked together for some time and who communicate well with one another.

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Organisation

The format for monitoring and assessing the quality of service offered to young people has been revised. The Registered Provider continues to carry out visits to the home on a monthly basis and submits reports in a timely manner. Young people's views are gained whenever possible to inform the process and all significant records, such as complaints and sanctions are checked on each occasion. The strong emphasis on monitoring and review of practice ensures the home's strengths and weaknesses are identified, to inform the development plan for the home. This means young people benefit from an improving service.

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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): • ensure accurate records are maintained in respect of monies taken from young people as reparation or restitution (NMS 22) 7 of 8 Inspection Report: SC063284 • ensure young people's needs and development are reviewed promptly, in response to significant changes in their life or circumstances (NMS 3) • ensure young people's placement plans are regularly reviewed, in a timely manner, to reflect changes in their need. (NMS 3) 8 of 8 Inspection Report: SC063284

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