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SC370956 Unique reference number 9 June 2009 Inspection date Sharon Treadwell Inspector Key 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 11 Inspection Report: SC370956

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Brief description of the service

The home is located within a rural setting and provides placements for up to four young people, of both genders, aged 10 to 16 years. The home has been owned by the current provider since January 2008. Five young people have been placed at the home, since the previous inspection and three have moved on in a planned and positive manner. Two young people remain in placement and have taken part in this inspection, either personally or through questionnaire responses.

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Brief description of the service

The property is a large detached bungalow, which was modernised and refurbished last year, with large gardens suitable for outdoor play and recreation. Communal accommodation includes a large lounge, an education room, dining area and kitchen. All young people have single bedrooms and there are separate sleeping and bathroom facilities for staff sleeping at the home. The home focuses on using outdoor pursuits as a basis for engaging young people, often with particularly challenging behaviours, who may have difficulty settling in more mainstream provision. The aim of the home is to offer short-term (maximum six months), often emergency, placements for young people who have complex emotional and behavioural difficulties and, according to the Statement of Purpose, who 'may need positive interrupters to their current pattern of behaviour'. The Statement of Purpose details that placements of the following type

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Brief description of the service

are provided: bridging placements, respite placements, crisis intervention and assessment. The home has an on site school room, providing education for the young people accommodated, co-ordinated by a local special school, which is also owned and operated by the same provider. A teacher is employed specifically to provide education to the young people accommodated at this home.

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Summary

The home was rated as inadequate less than three months ago and it is to the credit of the provider organisation, the manager and the staff that significant improvements can be demonstrated in all areas. The findings of this inspection demonstrate that there has been a robust focus on ensuring that shortfalls have been addressed and that the majority of the National Minimum Standards are now met. All actions and recommendations from the last inspection have been fully implemented.

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Summary

The home needs to better clarify how outdoor pursuits activities are used to promote the achievement of young people's identified placement objectives and must ensure that staff have a clear understanding of what are acceptable consequences in dealing with young people's unacceptable behaviours 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

There were two actions made following the last inspection of the home in March 2009. The home was required to promote and make proper provision for the welfare of all young people accommodated. There was insufficient indication that the admissions process fully considered the home's capacity to meet the needs of young people being referred alongside the needs of those already accommodated. The home now has a comprehensive referrals and admissions 4 of 11 Inspection Report: SC370956 policy, which incorporates the requirement for the manager to complete an impact risk assessment in relation to any proposed admission. All placements since March have been successful, have had clear objectives and have had positive outcomes for young people. The young people currently placed appear to have appropriate placements and their needs are being well met.

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Improvements since the last inspection

The second action related to the need for the home to ensure that appropriate notifications were made to Ofsted, in accordance with Regulation 30. Since the inspection all incidents have been notified appropriately.

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Improvements since the last inspection

Ten recommendations were identified during the key inspection of the home in October 2008. At the time of the interim inspection in March 2009 only four of these had been fully implemented. Three of the recommendations had been partially implemented and were amended and reiterated to reflect the elements still outstanding. Three recommendations, originally made in October 2008, had not been implemented when the interim inspection was undertaken in March 2009.

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Improvements since the last inspection

All outstanding recommendations have now been implemented. Physical restraint records are appropriately retained; personnel records, relating to all staff working at the home, are now available to the manager with copies held at the home; procedural guidelines are in place to ensure that confidential information is safely handled when staff are working off site with young people; car parking arrangements at the home, have been reviewed and risk assessed to demonstrate proper consideration of the safety of staff and young people; six places have been secured for staff to commence National Vocational Qualification (NVQ) level 3 training and this will promote compliance with the requirement for 80% of the staff to be qualified to this level.

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Helping children to be healthy

The provision is good. Where they are willing young people are involved each week in compiling the menu. If the young people are reluctant to be involved the staff utilise the lists of their likes and dislikes. The inspector ate lunch with young people and staff and the occasion was used for positive social interaction with young people actively involved in conversation. The menu reflects that a range of good, wholesome food is served and this includes plenty of fruit and vegetables. Food is used to broaden young people's awareness of other cultures. The home selects a country to focus on each week and the staff endeavour to carry the theme into the menu. There was discussion over lunch about traditional French dishes. The focus on outdoor activities ensures that young people are strongly encouraged to be physically active.

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Helping children to be healthy

Young people are appropriately registered with the local GP and are encouraged and supported to visit dentists and opticians as needed. Appointments are recorded in placement diaries. Young people have been encouraged to have glasses provided, and to wear them, are being supported with smoking cessation and are receiving good advice and support with sexual health matters. All young people have a written health care plan, which they sign, and the home has signed consent for medical treatment. Where placing authorities are slow to provide historical health information the home is well able to demonstrate persistent requests for this information to be supplied. The manager has recently established contact with the local authority Looked After Children (LAC) nurse and this has promoted improved knowledge of, and access to, local health services. 5 of 11 Inspection Report: SC370956 Young people's placement diaries contain a record of medication administered and central

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Helping children to be healthy

records are also retained. A new pro-forma record has recently been introduced and contains all appropriate information. All medication is appropriately stored. When young people are taken off site on activity trips there is secure storage for transporting medication. There is a first aid kit in the home and in each of the vehicles used to transport young people and the contents are regularly checked. The manager confirms that all staff have received first aid training.

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Helping children to be healthy

Asked what River Cottage was particularly good at young people responded: 'keeping us happy and busy and trying to make us eat healthily and do exercise'. Some young people feel that, when they are away from the home on outdoor activities, there is more use of junk food and 'take away' meals but the same young people say that the food is one of the best things about the home and were able to tell the inspector about meals they had cooked, using fresh foods, whilst on camping trips.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Staff have a good awareness of the need to respect young people's privacy. Young people have single bedrooms and all have keys to their own room. No bedroom searches have been required but clear guidelines are available to staff, should this procedure be necessary, and a pro-forma record is required to be completed. There is a telephone available solely for young people's use.

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Protecting children from harm or neglect and helping them stay safe

Only one complaint has been received since the previous inspection. The home's complaints procedure is wholly appropriate and is well summarised for young people in the young people's guide and on their notice board. Young people are also provided with good information about advocacy services and with contact details for Ofsted. The manager has obtained contact details and complaints procedures for the placing authorities of all young people placed. Records demonstrate that complaints are managed in a timely manner and that complainants are fully informed of outcomes. A placing social worker has commented on the efficient and professional way in which a complaint was handled by the home.

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Protecting children from harm or neglect and helping them stay safe

All staff have undertaken safeguarding training. There have been two potential child protection situations which have been appropriately referred for investigation and reported to Ofsted. The home has appropriate child protection policies and procedures and staff are fully aware of the requirement to inform a senior manager immediately, should such a situation arise. The home prioritises young people's safety and placement plans, positive handling plans and risk assessments demonstrate a good awareness of young people's potentially unsafe behaviours and practices and how these will be managed to promote their safety and well-being. Staff endeavour to raise young people's awareness of personal safety through group discussions and individual sessions. This was observed during the inspection. Young people feel safe and well cared for.

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Protecting children from harm or neglect and helping them stay safe

The young people currently accommodated get on reasonably well and confirm that there are no current concerns about bullying. Young people confirm that bullying is not tolerated within the home and clear policies and procedures inform staff of how any incidents or suspicions of bullying should be challenged. Staff are aware of the need to always be vigilant for any potentially intimidating behaviour. Some young people have histories of regular and frequent absconding behaviours, prior to admission, and these have reduced whilst they have been at 6 of 11 Inspection Report: SC370956 this home. When young people do abscond there is appropriate notification to the police and to placing authorities and, if appropriate, parents.

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Protecting children from harm or neglect and helping them stay safe

Young people each have a positive handling plan to identify any potential behaviour management issues. The plans detail the potential triggers of adverse behaviours and identify the strategies to be adopted to challenge the behaviours in a positive way. The home operates a merit system to reward positive behaviours and individual achievements and the system provides young people with financial rewards. House rules are fully explained to young people when they are admitted and are displayed on the notice board so that they can refer to them. The positive handling plan incorporates the preferred handling strategies, as discussed with each young person, should physical intervention prove necessary. This is a very positive practice. All staff have attended 'Team Teach' training on physical restraint, to promote the safe handling of young people, and the deputy at the home is a qualified trainer. Young people also receive

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Protecting children from harm or neglect and helping them stay safe

written information, in the young people's guide, about safe holding practices employed by the staff. Written policy recommends, and records demonstrate, that staff endeavour to diffuse and de-escalate incidents rather than resorting to physical intervention. Robust records are retained in relation to the use of sanctions and physical restraints and these are carefully and consistently monitored by the manager.

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Protecting children from harm or neglect and helping them stay safe

Risk assessments are appropriately completed in relation to young people's presenting behaviours, the activities they are involved in and the environment in which they live, to demonstrate that their safety is prioritised. There is a strong focus, at the home, on the incorporation of outdoor pursuits into young people's programmes and the home has a full Adventure Activities Licensing Authority (AALA) licence to operate a wide range of activities such as sailing, cycling, climbing and canoeing. The home has robust procedures to ensure that activities are well planned and safely executed.

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Protecting children from harm or neglect and helping them stay safe

Fire procedures are wholly appropriate to promote the safety of staff and visitors. All staff have signed to confirm that they have read the fire safety procedures and risk assessment. Staff complete weekly checks on fire safety equipment and fire drills have been routinely held each time a young person has been admitted to the home. Fire evacuation procedures are regularly discussed with young people to confirm their continuing awareness. Senior managers confirm that the home's maintenance agreement, with an external contractor, works more efficiently since the provider organisation designated one person with responsibility for chasing outstanding requests for completion of work.

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Protecting children from harm or neglect and helping them stay safe

There have been significant improvements to recruitment procedures providing the manager of the home with the capacity to demonstrate that all person's employed are suitable to work with young people.

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Helping children achieve well and enjoy what they do

The provision is satisfactory. Placing social workers comment on the home's capacity to provide young people with a good sense of achievement and note the advantage of the flexibility of service delivery, promoted by the availability of a wide range of outdoor pursuits, and the high staffing ratio. Some social workers point out that, in relation to their placements, a high level of attention and activity was crucial to meeting young people's individual needs and note that: 'This was provided in abundance by a dedicated staff team'; 'I was very impressed with the whole service and their ability to adapt quickly to the needs of my client I was particularly impressed with staff tolerance 7 of 11 Inspection Report: SC370956 and patience especially when behaviours had been challenging, aggressive and potentially violent'. Some young people feel that the opportunities to take part in outdoor activities are

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Helping children achieve well and enjoy what they do

unfairly distributed but young people activity planners demonstrate that all of them have equal access.

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Helping children achieve well and enjoy what they do

Young people have designated key workers and receive a high level of individual support. Observations during this inspection demonstrate that relationships between staff and young people are positive with young people citing staff as one of the best things about this home. Individual identity is positively promoted with placement plans identifying any specific cultural or religious needs. The staff say that the reduction in the use of staff from other units has resulted in improved systems of communication when young people are off site and in more consistent approaches to managing young people's behaviours on and off site. The manager has good oversight of both areas of work.

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Helping children achieve well and enjoy what they do

Many of the young people accommodated at the home have poor school attendance histories and low levels of self-esteem, viewing themselves as poor achievers academically. The home has a designated classroom and employs a full time teacher, who works closely with the residential and activity staff. The on site school room is able to provide a broad and well balanced curriculum based on national curriculum guidelines but adapted to the very specific needs of the individual young person and young people can be entered for formal qualifications. The teacher fully assesses young people's academic capacity, when they are admitted to the home, to ensure that their education programme can be fully tailored to meet their individual needs and robust efforts are made to obtain full information from the young person's previous school. The teacher and the staff detail that there are often huge difficulties in persuading young

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Helping children achieve well and enjoy what they do

people to engage with education and that approaches to providing educational input often have to be innovative to achieve any level of compliance.

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Helping children achieve well and enjoy what they do

Outdoor pursuits activities are represented, in the Statement of Purpose, as an integral element of young people's educational and social skills development programme at this home. The enjoying and achieving section of young people's placement plans is generally a poor reflection of this. Placement plans do not currently give any indication of the range of activities young people will be encouraged to participate in or of how these activities will be managed to promote the achievement of identified educational or personal objectives. In signing placement plans young people and their families are not being alerted to the learning and development aspects of these activities and could view them as purely fun. Individual placement diaries are retained and these do demonstrate that the activities undertaken are promoting the development of young people's self confidence and improving their skill levels.

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Helping children make a positive contribution

The provision is good. Young people's individual placement plans are robust and give good attention to identifying their very individual support needs. Placement plans are compiled under the five Every Child Matters headings and identify clear and achievable aims and objectives and individual placement diaries record young people's progress towards achieving these. Young people have regular key worker sessions and records of these sessions demonstrate that some crucial areas of personal and social development and learning are addressed, such as personal safety, drugs awareness and stranger danger but the sessions do not always cross reference well to the aims and objectives identified in the placement plan. The home is supporting some young people 8 of 11 Inspection Report: SC370956 to make significant progress in key areas and the failure to cross reference records does not always fully demonstrate this.

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Helping children make a positive contribution

Looked After Children (LAC) reviews are being held in a timely manner and young people are encouraged and supported to contribute their views. Young people confirm that they are ware of future plans and are consulted about them. The manager is very pro-active in pursuing any shortfalls in placing authority services to the young people in placement. Referral forms are completed when a request is made for a placement and these clearly detail the reason for the placement and the proposed duration. The front sheet of young people's placement plans provides a good summary of the reasons for their placement and this is carefully shared with them to promote their full understanding. The introduction of a new referrals and admissions policy, since the previous inspection, has significantly improved the home's capacity to demonstrate that it is able to meet the needs of young people referred for placement.

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Helping children make a positive contribution

Young people's contact arrangements are clearly stated in their placement plans and are well supported and facilitated by the staff. There are instances where the home has provided financial support to ensure that contact visits provide positive experiences for young people and their families. Placing social workers comment that the home works well with them and with young people's families: 'Communication very good, excellent partnership working'.

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Helping children make a positive contribution

Young people are observed to be comfortable and confident in their interactions with the staff. They make their views very clearly known and staff respect their opinions. Young people's meetings are held regularly and there are clear demonstrations of young people stated wishes being granted, for example Sky TV has been installed in the lounge. Young people are also able to have individual discussions with key workers or, if preferred, with a member of staff of their choice. The provider organisation regularly consults with young people and their families to obtain their views about their placements. The organisation is currently looking to develop a young people's council to represent looked after children accommodated in all its local provisions.

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Helping children make a positive contribution

Some young people commented that they were unable to visit friends or have friends to visit the home. Records clearly demonstrate that such restrictions are only imposed where the placement plan determines such contacts to be inappropriate.

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Achieving economic wellbeing

The provision is satisfactory. None of the young people currently accommodated are old enough to have a pathway plan. The Statement of Purpose details that Keys has its own independence training programme and that this can be implemented if older young people are accommodated and are happy to contract in to this scheme. Placement planning reflects the commitment to supporting and encouraging all young people to become increasingly independent through the development of self confidence and social skills. The home is in the process of introducing the provider organisations independence training folder with all young people. The folder will require each young person to demonstrate the acquisition of a range of knowledge and practical skills, confirmed by their key workers, and leads to a bronze, silver and gold award stage as skills increase. This is not yet in place to a sufficient degree to inspect.

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Achieving economic wellbeing

The manager and staff are commended on the notable improvements to the environment. At the time of the last inspection a huge amount of damage had been inflicted on the premises, 9 of 11 Inspection Report: SC370956 by young people, making the home unsightly and unwelcoming. There is now a pleasant, homely and welcoming feel to the home. New internal doors and widows have been fitted in most areas. All areas are well decorated and well furnished and young people's bedrooms are tidy and well equipped. there are ample communal areas for young people to relax. The home is situated in a very rural setting and this fits well with the short term nature of placements and the focus on outdoor pursuits.

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Organisation

The organisation is satisfactory. The home's Statement of Purpose (SOP) has been recently reviewed and updated with full details of the current staff team and of any staff, from the provider's other units, who have provided support to the home. The SOP provides comprehensive information about the services and facilities provided and the aims and objectives of the home. The home has a comprehensive guide for young people and it contains a wealth of relevant information in an attractive and easily accessed format. The home proposes to update the guide with input from some of the young people in placement.

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Organisation

The promotion of equality and diversity is satisfactory. Young people's individual needs are clearly identified and demonstrably being met. Staff have not all had equality and diversity training but a written development plan is in place at the home and this reflects the objective for all staff to complete this training. Both the registered manager and the deputy are appropriately qualified and have a wealth of residential care experience. the home is overseen by an Operations Manager, who was present during the inspection and who also has extensive relevant experience. There is a vocalised and clearly demonstrated commitment to developing and improving practice in this home and to promoting positive outcomes for young people.

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Organisation

Newly appointed staff are required to undertake a formal induction programme covering the provider organisation policies, procedures and working practices and incorporating the Children's Workforce Development Council induction standards. At the present time the home does not meet the requirement for 80% of the staff team to have the NVQ Level 3 qualification but this is being appropriately addressed. Appropriately qualified staff are involved in providing outdoor activities and, where external expertise is utilised, the trainer's qualifications are verified by the staff. The organisation provides ongoing core training opportunities for all the staff and the operations manager confirms that she is allocated a training budget to meet any additional training requirements identified in relation to the specific needs of young people placed at the home. The staff at the home have recently received training on sexually harmful behaviour and

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Organisation

an appropriate written training programme is in place for the coming year.

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Organisation

An unannounced monitoring visit was undertaken on May 14th 2009, under Regulation 33 requirements, by a representative of the provider organisation. These visits are made on a monthly basis. The pro-forma used to record these visits is exceptionally comprehensive. The manager is fully aware of her monitoring responsibilities under Regulation 34 and a pro-forma is in place to demonstrate what areas of practice are included.

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Organisation

There are a number of instances where consequences, imposed by the staff in relation to young people's negative behaviours, have been reduced or overridden by the manager as not appropriate. Whilst the records support the manager's decisions, this impacts on staff confidence and has the potential to be disempowering in the eyes of the young people and to impact on their capacity to manage young people's adverse behaviours. Young people have recognised 10 of 11 Inspection Report: SC370956 this and commented about the inability of staff to make decisions without reference to the manager. The training programme details that training, for staff, on the appropriate use of sanctions and consequences is scheduled for later this year. The manager demonstrates full awareness of the current need for team building work, a requirement also recognised by the Regulation 33 visitor, and of the need for senior managers to continue to build the confidence

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Organisation

of the staff team. When the current provider opened this home, in September 2008, the staff team, apart from the manager and the deputy, were largely unqualified and relatively inexperienced. There was not a full compliment of permanent staff. Staff from one of the provider's other activity based units have provided ongoing support, particularly in supporting young people's outward bound activities. Whilst this has been necessary it has not always been conducive to team building or to the establishment of consistent approaches to young people. There is now almost a full staff complement with only one vacancy and staff, appointed in September, have gained in knowledge and experience and external support has almost wholly been withdrawn. Senior managers demonstrate good awareness of the team's development needs and are addressing this through individual supervision and current and scheduled training

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Organisation

and team development days. Formal supervision is being provided on a regular basis and staff confirm that the team is developing in confidence and that a better awareness of individual strengths and weaknesses is promoting stronger working relationships and more consistent handling of 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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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • clarify, within young people's placement plans, how the incorporation of outdoor pursuits activities is supporting placement objectives to be met. Ensure that key worker monitoring, through individual sessions, demonstrates the meeting of placement plan objectives (National Minimum Standards 2.1,2.2) • ensure that staff have a clear understanding of what are acceptable consequences, in dealing with young people's unacceptable behaviours, in order that they can confidently respond to such behaviours with measures relevant to the incident and approved by the registered person (National Minimum Standards 22.1,22,4) 11 of 11 Inspection Report: SC370956

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