Children's Home run by Oracle Care Limited in Bedford

SC389698 Unique reference number 4 August 2009 Inspection date Mary Timms Inspector Key Type of Inspection

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27 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: SC389698

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Brief description of the service

This home provides two placements for young people with emotional and behavioural difficulties. The service is one of three small homes operated locally in addition to homes in other regions. The service also provides a school setting within easy travelling distance, which is available to meet the needs of young people who have no current mainstream school placement.

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Brief description of the service

Young people have individual bedrooms and open access to an appropriate range of communal living areas. There is a garden providing space for games or relaxation.

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Summary

This was an unannounced full inspection planned to review the care children receive against identified key National Minimum Standards. This is the first inspection of this service

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Summary

Good arrangements are in place to support children's health and welfare needs. Safeguarding arrangements are prioritised and are supported by appropriate policies and procedures. Individual needs are assessed at the point of admission and reflected into detailed planning documents. Young people are consulted about day to day care arrangements and are able to make choices. The service young people receive is monitored by internal and external manager's from the provider organisation. Young people are cared for by appropriately trained and supported staff. One required action has been set in relation to record keeping in addition to recommendations to improve the service in line with National Minimum Standards. The overall quality rating is good. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

Not applicable as this is the first inspection of this service.

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Helping children to be healthy

The provision is good. Good arrangements are in place to support young people's health.

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Helping children to be healthy

A safe medication administration system is operated. Medication is stored securely in the staff office. A record is made on each occasion medication is administered. A stock check of prescribed medication is undertaken on a daily basis. However, currently the stock system fails to include all non-prescribed medication which highlights that there may not always an accurate stock record.

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Helping children to be healthy

Young people's health is monitored and a health care plan is developed to guide care arrangements. Young people are registered with a local GP and are supported to attend for expected check-ups with a dentist and optician. The service consults with other health professionals in line with young people's individual assessed needs.

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Helping children to be healthy

A balanced and varied diet is provided. Young people are encouraged to try new and different foods, including a diverse range of cultural foods. Records are maintained of the dietary intake of young people, however, on occasions records lack the level of detail necessary to support 4 of 8 Inspection Report: SC389698 the effective oversight of this area of care. For example 'Roast Lamb' recorded rather than the detail of whether vegetables were eaten or not.

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Helping children to be healthy

Young people have open access to the kitchen and are able to make their own drinks and snacks, they are involved in food shopping and menu planning. Comments from young people include 'the food is good'.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Young people are safeguarded and their general wellbeing is promoted.

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Protecting children from harm or neglect and helping them stay safe

The service has safeguarding policies and procedures and staff receive safeguarding children training during the induction period of employment.

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Protecting children from harm or neglect and helping them stay safe

Young people's behaviour is well managed. They confirm that they were informed about house rules and behavioural expectations when they were first admitted to the home. Comments include 'the house rules are fair and not too strict'. Individual incentive schemes are developed which focus young people's attention on agreed behavioural targets. One-to-one time is spent with young people providing support and guidance in relation to unwanted behaviours. More complex behavioural issues are addressed during 'therapy' agreed with placing authorities and provided by mental health professionals working within the provider organisation. The home keeps a record on occasions physical intervention is used, however, there are times when records fail to reflect the level of detail required by regulation, necessary to evidence that young people are fully safeguarded.

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Protecting children from harm or neglect and helping them stay safe

Young people are cared for in a safe environment. The facilities are monitored for health and safety concerns and action is taken promptly in response to necessary repairs. A fire safety risk assessment guides the protection of young people from the risk of a fire. Evacuation drills are practiced with both staff and young people and weekly checks of fire safety equipment are undertaken.

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Protecting children from harm or neglect and helping them stay safe

Young people are safeguarded by robust recruitment procedures. All required checks are undertaken prior to staff commencing work in the home.

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Protecting children from harm or neglect and helping them stay safe

Young people's privacy is respected. They are issued with a key for their bedroom. Comments from young people include confirmation that 'staff knock before entering my bedroom' and that they are able to 'make and receive private telephone calls'.

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Protecting children from harm or neglect and helping them stay safe

Young people are able to make a complaint. Complaints procedures and blank complaints forms are openly displayed in the home. Young people confirm in discussion that they 'know how to make a complaint' and also that they feel confident that staff would listen and respond if they raised a concern.

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Protecting children from harm or neglect and helping them stay safe

There have been no occasions of young people being found to be missing since the home opened. Risk assessments set out details of individual vulnerabilities and actions to be taken should they go missing. A log is in place to record details of events and actions should such an occasion occur. 5 of 8 Inspection Report: SC389698

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Helping children achieve well and enjoy what they do

The provision is good. Young people receive a good level of support and educational achievement is promoted.

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Helping children achieve well and enjoy what they do

The provider organisation operates a registered school within easy travelling distance of the home. Care staff are available in school and support the school day. When young people reach formal school leaving age they are encouraged to continue into further education. A study area is provided for young people within their bedroom.

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Helping children achieve well and enjoy what they do

Individual support needs are detailed within placement planning documents. One-to-one time is spent consulting young people about care arrangements and providing support. Comments from young people include confirmation of 'feeling supported and able to talk to staff'. Issues relating to equality and diversity are promoted and supported, for example, young people are encouraged to become more accepting of difference.

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Helping children make a positive contribution

The provision is satisfactory. Young people are supported during the admission process. Comments from young people include confirmation that they 'felt welcome when they were first admitted'. A copy of the home's guide for young people is not always issued, which means that young people may not always fully understand the service they can expect to receive. However, comments from young people confirm that they received verbal guidance about house rules and expectations.

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Helping children make a positive contribution

Young people are consulted about day to day life in the home and are able to make choices. They are encouraged to take part in regular house meetings when activities and day to day arrangements are discussed. One-to-one time is spent with young people providing further opportunities for consultation. Young people confirm in discussion that they are consulted about menu planning and that they are able to choose the activities they take part in.

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Helping children make a positive contribution

Whilst comments from placing social workers are generally positive about the care provided to young people they also include reference to 'communication and updates about events and incidents on occasions being delayed'. This highlights that there is no current system to gather regular feedback about the operation of the home from social workers, necessary to inform service development.

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Helping children make a positive contribution

Detailed placement plans are produced, however, these are not always reviewed and updated promptly as needs change. Placement plans are not endorsed by placing social workers or young people to demonstrate that they were consulted about detailed care arrangements.

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Helping children make a positive contribution

Young people are supported to maintain contact with family members. Placement plans inform contact arrangements and clarify any necessary supervision and support. Comments from young people include confirmation that they 'know the contact arrangements and feel supported'.

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Achieving economic wellbeing

The provision is satisfactory. The home provides young people with individual bedrooms which they are able to personalise. They have a choice of a bathroom and shower room. There is a range of openly available 6 of 8 Inspection Report: SC389698 communal areas, appropriate to the needs of the young people and the service provided. The accommodation is decorated and furnished in a domestic fashion. In addition young people have access to a garden of adequate size to play games.

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Achieving economic wellbeing

Individual needs relating to developing independence are not always reflected into detailed planning documents as guided by National Minimum Standards. However, in discussion with both staff and young people comments confirm that young people are encouraged to assist with household tasks, including menu planning, shopping and meal preparation. They are able to make their own drinks and snacks and are encouraged to undertake laundry tasks. Guidance and support is provided in the area of personal responsibilities. For example, young people are encouraged to maintain their own bedroom tidiness and consequences of unwanted behaviours are discussed with young people.

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Organisation

The organisation is good. The service provided is reflected into a Statement of Purpose document which is also summarised into a guide for young people. However, a copy of this document is not always issued to young people when they are first admitted to the home which is necessary to ensure that they fully understand the service they can expect to receive.

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Organisation

The service is managed by a Registered Manager supported by an appropriately experienced and knowledgeable assistant manager who is able to deputise when necessary. Key members of staff are adequately experienced to support newly appointed staff. Staff undertake a training programme during their induction period which includes behaviour management and safeguarding children training. In addition they complete an induction workbook which reflects the induction modules set by the Children's Workforce Development Council. Staff meetings are held on a regular basis and one-to-one staff supervision meetings are facilitated with a senior member of staff.

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Organisation

The quality of care young people receive is monitored by the Registered Manager in addition to during monitoring visits made to the home on a monthly basis by an external manager employed by the provider organisation. The Registered Manager has identified areas for further improvement and development. Young people's files are kept in good order and are stored securely in the home.

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Organisation

The promotion of equality and diversity is good. Differing needs relating to culture, ethnicity and religion are embraced and supported by the staff team. Children are encouraged to widen their awareness and understanding of issues of diversity and equality and are challenged if heard to make inappropriate remarks.

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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: SC389698 7 September 2009 Maintain an accurate and up to date record of measures of control used, as set out in regulation 17 (Reg 17.4)

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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 written policy and guidance for staff, which is implemented in practice ,for all prescribed and non-prescribed medication. In particular this relates to the need to include all non-prescribed medication in the stock control system of medication currently held in the home (NMS 13) • seek the views of children, their parents (unless inappropriate) and the placing social worker on the content and implementation of the placement plan. In particular placement plans should be signed as agreed by placing social workers and in addition reflect consultation with children (NMS 2.5) • ensure that staff regularly and frequently seek the views of the relevant contact officers in the children's placing authorities on the care of the children concerned and the overall

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Recommendations

operation of the home (NMS 8.10) • ensure that there is a comprehensive plan for young people preparing to leave care as guided by National Minimum Standards (NMS 6.1) • ensure that on moving into the home young people are provided with written information providing facts which they need and wish to have. In particular this relates to the need to issue each young person with a copy of the Young People's Guide (NMS 5.5 and 1.3) • ensure that the placement plan for each young person sets out clearly the assessed needs of the young person, the objectives of the placement and how these are to be met by the service on a day to day basis. In particular this relates to the need to update plans promptly as needs change (NMS 2.1 and 3.1) 8 of 8 Inspection Report: SC389698

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